Desempeño del proceso preanalítico del análisis de gases sanguíneo en un hospital pediátrico en la ciudad de Lima, 2018

Authors

DOI:

https://doi.org/10.58597/rpe.v2i2.60

Keywords:

Diagnostic errors, Blood gas analysis, Preanalytical errors, Pediatrics

Abstract

Objective: To describe the performance of the preanalytical process during blood gas analysis (BGA) at the INSN-2018. Materials and methods: An observational, descriptive, and cross-sectional study was developed, and it identified critical points during the analysis in requests from 2428 patients by applying the sigma (σ) metric. Results: 62% presented preanalytical errors in the BGA, 93% of the cases corresponded to syringes and 7% to capillaries. In syringes, relative errors are illegible request (13.3%), rewritten (2.4%), and temporary (1.1%). In samples, relative errors are clot (1.6%), bubble (12.3%), without plug (56.1%), and little volume (12.6%). In capillaries, relative errors are illegible request (10.8%), rewritten (8.8%), and temporary (3.1%). In samples, relative error is the bubble (1.3%). Critical services have greater preanalytical error in syringes (72%) and capillaries (67%) than other services. Also, volumes less than 0.4 mL were considered unacceptable according to the sigma values. Conclusions: It was found that there is a high rate of preanalytical errors, coming from critical units, where samples taken from syringes presented the greatest problems. At the hospital it is recommended to implement quality policies focused on the pre-analytical phase and to purchase appropriate devices for sample collection for BGA.

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References

Forsman RW. Why is the laboratory an afterthought for managed care organizations? Clin Chem. 1996;42(5):813–6.

Kohn LT, Corrigan JM, Molla S. To Err Is Human. Medicine (Baltimore) [Internet]. 1999;126(November):312. Available from: http://www.journals.cambridge.org/abstract_S095026880100509X

Abdollahi A, Saffar H, Saffar H. Types and frequency of errors during different phases of testing at a clinical medical laboratory of a teaching hospital in Tehran, Iran. N Am J Med Sci. 2014;6(5):224–8.

Carraro P, Plebani M. Errors in a stat laboratory: Types and frequencies 10 years later. Clin Chem. 2007;53(7):1338–42.

Wiwanitkit V. Types and frequency of preanalytical mistakes in the first Thai ISO 9002:1994 certified clinical laboratory, a 6 – month monitoring. BMC Clin Pathol [Internet]. 2001;1(1):1. Available from: http://bmcclinpathol.biomedcentral.com/articles/10.1186/1472-6890-1-5

Angüiano N, Perales M, Díaz C, Cázares R, Pérez F, Llaca J. Errores en el laboratorio clínico; evaluación de tipos y frecuencias. Elsevier. 2013;12(54):187–92.

Eliche M, Contreras H, Paino S, Campos G. Evaluación de incidencias preanalíticas en un laboratorio de urgencias. 2010;14–5.

Tovo A, Parsehian S Der, Briozzo G. El laboratorio de urgencia en la detección de errores preanalíticos. 2008;27(2):79–84.

Landt M, Hortin GL, Smith CH, Mcclellan A, Scott MG. Interference in Ionized Calcium Measurements by Heparin Salts. Clin Chem. 1994;40(4):565–70.

Chaneac M, Kindermans C. Preanalytical errors in ionized calcium measurements induced by the use of liquid heparin. Ann Clin Biochem. 1991;28:167–73.

Hutchison AS, Ralston SH, Dryburgh FJ, Small M, Fogelman I. Too much heparin: possible analysis source of error in blood gas. Br Med J. 1983;287(October):1131–2.

Hawking R. Measurement of Whole-Blood Potassium-Is It Clinically Safe? Clin Chem. 2003;2105(12):2105–6.

Wennecke G. Useful tips to avoid preanalytical errors in blood gas testing: electrolytes. acutecaretesting.org. 2003;

Lu J. Effects of air bubbles and tube transportation on blood oxygen tension in arterial blood gas analysis M ethods. 2003;(August 2017).

Biswas C, Ramos J, Agroyannis B, Kerr D. Blood gas analysis: effect of air bubbles in syringe and delay in estimation. Br Med J. 1982;284(March):923–7.

Navarro X, Guillén E, Pérez MM, Sáez PO, Barcenilla NR. Recomendaciones preanalíticas para la medición del equilibrio ácido-base y gases en sangre. SEQC. 2009;18–22.

Oliver P, Rodriguez O, Marin J, Guillen E, Valcárcel G, Galán A, et al. Estudio de la oxigenación e interpretación de la gasometría arterial. SEQC. 2015;(2014):31–47.

Laboratory C and, Institute S. Blood Gas and pH Analysis and Related Measurements; Approved Guideline — Second Edition. Clinical and Laboratory Standards Institute. 2009;29(8).

Küme T, Şişman AR, Solak A, Tuğlu B, Çinkooğlu B, Çoker C. The eff ects of diff erent syringe volume, needle size and sample volume on blood gas analysis in syringes washed with heparin. Biochem Medica. 2012;22(2):189–201.

Olivera, Cristiane.Talma F. Analysis of the pre-analytical phase in a private pathology laboratory of Maringá city-PR, Brazil. J Bras Patol Med LAb. 2016;(April):78–83.

