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Journal of veterinary internal medicine2020; 34(6); 2758-2766; doi: 10.1111/jvim.15889

Agreement of 2 electrolyte analyzers for identifying electrolyte and acid-base disorders in sick horses.

Abstract: Use of different analyzers to measure electrolytes in the same horse can lead to different interpretation of acid-base balance when using the simplified strong ion difference (sSID) approach. Objective: Investigate the level of agreement between 2 analyzers in determining electrolytes concentrations, sSID variables, and acid-base disorders in sick horses. Methods: One hundred twenty-four hospitalized horses. Methods: Retrospective study using paired samples. Electrolytes were measured using a Beckman Coulter AU480 Chemistry analyzer (PBMA) and a Nova Biomedical Stat Profile (WBGA), respectively. Calculated sSID variables included strong ion difference, SID ; unmeasured strong ions, USI; and total nonvolatile buffer ion concentration in plasma (A ). Agreement between analyzers was explored using Passing-Bablok regression and Bland-Altman analysis. Kappa (κ) test evaluated the level of agreement between analyzers in detecting acid-base disorders. Results: Methodologic differences were identified in measured Na and Cl and calculated values of SID and USI. Mean bias (95% limits of agreement) for Na , Cl , SID , and USI were: -1.2 mmol/L (-9.2 to 6.8), 4.4 mmol/L (-4.4 to 13), -5.4 mmol/L (-13 to 2), and -6.2 mmol/L (-14 to 1.7), respectively. The intraclass correlation coefficient for SID and USI was .55 (95%CI: -0.2 to 0.8) and .2 (95%CI: -0.15 to 0.48), respectively. There was a poor agreement between analyzers for detection of SID (κ = 0.20, 95%CI, 0.1 to 0.31) or USI abnormalities (κ = -0.04, 95%CI, -0.11 to 0.02). Conclusions: Differences between analyzer methodology in measuring electrolytes led to a poor agreement between the diagnosis of acid-base disorders in sick horses when using the sSID approach.
© 2020 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.
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Publication Date: 2020-09-23 PubMed ID: 32965055PubMed Central: PMC7694849DOI: 10.1111/jvim.15889Google Scholar: Lookup
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  • Journal Article

Summary

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This research investigates the lack of consistency between two electrolyte analyzers and their determination of electrolyte concentrations and acid-base disorders in ill horses. In particular, it was found that the methodology variations between the analyzers resulted in a discrepancy when diagnosing acid-base disorders using a specific approach.

Research Methodology

  • The research involved a retrospective study with samples taken from 124 hospitalized horses.
  • Interestingly, the researchers adopted a method where they utilised two separate electrolyte analyzers for the experiment; Beckman Coulter AU480 Chemistry analyzer (PBMA) and a Nova Biomedical Stat Profile (WBGA).
  • Through these analyzers, the electrolyte concentration was measured and variables for the simplified strong ion difference (sSID) approach were calculated.
  • This approach considered variables such as the strong ion difference (SID), unmeasured strong ions (USI), and total nonvolatile buffer ion concentration in plasma (A).
  • In order to check for agreement between the results of the two analyzers, Passing-Bablok regression and Bland-Altman analysis were employed.
  • The level of agreement in identifying acid-base abnormalities between the two analyzers was tested via Kappa (κ) test.

Results

  • There were differences identified in the method of measuring the electrolytes Na and Cl, as well as in the calculated values of SID and USI.
  • Furthermore, the intraclass correlation coefficient between SID and USI was as low as .55 and .2 respectively.
  • The lack of agreement between the two analyzers in detecting abnormalities in SID and USI was quite poor (κ = 0.20 for SID and κ = -0.04 for USI).

Conclusion

  • The research concluded that differences in the methodology of the two electrolyte analyzers resulted in a poor correlation in diagnosing acid-base disorders in sick horses when using the sSID method.
  • This lack of consistency can be attributed to how the analyzers measure electrolytes, prompting the need to standardize methods to ensure accurate diagnostic results.

