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Dear All

We offer POCT creatinine testing to ED on a Radiometer BGA. Analytical agreement with our laboratory (Roche) method was good when validated 2 years ago.

Our AKI alerts for inpatients have now been working well for a few month, using lab. generated results only.

Many community acquired AKIs would ideally be picked up in ED but the POCT data don’t currently feed to the AKI algorithm and so electronic alerts are not generated on such patients.

I am wary of combining creatinine results from 2 different methods into the same algorithm given matrix effects, susceptibility to different interferants (e.g. haemolysis which might not even be picked up at POCT analysis), and differing methodologies, not to mention the differing competencies of lab. BMS vs. POCT user in ED. However, significant differences between a POCT baseline in ED and a subsequent lab. creatinine could unambiguously spell AKI and there should be some alert system for this.

Has anyone else found a clever solution to this?

Kind regards

Seán

 

Seán J. Costelloe Ph.D. F.R.C.Path.

Consultant Clinical Scientist

Derriford Combined Laboratory

Plymouth Hospital NHS Trust

Ph: +44 (0)1752792291

Ext: 52291

cid:533264109@05022014-32E5

 


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