Commercially available blood-gas quality controls compared with tonometered blood

We compared three commercially supplied blood-gas quality control solutions ("contrIL," "G.A.S.," and "Quantra") and tonometered whole blood under research and service conditions in four hospital laboratories. In some situations Quantra and tonometered blood were comparably sensitive to problems with blood-gas instrument malfunctions (e.g., hydraulics or temperature control) but the aqueous buffer-based materials were less sensitive. Within-day precision for all control materials was similar. The precision of pCO2 determinations in long-term studies was also similar for all control materials, as were pH determinations on commercial controls. For pO2 (especially at O2 < 50 mmHg), sample handling technique influenced the precision and accuracy of Quantra more than the other materials. The variability in pO2 determination with Quantra seems primarily to result from sensitivity in incubation temperature (3% change per degree C at 145 mmHg and 7% change per degree C at 43 mmHg). This study identifies some of the limitations of blood-gas control materials per se and some limitations related to specific blood-gas instruments that affect interpretation of results from them.