Cite This Article

APA
Gomez DE, Buczinski S, Darby S, Palmisano M, Beatty SSK, Mackay RJ. (2020). Agreement of 2 electrolyte analyzers for identifying electrolyte and acid-base disorders in sick horses. J Vet Intern Med, 34(6), 2758-2766. https://doi.org/10.1111/jvim.15889

Publication

Journal of veterinary internal medicine
ISSN: 1939-1676
NlmUniqueID: 8708660
Country: United States
Language: English
Volume: 34
Issue: 6
Pages: 2758-2766

Researcher Affiliations

Gomez, Diego E
  • Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada.
  • Department of Clinical Studies, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA.
Buczinski, Sébastien
  • Département de Sciences Cliniques, Faculté de Médecine Vétérinaire, Université de Montréal, Montréal, Q, Canada.
Darby, Shannon
  • Department of Clinical Studies, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA.
Palmisano, Megan
  • Department of Clinical Studies, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA.
Beatty, Sarah S K
  • Department of Comparative, Diagnostic & Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA.
Mackay, Robert J
  • Department of Clinical Studies, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA.

MeSH Terms

  • Acid-Base Equilibrium
  • Acid-Base Imbalance / diagnosis
  • Acid-Base Imbalance / veterinary
  • Animals
  • Electrolytes
  • Horse Diseases / diagnosis
  • Horses
  • Retrospective Studies
  • Sodium

Conflict of Interest Statement

Sébastien Buczinski serves as Consulting Editor for Experimental Design and Statistics for the Journal of Veterinary Internal Medicine. He was not involved in review of this manuscript.

