fa بررسی مقدار فاکتورهای بیوشیمیایی نمونه خون ورید و شریان در بیماران بستری در بخش مراقبت ویژه بيولوژي Biology پژوهشي-کامل Research(Original) <span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:94%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span lang="FA" style="line-height:94%"><span b="" koodak="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.1pt">سابقه</span></span></span></span><span lang="AR-SA" style="line-height:94%"><span b="" koodak="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.1pt"> و هدف:</span></span></span></span> <span lang="AR-SA" style="line-height:94%"><span b="" nazanin="" style="font-family:">: </span></span><span lang="AR-SA" style="line-height:94%"><span b="" style="font-family:" zar=""><span style="color:black">بیماران بستری در بخش‌های مراقبت ویژه نیازمند خون‌گیری مکرر جهت بررسی آنتات</span></span></span><span lang="AR-SA" style="line-height:94%"><span b="" style="font-family:" zar=""><span style="color:black">‌</span></span></span><span lang="AR-SA" style="line-height:94%"><span b="" style="font-family:" zar=""><span style="color:black">های بیوشیمیایی و گازهای خونی شریانی (</span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:94%"><span style="color:black">ABG</span></span></span><span lang="AR-SA" style="line-height:94%"><span b="" style="font-family:" zar=""><span style="color:black">) هستند. خون‌گیری مکرر از علل شایع آنمی در این بیماران است</span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:94%"><span style="color:black">.</span></span></span><span style="line-height:94%"><span b="" style="font-family:" zar=""> اندازه‌گیری آنتات‌ها تنها در نمونه </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:94%">ABG</span></span><span lang="AR-SA" style="line-height:94%"><span b="" style="font-family:" zar=""> می‌تواند از</span></span> <span lang="AR-SA" style="line-height:94%"><span b="" style="font-family:" zar="">آنمی جلوگیری کند.</span></span> <span lang="AR-SA" style="line-height:94%"><span b="" style="font-family:" zar="">در این مطالعه میزان فاکتورهای بیوشیمیایی در نمونه خون ورید با </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:94%">ABG</span></span><span lang="AR-SA" style="line-height:94%"><span b="" style="font-family:" zar=""> در بیماران بستری در بخش‌های مراقبت ویژه مقایسه شد.</span></span></span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:94%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span lang="AR-SA" style="line-height:94%"><span b="" koodak="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.1pt">مواد و روش</span></span></span></span><span lang="FA" style="line-height:94%"><span b="" style="font-family:" zar=""><span style="color:black"><span style="letter-spacing:-.1pt">‌</span></span></span></span><span lang="AR-SA" style="line-height:94%"><span b="" koodak="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.1pt">ها:</span></span></span></span> <span lang="AR-SA" style="line-height:94%"><span b="" style="font-family:" zar="">این مطالعه مقطعی-تحلیلی در 223 بیمار بستری در بخش‌های مراقبت‌های ویژه انجام شد. مقدار سدیم، پتاسیم، گلوکز، کلسیم و هماتوکریت در نمونه ورید با اتوآنالایزر آزمایشگاهی و در نمونه شریان با آنالایزر </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:94%">ABG</span></span><span lang="AR-SA" style="line-height:94%"><span b="" style="font-family:" zar=""> اندازه‌گیری شد.</span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:94%"></span></span></span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:10%"><span style="line-height:94%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span lang="AR-SA" style="line-height:94%"><span b="" koodak="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.2pt">یافته</span></span></span></span><span lang="FA" style="line-height:94%"><span b="" style="font-family:" zar=""><span style="color:black"><span style="letter-spacing:-.2pt">‌</span></span></span></span><span lang="AR-SA" style="line-height:94%"><span b="" koodak="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.2pt">ها:</span></span></span></span> <span lang="AR-SA" style="line-height:94%"><span b="" style="font-family:" zar=""><span style="letter-spacing:-.1pt">میانگین اختلاف آنتات‌ها در نمونه </span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:94%"><span style="letter-spacing:-.1pt">ABG</span></span></span><span lang="AR-SA" style="line-height:94%"><span b="" style="font-family:" zar=""><span style="letter-spacing:-.1pt"> با ورید به</span></span></span><span lang="AR-SA" style="line-height:94%"><span b="" style="font-family:" zar=""><span style="color:black"><span style="letter-spacing:-.1pt">‌</span></span></span></span><span lang="AR-SA" style="line-height:94%"><span b="" style="font-family:" zar=""><span style="letter-spacing:-.1pt">ترتیب برای سدیم1/12 میلی</span></span></span><span lang="AR-SA" style="line-height:94%"><span b="" style="font-family:" zar=""><span style="color:black"><span style="letter-spacing:-.1pt">‌</span></span></span></span><span