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New solutions to old problems: A practical approach to identify samples with intravenous fluid contamination in clinical laboratories.
Newbigging, Ashley; Landry, Natalie; Brun, Miranda; Proctor, Dustin; Parker, Michelle; Zimmer, Carmen; Thorlacius, Laurel; Raizman, Joshua E; Tsui, Albert K Y.
Afiliación
  • Newbigging A; Department of Laboratory Medicine and Pathology, Faculty of Medicine and Dentistry, College of Health Science, University of Alberta, Edmonton, Alberta, Canada.
  • Landry N; Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada; Clinical Biochemistry, Diagnostic Services, Shared Health Manitoba, Winnipeg, Manitoba, Canada.
  • Brun M; Department of Laboratory Medicine and Pathology, Faculty of Medicine and Dentistry, College of Health Science, University of Alberta, Edmonton, Alberta, Canada; Alberta Precision Laboratories, Edmonton, Alberta, Canada.
  • Proctor D; Department of Laboratory Medicine and Pathology, Faculty of Medicine and Dentistry, College of Health Science, University of Alberta, Edmonton, Alberta, Canada; Alberta Precision Laboratories, Edmonton, Alberta, Canada.
  • Parker M; Department of Laboratory Medicine and Pathology, Faculty of Medicine and Dentistry, College of Health Science, University of Alberta, Edmonton, Alberta, Canada; DynaLIFE Medical Labs, Edmonton, Alberta, Canada.
  • Zimmer C; Alberta Precision Laboratories, Edmonton, Alberta, Canada.
  • Thorlacius L; Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada; Clinical Biochemistry, Diagnostic Services, Shared Health Manitoba, Winnipeg, Manitoba, Canada; Departments of Pathology and Biochemistry & Medical Genetics, University of Manitoba,
  • Raizman JE; Department of Laboratory Medicine and Pathology, Faculty of Medicine and Dentistry, College of Health Science, University of Alberta, Edmonton, Alberta, Canada; Alberta Precision Laboratories, Edmonton, Alberta, Canada.
  • Tsui AKY; Department of Laboratory Medicine and Pathology, Faculty of Medicine and Dentistry, College of Health Science, University of Alberta, Edmonton, Alberta, Canada; Alberta Precision Laboratories, Edmonton, Alberta, Canada. Electronic address: atsui@ualberta.ca.
Clin Biochem ; 127-128: 110763, 2024 May.
Article en En | MEDLINE | ID: mdl-38615787
ABSTRACT

OBJECTIVES:

Contamination with intravenous (IV) fluids is a common cause of specimen rejection or erroneous results in hospitalized patients. Identification of contaminated samples can be difficult. Common measures such as failed delta checks may not be adequately sensitive nor specific. This study aimed to determine detection criteria using commonly ordered tests to identify IV fluid contamination and validate the use of these criteria.

METHODS:

Confirmed contaminated and non-contaminated samples were used to identify patterns in laboratory results to develop criteria to detect IV fluid contamination. The proposed criteria were implemented at a tertiary care hospital laboratory to assess performance prospectively for 6 months, and applied to retrospective chemistry results from 3 hospitals and 1 community lab to determine feasibility and flagging rates. The algorithm was also tested at an external institution for transferability.

RESULTS:

The proposed algorithm had a positive predictive value of 92 %, negative predictive value of 91 % and overall agreement of 92 % when two or more criteria are met (n = 214). The flagging rates were 0.03 % to 0.07 % for hospital and 0.003 % for community laboratories.

CONCLUSIONS:

The proposed algorithm identified true contamination with low false flagging rates in tertiary care urban hospital laboratories. Retrospective and prospective analysis suggest the algorithm is suitable for implementation in clinical laboratories to identify samples with possible IV fluid contamination for further investigation.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Algoritmos Límite: Humans Idioma: En Revista: Clin Biochem Año: 2024 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Algoritmos Límite: Humans Idioma: En Revista: Clin Biochem Año: 2024 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Estados Unidos