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Evaluación de la variación específica del instrumento entre bicarbonato medido y calculado

Nga Yeung Tang1, Carmen Gherasim2, Lee Schroeder2

  • 1Department of Pathology, University of Illinois Chicago, Chicago, IL, United States.

The journal of applied laboratory medicine
|January 7, 2026
PubMed
Resumen
Este resumen es generado por máquina.

Las discrepancias entre el bicarbonato medido (mHCO3-) y el bicarbonato calculado (cHCO3-) pueden causar confusión diagnóstica. Este estudio encontró una buena concordancia entre Radiometer y algunos analizadores de química, pero notó un sesgo con Abbott Architect.

Palabras clave:
bicarbonatoequilibrio ácido-basediagnósticoanalizadorsesgo

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Área de la Ciencia:

  • Química Clínica
  • Equilibrio Ácido-Base
  • Precisión Diagnóstica

Sus antecedentes:

  • La concentración de bicarbonato es crucial para evaluar los trastornos del equilibrio ácido-base.
  • Las discrepancias entre el bicarbonato medido (mHCO3-) y el calculado (cHCO3-) pueden provocar confusión clínica y diagnósticos erróneos.
  • La medición precisa del bicarbonato es vital para el manejo del paciente.

Objetivo del estudio:

  • Evaluar la concordancia entre el bicarbonato calculado (cHCO3-) de un analizador de gases en sangre Radiometer y el bicarbonato medido (mHCO3-) de tres instrumentos de química diferentes.
  • Identificar posibles sesgos en las mediciones de bicarbonato en diferentes plataformas analíticas.
  • Mejorar la fiabilidad de la evaluación del trastorno del equilibrio ácido-base.

Principales métodos:

  • Estudio multiinstitucional que involucra a tres fabricantes diferentes de analizadores de química.
  • Se recopilaron datos de pacientes desidentificados que incluían mHCO3- plasmático y cHCO3- de gases en sangre (arterial y venoso) dentro de una ventana de 20 minutos.
  • Se utilizó la regresión de Deming y el análisis de Bland-Altman para determinar las correlaciones y los sesgos.

Principales resultados:

  • Se observaron buenas correlaciones entre cHCO3- y mHCO3- en todas las plataformas.
  • El análisis de Bland-Altman reveló el mayor sesgo entre Radiometer y Abbott Architect (-2,63 mmol/L).
  • Siemens Advia (0,49 mmol/L) y Beckman AU680 (-0,45 mmol/L) mostraron un sesgo mínimo en comparación con Radiometer.

Conclusiones:

  • Este estudio es el primero en comparar el cHCO3- de Radiometer con el mHCO3- de múltiples analizadores de química.
  • El analizador de gases en sangre Radiometer, Siemens Advia y Beckman AU680 demuestran una buena concordancia.
  • Abbott Architect puede presentar un sesgo negativo en las mediciones de bicarbonato en comparación con otros métodos, lo que requiere atención clínica.