Gil P, Franco M, Galbán G. Evaluación de errores preanalíticos en el laboratorio de planta del HIGA O . Alende de Mar del Plata Evaluation of preanalytical mistakes in the routine. 2016;50(3).

Triachini F, Flores S, Shcolnik W, Da Silva S, Andrade L, Olivera V, et al. The use of indicators in the pre-analytical phase as a laboratory management tool. J Bras Patol e Med Lab. 2014;50(2):100–4.

Quiroz-Arias C. Errores preanalíticos en el laboratorio clínico de un hospital de tercer nivel: Prueba piloto. Vol. 26, Salud Uninorte. 2010. p. 189–200.

Galbán G, Misino S, Wekken M Van Der, Tomassini L, Suarez M. Investigación del Hospital Interzonal Especializado Materno Infantil. Bioanálisis. 2007;18–21.

Stark A, Jones BA, Chapman D, Well K, Krajenta R, Meier FA, et al. Clinical laboratory specimen rejection - Association with the site of patient care and patients’ characteristics: Findings from a single health care organization. Arch Pathol Lab Med. 2007;131(4):588–92.

Quiroz Arias C. Errores preanalíticos en el laboratorio clínico de un hospital de tercer nivel : prueba piloto. Salud Uninorte. 2010;26(2):189–200.

Salinas M, López-Garrigós M, Yago M, Ortuño M, Carratala A, Aguado C, et al. Evaluación de la calidad en el laboratorio en la fase preanalítica: un estudio multicéntrico. Rev Calid Asist. 2011;26(4):264–8.

Gonzáles E, Guillén E, Canalias F. Gestión de los riesgos en laboratorio de urgencias y su impacto en la seguridad del paciente. Universiodad Autónoma de Barcelona; 2017.

UNICEF. Comprimidos dispersables: Suministros y logística [Internet]. OMS. 2017. Available from: https://www.unicef.org/spanish/supply/index_53571.html

Pineda D, Cabezas Á. Aplicación del Modelo Seis Sigma en el Laboratorio Clínico. ResearchGate. 2014;(June).

Tecnology Inteligent. Guía de Procedimientos Para Toma de Muestras de Gases Arteriales. Perú-Lima; 2014.

Arias L, Portilla L, Castaño J. Aplicación de Six Sigma en las organizaciones. 2008;(38):265–70.

Agnes Leotsakos, Hill CD. Nueve soluciones para la seguridad del paciente: A fin de salvar vidas y evitar daños [Internet]. OMS. 2007. Available from: http://www.who.int/mediacentre/news/releases/2007/pr22/es/

Baird G. Preanalytical considerations in blood gas analysis. Biochem Medica. 2013;23(1):149–27.

Robert W. Burnett, Ehrmeyer SS, Moran RF, Kessel AL Van. Blood Gas and pH Analysis and Related Measurements; Approved Guideline. NCCLS document C46-A. CLSI C46-A. 2001;21(14):9–16.

Mollard J. Précautions préanalytiques et matériel de prélèvement pour l’analyse des gaz du sang. Ann Biol Clin (Paris) [Internet]. 2000;58(4):472–83. Available from: http://www.jle.com/fr/revues/abc/e-docs/precautions_preanalytiques_et_materiel_de_prelevement_pour_lanalyse_des_gaz_du_sang_50548/article.phtml?tab=citer

Bonini P, Plebani M, Ceriotti F, Rubboli F. Errors in laboratory medicine. Clin Chem. 2002;48(5):691–8.

Wiwanitkit V. Glass syringes are better than plastic for preserving arterial blood gas for oxygen partial pressure determination: an explanation based on nanomaterial composition. 2006;346(2):223–4.

Dalpatbhai H, Meheshehandra N, Sundarbhai V. a Study of Pre-Analytical Errors in a Hospital Based Clinical Biochemistry Laboratory. Int J Clin Biochem Res. 2015;3(Ccl):380–6.

Jurado Roger A, López Braos J, Mart??nez Nogueras R, Rodr??guez Morales R, de la Pe??a Carretero L, Romero Sotomayor M V. La gestión por procesos en el laboratorio clínico como herramienta para disminuir los errores preanalíticos. Rev del Lab Clin. 2012;5(2):57–67.

Coffin CM, Hamilton MS, Pysher TJ, Bach P, Ashwood E, Schweiger J, et al. Current Challenges and Future Opportunities. 2002;683–90.

Graber M, Gordon R, Franklin N. Reducing Diagnostic Errors in Medicine: What's the Goal? Acad Med. 2002;77(10):981.

West J, Atherton J, Costelloe SJ, Pourmahram G, Stretton A, Cornes M. Preanalytical errors in medical laboratories: a review of the available methodologies of

Tabla 4. Errores preanalíticos relacionados al volumen iónico no dosable

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Published

2023-12-07

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1.
Arellano-Núñez VJ. Desempeño del proceso preanalítico del análisis de gases sanguíneo en un hospital pediátrico en la ciudad de Lima, 2018. Rev Pediatr Espec [Internet]. 2023 Dec. 7 [cited 2026 Jun. 5];2(2):68-75. Available from: https://revistapediatricae.insn.gob.pe/index.php/rpe/article/view/60