References

This article includes 35 references
  1. Constable PD. Clinical assessment of acid-base status: comparison of the Henderson-Hasselbalch and strong ion approaches.. Vet Clin Pathol 2000;29(4):115-128.
    pubmed: 12070822doi: 10.1111/j.1939-165x.2000.tb00241.xgoogle scholar: lookup
  2. Kurtz I, Kraut J, Ornekian V, Nguyen MK. Acid-base analysis: a critique of the Stewart and bicarbonate-centered approaches.. Am J Physiol Renal Physiol 2008 May;294(5):F1009-31.
    pubmed: 18184741doi: 10.1152/ajprenal.00475.2007google scholar: lookup
  3. Constable PD. A simplified strong ion model for acid-base equilibria: application to horse plasma.. J Appl Physiol (1985) 1997 Jul;83(1):297-311.
    pubmed: 9216976doi: 10.1152/jappl.1997.83.1.297google scholar: lookup
  4. van Gammeren AJ, van Gool N, de Groot MJ, Cobbaert CM. Analytical performance evaluation of the Cobas 6000 analyzer - special emphasis on trueness verification.. Clin Chem Lab Med 2008;46(6):863-71.
    pubmed: 18601611doi: 10.1515/cclm.2008.159google scholar: lookup
  5. Jain A, Subhan I, Joshi M. Comparison of the point-of-care blood gas analyzer versus the laboratory auto-analyzer for the measurement of electrolytes.. Int J Emerg Med 2009 Feb 24;2(2):117-20.
    pmc: PMC2700230pubmed: 20157454doi: 10.1007/s12245-009-0091-1google scholar: lookup
  6. King R, Campbell A. Performance of the radiometer OSM3 and ABL505 blood gas analysers for determination of sodium, potassium and haemoglobin concentrations.. Anaesthesia 2000 Jan;55(1):65-9.
    pubmed: 10594433doi: 10.1046/j.1365-2044.2000.01166.xgoogle scholar: lookup
  7. Fu H, Yan S, Wang Y, Gu D, Li X, Yang G, Liu Y. Methods Comparison and Bias Estimation of Three Distinct Biochemistry Analytical Systems in One Clinical Laboratory Using Patient Samples.. Clin Lab 2016;62(1-2):187-94.
    pubmed: 27012049doi: 10.7754/clin.lab.2015.150629google scholar: lookup
  8. West E, Bardell D, Senior JM. Comparison of the EPOC and i-STAT analysers for canine blood gas and electrolyte analysis.. J Small Anim Pract 2014 Mar;55(3):139-44.
    pubmed: 24428140doi: 10.1111/jsap.12177google scholar: lookup
  9. Kirsch K, Detilleux J, Serteyn D, Sandersen C. Comparison of two portable clinical analyzers to one stationary analyzer for the determination of blood gas partial pressures and blood electrolyte concentrations in horses.. PLoS One 2019;14(2):e0211104.
    pmc: PMC6377089pubmed: 30768603doi: 10.1371/journal.pone.0211104google scholar: lookup
  10. Stämpfli HR, Schoster A, Constable PD. Clinical utility of serum biochemical variables for predicting acid-base balance in critically ill horses.. Vet Clin Pathol 2014 Dec;43(4):547-56.
    pubmed: 25219754doi: 10.1111/vcp.12200google scholar: lookup
  11. Morimatsu H, Rocktäschel J, Bellomo R, Uchino S, Goldsmith D, Gutteridge G. Comparison of point-of-care versus central laboratory measurement of electrolyte concentrations on calculations of the anion gap and the strong ion difference.. Anesthesiology 2003 May;98(5):1077-84.
    pubmed: 12717128doi: 10.1097/00000542-200305000-00009google scholar: lookup
  12. Nguyen BV, Vincent JL, Hamm JB, Abalain JH, Carre JL, Nowak E, Ahmed MO, Arvieux CC, Gueret G. The reproducibility of Stewart parameters for acid-base diagnosis using two central laboratory analyzers.. Anesth Analg 2009 Nov;109(5):1517-23.
    pubmed: 19713255doi: 10.1213/ane.0b013e3181b62664google scholar: lookup
  13. Constable PD, Hinchcliff KW, Muir WW 3rd. Comparison of anion gap and strong ion gap as predictors of unmeasured strong ion concentration in plasma and serum from horses.. Am J Vet Res 1998 Jul;59(7):881-7.
    pubmed: 9659556
  14. Gomez DE, Arroyo LG, Stämpfli HR, Cruz LE, Oliver OJ. Physicochemical interpretation of acid-base abnormalities in 54 adult horses with acute severe colitis and diarrhea.. J Vet Intern Med 2013 May-Jun;27(3):548-53.
    pubmed: 23551698doi: 10.1111/jvim.12071google scholar: lookup
  15. Stämpfli H, Oliver‐Espinosa O. Clinical chemistry test. In: Smith B, Van Metre D, Pusterla N: Large Animal Internal Medicine. 5th ed. St Louis, MO: Elsevier, 2019:395–420.
  16. Bland JM, Altman DG. Measuring agreement in method comparison studies.. Stat Methods Med Res 1999 Jun;8(2):135-60.
    pubmed: 10501650doi: 10.1177/096228029900800204google scholar: lookup
  17. Landis JR, Koch GG. The measurement of observer agreement for categorical data.. Biometrics 1977 Mar;33(1):159-74.
    pubmed: 843571
  18. Koo TK, Li MY. A Guideline of Selecting and Reporting Intraclass Correlation Coefficients for Reliability Research.. J Chiropr Med 2016 Jun;15(2):155-63.
    pmc: PMC4913118pubmed: 27330520doi: 10.1016/j.jcm.2016.02.012google scholar: lookup
  19. Dimeski G, Barnett RJ. Effects of total plasma protein concentration on plasma sodium, potassium and chloride measurements by an indirect ion selective electrode measuring system.. Crit Care Resusc 2005 Mar;7(1):12-5.
