Improved quality control of blood acid-base equilibrium using the daily mean of patients' results: a validation study

The efficiency of the daily mean of patients' results as a quality control tool for acid-base equilibrium has been studied in three one-month periods. Results for the first two periods were obtained in a stable patient population using tonometry in one period, direct measurement of PCO2 in the other; the third period corresponded to another patient population in which PCO2 was determined by direct measurement. These comparisons allowed demonstration that both methodology and patient populations influenced the optimal truncation limits used to exclude extreme values. Furthermore, the efficiency of the daily mean in itself was poor. Using a cusum plot of the differences of each daily mean from the monthly mean of the daily means, however, dramatically improved this efficiency. So modified, quality control using the daily mean of patients' results represents a useful tool, since the whole analytic process, from blood sampling to result, is checked.