Objective. To evaluate the utility of the iSTAT blood analyzer, a bedside device for hematocrit, sodium, potassium, and glucose measurement
during cardiopulmonary bypass (CPB).
Methods. Forty patients scheduled for elective CPB were evaluated prospectively. In addition to using the iSTAT analyzer, blood samples
were analyzed at four time points: following induction of anesthetic, 10 min. after initiation of CPB, 60 min. after initiation
of CPB, and following heparin neutralization by protamine. Blood glucose concentration was measured by the hospital laboratory
using a Kodak Analyzer and by a glucose meter, electrolytes were evaluated by the Kodak Analyzer and BGE (a device which is
commonly used for “satellite laboratory” determinations of electrolyte and blood gas results), and hematocrit samples were
measured by the hospital laboratory using an NE 8,000 and a centrifuge. The means and standard deviations of the differences
between the methods were calculated.
Results. The hematocrit values determined by the iSTAT machine, when adjusted for the level of total protein (according to manufacturer's
directions), differed from the laboratory values by 0.53 = 1.46 percentage points. An alternative to measuring total protein
and making the adjustment is simply adding 1 % to the hematocrit in the pre-CPB period and 3% on-CPB or post-CPB, which we
found to yield values that differed from the laboratory by 0.52 ± 1.42 percentage points. For all four tests (hematocrit,
sodium, potassium, and glucose) the iSTAT had a similar relationship to the laboratory values as did the other commonly used
means (centrifuge, BGE, and glucose meter) of clinical evaluation.
Conclusion. In summary, we found that in patients undergoing CPB, the iSTAT values agreed sufficiently well with standard laboratory
values and that the iSTAT instrument can be relied upon for bedside measurements.
Key words Surgery: cardiopulmonary bypass - Analyzers: glucose meter - iSTAT - Laboratory: electrolyte - hematocrit
Presented in part at the Annual Meeting of the Society of Cardiovascular Anesthesiologists, Philadelphia, PA, May 1995, and
at the 70th meeting of the IARS, Washington DC, March 1996. Supported in part by a grant by iSTAT Corporation.