    pubmed: 16548813
  20. Dimeski G, Morgan TJ, Presneill JJ, Venkatesh B. Disagreement between ion selective electrode direct and indirect sodium measurements: estimation of the problem in a tertiary referral hospital.. J Crit Care 2012 Jun;27(3):326.e9-16.
    pubmed: 22227082doi: 10.1016/j.jcrc.2011.11.003google scholar: lookup
  21. Heins M, Heil W, Withold W. Storage of serum or whole blood samples? Effects of time and temperature on 22 serum analytes.. Eur J Clin Chem Clin Biochem 1995 Apr;33(4):231-8.
    pubmed: 7626695doi: 10.1515/cclm.1995.33.4.231google scholar: lookup
  22. Viu J, Armengou L, Ríos J, Cesarini C, Jose-Cunilleras E. Acid base imbalances in ill neonatal foals and their association with survival.. Equine Vet J 2017 Jan;49(1):51-57.
    pubmed: 26595881doi: 10.1111/evj.12542google scholar: lookup
  23. Gomez DE, Biermann NM, Sanchez LC. Physicochemical Approach to Determine the Mechanism for Acid-Base Disorders in 793 Hospitalized Foals.. J Vet Intern Med 2015 Sep-Oct;29(5):1395-402.
    pmc: PMC4858039pubmed: 26256847doi: 10.1111/jvim.13590google scholar: lookup
  24. Aleman MR, Kuesis B, Schott HC, Carlson GP. Renal tubular acidosis in horses (1980-1999).. J Vet Intern Med 2001 Mar-Apr;15(2):136-43.
    pubmed: 11300597doi: 10.1892/0891-6640(2001)015<0136:rtaih>2.3.co;2google scholar: lookup
  25. Stewart AJ. Secondary renal tubular acidosis in a quarter horse gelding.. Vet Clin North Am Equine Pract 2006 Apr;22(1):e47-61.
    pubmed: 16627094doi: 10.1016/j.cveq.2005.12.024google scholar: lookup
  26. Kikura M, Nishino J, Suzuki Y, Uraoka M. Effect of Furosemide under Hyperchloremic Acidosis on Intraoperative Oliguria and Acute Kidney Injury in Patients with Normal Renal Function.. Nephron 2019;142(4):320-327.
    pubmed: 30991386doi: 10.1159/000499938google scholar: lookup
  27. Yunos NM, Bellomo R, Hegarty C, Story D, Ho L, Bailey M. Association between a chloride-liberal vs chloride-restrictive intravenous fluid administration strategy and kidney injury in critically ill adults.. JAMA 2012 Oct 17;308(15):1566-72.
    pubmed: 23073953doi: 10.1001/jama.2012.13356google scholar: lookup
  28. Constable PD. Hyperchloremic acidosis: the classic example of strong ion acidosis.. Anesth Analg 2003 Apr;96(4):919-922.
    pubmed: 12651634doi: 10.1213/01.ane.0000053256.77500.9dgoogle scholar: lookup
  29. Kopper JJ, Bolger ME, Kogan CJ, Schott HC 2nd. Outcome and complications in horses administered sterile or non-sterile fluids intravenously.. J Vet Intern Med 2019 Nov;33(6):2739-2745.
    pmc: PMC6872628pubmed: 31609037doi: 10.1111/jvim.15631google scholar: lookup
  30. Gomez DE, Lofstedt J, Arroyo LG, Wichtel M, Muirhead T, Stämpfli H, McClure JT. Association of unmeasured strong ions with outcome of hospitalized beef and dairy diarrheic calves.. Can Vet J 2017 Oct;58(10):1086-1092.
    pmc: PMC5603936pubmed: 28966359
  31. Naka T, Bellomo R, Morimatsu H, Rocktaschel J, Wan L, Gow P, Angus P. Acid-base balance in combined severe hepatic and renal failure: a quantitative analysis.. Int J Artif Organs 2008 Apr;31(4):288-94.
    pubmed: 18432583doi: 10.1177/039139880803100403google scholar: lookup
  32. Naka T, Bellomo R, Morimatsu H, Rocktaschel J, Wan L, Gow P, Angus P. Acid-base balance during continuous veno-venous hemofiltration: the impact of severe hepatic failure.. Int J Artif Organs 2006 Jul;29(7):668-74.
    pubmed: 16874671doi: 10.1177/039139880602900704google scholar: lookup
  33. Maciel AT, Park M, Macedo E. Physicochemical analysis of blood and urine in the course of acute kidney injury in critically ill patients: a prospective, observational study.. BMC Anesthesiol 2013 Oct 10;13(1):31.
    pmc: PMC3851869pubmed: 24112801doi: 10.1186/1471-2253-13-31google scholar: lookup
  34. Gomez DE, Rodriguez-Lecompte JC, Lofstedt J, Arroyo LG, Nino-Fong R, McClure JT. Detection of endotoxin in plasma of hospitalized diarrheic calves.. J Vet Emerg Crit Care (San Antonio) 2019 Mar;29(2):166-172.
    pubmed: 30810269doi: 10.1111/vec.12815google scholar: lookup
  35. Balasubramanyan N, Havens PL, Hoffman GM. Unmeasured anions identified by the Fencl-Stewart method predict mortality better than base excess, anion gap, and lactate in patients in the pediatric intensive care unit.. Crit Care Med 1999 Aug;27(8):1577-81.
    pubmed: 10470767doi: 10.1097/00003246-199908000-00030google scholar: lookup

Citations

This article has been cited 1 times.
  1. Coenen MC, Gille L, Eppe J, Casalta H, Bayrou C, Dubreucq P, Frisée V, Moula N, Evrard J, Martinelle L, Sartelet A, Bossaert P, Djebala S. Blood Inflammatory, Hydro-Electrolytes and Acid-Base Changes in Belgian Blue Cows Developing Parietal Fibrinous Peritonitis or Generalised Peritonitis after Caesarean Section. Vet Sci 2022 Mar 14;9(3).
    doi: 10.3390/vetsci9030134pubmed: 35324862google scholar: lookup
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