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Clinical Chemistry 48: 2030-2043, 2002;
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(Clinical Chemistry. 2002;48:2030-2043.)
© 2002 American Association for Clinical Chemistry, Inc.

Clinical Performance of an In-Line, ex Vivo Point-of-Care Monitor: A Multicenter Study

Glenn F. Billman1, Amy B. Hughes2, Golde G. Dudell3, Elizabeth Waldman1, Lisa M. Adcock4, Dan M. Hall5, Edmund N. Orsini, Jr6, Adolph J. Koska7, Linda J. Van Marter8, Neil N. Finer9, Jeff C. Kulhavy10, Ronald D. Feld10 and John A. Widness1a

1 Department of Pathology, Children’s Hospital of San Diego, San Diego, CA 92123.

2 Department of Pediatrics, The Children’s Hospital of Iowa, Iowa City, IA 52242.

3 Department of Pediatrics, Division of Neonatology, Children’s Hospital of San Diego, San Diego, CA 92123.

4 Texas Children’s Hospital, Baylor College of Medicine, Houston, TX 77030.
Departments of
5 Pediatrics and
6 Pathology, The Children’s Hospital, Denver, CO 80218.

7 Department of Anesthesia, Driscoll Children’s Hospital, Corpus Christi, TX 78411.

8 Department of Pediatrics, Division of Newborn Medicine, Children’s Hospital, Boston, MA 02115.

9 Department of Pediatrics, Division of Neonatology, University of California San Diego Medical Center, San Diego, CA 92103.

10 Department of Pathology, The University of Iowa, Iowa City, IA 52242.

aAddress correspondence to this author at: University of Iowa Hospitals & Clinics, 200 Hawkins Dr., W222-1 GH, Iowa City, IA 52242-1083. Fax 319-356-4685; e-mail john-widness{at}uiowa.edu.

Background: The management of critically ill infants and neonates includes frequent determination of arterial blood gas, electrolyte, and hematocrit values. An objective of attached point-of-care patient monitoring is to provide clinically relevant data without the adverse consequences associated with serial phlebotomy.

Methods: We prospectively determined the mean difference (and SD of the difference) from laboratory methods of an in-line, ex vivo monitor, the VIA LVM Blood Gas and Chemistry Monitoring System® (VIA LVM Monitor; Metracor Technologies, Inc.), in 100 critically ill neonates and infants at seven children’s hospitals. In doing so, we examined monitor stability with continuous use. In vivo patient test results from laboratory benchtop analyzers were compared with those from the VIA LVM Monitor on paired samples. In a separate in vitro comparison, benchtop analyzer and monitor test results were compared on whole-blood split samples.

Results: A total of 1414 concurrent, paired-sample measurements were obtained. The mean differences (SD of differences) from laboratory methods and r values for the combined data for the VIA LVM Monitor from the seven sites were 0.001 (0.026) and 0.97 for pH, 0.7 (3.6) mmHg and 0.94 for PCO2, 4.2 (9.6) mmHg and 0.98 for PO2, 0.0 (2.9) mmol/L and 0.87 for sodium, 0.1 (0.2) mmol/L and 0.96 for potassium, and 0.3% (2.9%) and 0.90 for hematocrit. Performance results were similar among the study sites with increasing time of monitor use and between in vivo paired-sample and in vitro split-sample test results.

Conclusion: The VIA LVM Monitor can be used to assess critically ill neonates and infants.




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