lang="AR-SA" style="line-height:94%"><span b="" style="font-family:" zar=""><span style="letter-spacing:-.1pt">اکی والان در لیتر، </span></span></span><span lang="AR-SA" style="line-height:94%"><span b="" style="font-family:" zar=""><span style="letter-spacing:-.2pt">پتاسیم 0/29- </span></span></span><span lang="AR-SA" style="font-size:11.5pt"><span style="line-height:94%"><span b="" style="font-family:" zar=""><span style="letter-spacing:-.2pt">میلی</span></span></span></span><span lang="AR-SA" style="font-size:11.5pt"><span style="line-height:94%"><span b="" style="font-family:" zar=""><span style="color:black"><span style="letter-spacing:-.2pt">‌</span></span></span></span></span><span lang="AR-SA" style="font-size:11.5pt"><span style="line-height:94%"><span b="" style="font-family:" zar=""><span style="letter-spacing:-.2pt">اکی والان درلیتر، گلوکز0/33 میلی‌گرم در دسی</span></span></span></span><span lang="AR-SA" style="font-size:11.5pt"><span style="line-height:94%"><span b="" style="font-family:" zar=""><span style="color:black"><span style="letter-spacing:-.2pt">‌</span></span></span></span></span><span lang="AR-SA" style="font-size:11.5pt"><span style="line-height:94%"><span b="" style="font-family:" zar=""><span style="letter-spacing:-.2pt">لیتر،کلسیم 0/98- میلی‌گرم</span></span></span></span><span lang="AR-SA" style="line-height:94%"><span b="" style="font-family:" zar=""><span style="letter-spacing:-.2pt"> در دسی</span></span></span><span b="" lang="AR-SA" style="font-family:" zar=""><span style="color:black"><span style="letter-spacing:-.2pt">‌</span></span></span><span lang="AR-SA" style="line-height:94%"><span b="" style="font-family:" zar=""><span style="letter-spacing:-.2pt">لیتر و هماتوکریت4/39 درصد مشاهده شد. به‌علاوه آنالیز </span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:94%"><span style="letter-spacing:-.2pt">Bland Altman</span></span></span><span lang="AR-SA" style="line-height:94%"><span b="" style="font-family:" zar=""><span style="letter-spacing:-.2pt">، 95درصد</span></span></span><span lang="AR-SA" style="line-height:94%"><span b="" style="font-family:" zar=""><span style="letter-spacing:-.1pt"> حد توافق را برای سدیم 12/3- تا 9، پتاسیم 0/7- تا1/29، گلوکز39/13- تا 40/32، کلسیم 1/31- تا 3/08 و هماتوکریت13/5- تا 8/5</span></span></span><span lang="AR-SA" style="line-height:94%"><span b="" style="font-family:" zar=""> نشان داد.</span></span></span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:10%"><span style="line-height:94%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span lang="AR-SA" style="line-height:94%"><span b="" koodak="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.2pt">استنتاج:</span></span></span></span> <span lang="AR-SA" style="line-height:94%"><span b="" style="font-family:" zar="">با توجه به میانگین اختلاف و حد توافق قابل قبول برای سدیم، پتاسیم و هماتوکریت می‌توان از آنالایزر </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:94%">ABG</span></span><span lang="AR-SA" style="line-height:94%"><span b="" style="font-family:" zar=""> جهت اندازه‌گیری این آنتات‌ها استفاده کرد. به دلیل تغییرات وسیع در میزان گلوکز و کلسیم، اندازه‌گیری این آنتات‌ها توسط آنالایزر </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:94%">ABG</span></span><span style="line-height:94%"><span b="" style="font-family:" zar=""> قابل اعتماد نیست.</span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:94%"></span></span></span></span></span></span></span></span></span><br> <br> <span style="font-size:11pt"><span style="line-height:115%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span sans-serif="" style="font-family:Calibri,"><span dir="LTR" style="font-size:10.0pt"><span style="line-height:115%"><span style="font-family:"Times New Roman","serif""></span></span></span></span></span></span></span></span> <span style="font-size:12pt"><span style="line-height:150%"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:10.0pt"><span style="line-height:150%"><span arial="" style="font-family:"><span style="letter-spacing:-.2pt">Background and purpose:</span></span></span></span></b> <span style="font-size:10.0pt"><span style="line-height:150%"><span style="color:black">Patients admitted at the intensive care unit (ICU) need blood draws for chemistry analytes and arterial blood gas (ABG) analysis. Repeated blood drawing is one of the most common causes of anemia</span></span></span> <span style="font-size:10.0pt"><span style="line-height:150%"><span style="color:black">in these group of patients. Measurement of analytes only by ABG analyzer can be beneficial for preventing anemia. The aim of this study was to compare the biochemical analytes in venous and ABG samples in ICU patients. </span></span></span><span dir="RTL" lang="AR-SA" style="font-size:10.