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The Application of a Dried Balanced Heparin Syringe Can Attenuate the Dilution Effect in Rapid Point-of-care Potassium Testing for the Early Identification of Hyperkalemia in the Emergency Department

Other Titles
 Min Kyung Seung  ;  Sung Phil Chung  ;  Yoo Seok Park  ;  Hyun Soo Chung  ;  Hye Sun Lee  ;  Youngseon Joo  ;  Je Sung You  ;  Incheol Park 
 Journal of the Korean Society of Emergency Medicine (대한응급의학회지), Vol.26(6) : 509-516, 2015 
Journal Title
 Journal of the Korean Society of Emergency Medicine (대한응급의학회지) 
Issue Date
Point-of-care testing ; Hyperkalemia ; Chronic ; Chronic kidney failure ; Resuscitation
Purpose: Current methods to evaluate the blood concentration of potassium (K) on point-of-care (POC) are influenced by the relative volumes of heparin and arterial blood. Blood potassium concentration may be underestimated with a high volume of heparin or low volume of blood. This dilution effect can produce false negative results that negatively affect decision-making of clinicians and throw critical patients into crisis. We hypothesized that the application of a dried balanced heparin syringe in rapid POC-K+ could attenuate the dilution effect and would more accurately and consistently measure the concentration of potassium compared with reference testing in emergency situations. Methods: This retrospective study was conducted between January, 1, 2008 and September, 30, 2013 at an urban hospital affiliated with our institution. To attenuate the dilution effect, dried balanced heparin syringes (HS) were also used between October, 1, 2011 and September, 30, 2013. Concentrations of potassium were compared between the dried balanced HS group and the liquid HS group. The reliability of each of these outcome measures was assessed using intra-class correlation coefficient analysis. Results: Application of dried balanced HS improved the degree of concordance for potassium using two different assays. The false negative rate was significantly improved from 9.1% (95% CI 7.3-11.0) to 5.7% (95% CI 3.5-8.0) in the dried balanced HS group compared with the liquid HS liquid group (p=0.037). Conclusion: This study suggests that the usage of dried balanced HS could attenuate the dilution effect in rapid POC-K+ and predict potassium levels more accurately for identification of patients at risk of hyperkalemia in emergency situations.
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1. College of Medicine (의과대학) > Dept. of Emergency Medicine (응급의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
Park, Yoo Seok(박유석) ORCID logo https://orcid.org/0000-0003-1543-4664
Park, Eun-Cheol(박은철) ORCID logo https://orcid.org/0000-0002-2306-5398
Seung, Min Kyung(성민경)
You, Je Sung(유제성) ORCID logo https://orcid.org/0000-0002-2074-6745
Lee, Hye Sun(이혜선) ORCID logo https://orcid.org/0000-0001-6328-6948
Chung, Sung Pil(정성필) ORCID logo https://orcid.org/0000-0002-3074-011X
Chung, Hyun Soo(정현수) ORCID logo https://orcid.org/0000-0001-6110-1495
Joo, Young Seon(주영선)
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