![]() Our routine blood gas Between-Laboratory Survey is done every 2 weeks using a freshly pooled heparinized blood sample taken to each analyzer location to verify comparability among our GEM4K and Radiometer ABL90 (Rad90) blood gas analyzers. Two previous reports from the same group concluded that the analytical reliability of Instrumentation Laboratory GEM4000 analyzers (GEM4K) deteriorated during a 24-hour period, based on results between samples from the same patient but collected at different times. Laboratories that use the GEM system should begin dialogues with its primary clinical users. This data confirm the reduced accuracy of the GEM 4000 in nonmorning hours, which probably negatively impacts patient care, and calls for technological enhancements in the next-generation GEM instruments. The analytical variation of the GEM approached the corresponding biological variation (low sigma) for glucose, hemoglobin, and electrolytes except K. The analytes most affected were glucose, Na, K, and hemoglobin. The GEM displayed optimal accuracy in the early morning, coincident with the daily (2:00 am) analysis of calibrator solution (PSC C), and worsened, reaching peak inaccuracy and plateauing at 6–8 hours post-calibration. The mean absolute differences were calculated for each sequence of 1000 pairs of central laboratory and GEM results, and graphed against time of day. Results were compared to concurrent testing (≤30 minutes interval) performed using comparable central laboratory methods, the Roche Cobas 8000 for chemistry and Sysmex XN-3000 for hemoglobin. In this study, accuracy was assessed by comparing patient GEM test results to corresponding central laboratory results for patients whose point-of-care and central laboratory specimens were tested within 30 minutes of each other.Ī laboratory database was mined for measurements of glucose, electrolytes, and hemoglobin using two GEM 4000 instruments on intensive care unit patients at the Foothills Hospital in Calgary, Alberta, over a 2-year period (2012–2013). Previous studies have shown that the instrument demonstrates increased imprecision compared to similar analyzers for iCa, electrolytes, and blood gases when external quality control material is run. The GEM 4000 (Instrumentation Laboratory, Bedford, MA) is a point-of-care analyzer, primarily used in a critical care setting to measure blood gases, glucose, electrolytes, and hemoglobin. ![]()
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