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"><span style="color:black"></span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="line-height:150%"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:10.0pt"><span style="line-height:150%"><span arial="" style="font-family:"><span style="letter-spacing:-.2pt">Materials and methods:</span></span></span></span></b><b> </b><span style="font-size:10.0pt"><span style="line-height:150%"><span style="color:black">This cross-sectional study was performed in 223 patients hospitalized in the ICU. These patients undergoing ABG analysis and simultaneous venous sampling. The value of Ca, Na, K, Hct, and glucose were measured in venous samples with a laboratory auto-analyzer and in arterial samples with an ABG analyzer. </span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="line-height:150%"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:10.0pt"><span style="line-height:150%"><span arial="" style="font-family:"><span style="letter-spacing:-.2pt">Results:</span></span></span></span></b> <span style="font-size:10.0pt"><span style="line-height:150%"><span style="color:black">The mean age of patients was 61.14</span></span></span><span style="font-size:10.0pt"><span style="line-height:150%"><span style="color:black">&plusmn;</span></span></span><span style="font-size:10.0pt"><span style="line-height:150%"><span style="color:black">16.96 years. </span></span></span><span style="font-size:10.0pt"><span style="line-height:150%">The mean difference between ABG <span style="color:black">and serum samples was</span></span></span> <span style="font-size:10.0pt"><span style="line-height:150%"><span style="color:black">1.12 </span></span></span><span style="font-size:10.0pt"><span style="line-height:150%">mEq/L <span style="color:black">for sodium</span>, -0.29 mEq/L for potassium, -0.98 mg/dl for calcium, 0.33 mg/dl for glucose, and 4.39%% for hematocrit.</span></span> <span style="font-size:10.0pt"><span style="line-height:150%">In addition, 95% limit of agreement was -12.3 to 9 for sodium, -0.7 to 1.29 for potassium, -1.31 to 3.8 for calcium, -39.13 to 40.32 for glucose, and -13.5 to 8.5 for hematocrit.</span></span></span></span></span><br> <span style="font-size:12pt"><span style="line-height:150%"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:10.0pt"><span style="line-height:150%"><span arial="" style="font-family:"><span style="letter-spacing:-.2pt">Conclusion:</span></span></span></span></b> <span style="font-size:10.0pt"><span style="line-height:150%"><span style="color:black">Because of acceptable agreement for sodium, potassium, and </span></span></span><span style="font-size:10.0pt"><span style="line-height:150%"><span style="color:black">hematocrit,</span></span></span><span style="font-size:10.0pt"><span style="line-height:150%"><span style="color:black"> ABG analyzer can be used in ICU patients and emergency situations.</span></span></span> <span style="font-size:10.0pt"><span style="line-height:150%"><span style="color:black">There is a remarkable bias between</span></span></span> <span style="font-size:10.0pt"><span style="line-height:150%"><span style="color:black">the ABG-measured and laboratory</span></span></span><span dir="RTL" lang="AR-SA" style="font-size:10.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"><span style="color:black">-</span></span></span></span><span style="font-size:10.0pt"><span style="line-height:150%"><span style="color:black">measured calcium and glucose, so the calcium and glucose measurement by the ABG analyzer are not reliable. </span></span></span><span style="font-size:10.0pt"><span style="line-height:150%"><span style="color:black"></span></span></span></span></span></span><br> &nbsp; پتاسیم, سدیم, هماتوکریت, گلوگز, کلسیم, خون وریدی, خون شریانی arterial blood, calcium, glucose, hematocrit, potassium, sodium, venous blood 170 179 http://jmums.mazums.ac.ir/browse.php?a_code=A-10-16543-1&slc_lang=fa&sid=1 Parviz Amri پرویز امری p.amri@mubabol.ac.ir 1003194753284600161903 1003194753284600161903 No Professor, Department of Anesthesiology, Clinical Research Development Unite of Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran استاد، گروه بیهوشی، واحد توسعه و تحقیقات بیمارستان آیت ا... روحانی، دانشگاه علوم پزشکی بابل، بابل، ایران Sarvin Seyfi سروین سیفی sarvinseyfi.ss@gmail.com 1003194753284600161904 1003194753284600161904 No Medical Student, Student Research Committee, Babol University of Medical Sciences, Babol, Iran دانشجوی پزشکی، کمیته تحقیقات دانشجویی، دانشگاه علوم پزشکی بابل، بابل، ایران shahram Seyfi شهرام سیفی sh.seifi@mubabol.ac.ir 1003194753284600161905 1003194753284600161905 Yes Assistant Professor, Department of Anesthesiology, Clinical Research Development Unite of Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran استادیار، گروه بیهوشی، واحد توسعه و تحقیقات بیمارستان آیت ا... روحانی، دانشگاه علوم پزشکی بابل، بابل، ایران Hoda Shirafkan هدی شیرافکن hodashirafkan@gmail.com 1003194753284600161906 1003194753284600161906 No Assistant Professor, Department of Biostatistics, Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran استادیار، گروه آمار حیاتی، مرکز تحقیقات عوامل اجتماعی موثر بر سلامت، پژوهشکده سلامت، دانشگاه علوم پزشکی بابل، بابل، ایران