Department of Pathology, UMass Memorial Medical Center
Analytical, Diagnostic and Therapeutic Techniques and Equipment | Endocrine System Diseases | Endocrinology, Diabetes, and Metabolism | Nutritional and Metabolic Diseases | Pathology
Objective: To determine if bicarbonate values from venous blood gas (VBG) and plasma chemistry samples provided agreement in determining the bicarbonate criteria for the diagnosis and/or resolution of diabetic ketoacidosis (DKA).
Methods: A retrospective chart review of data from patients admitted to a tertiary care hospital with a diagnosis of DKA over a four year period was performed. Paired bicarbonate values from a VBG and chemistry panel, if drawn within 60minutes of each other, were compared.
Results: At the time of diagnosis of DKA, 197 paired bicarbonate values were available for analysis with the mean difference between the two methods of testing of 2.5mmol/L. 16 of the 197 (8%) paired values were discordant in meeting criteria for diagnosis of DKA. At the time of resolution of DKA, 83 paired bicarbonate samples were compared. The mean difference was 2.3mmol/L. 20 of the 83 (24%) paired bicarbonate values showed discordance with regards to meeting the bicarbonate criteria for resolution of DKA.
Conclusion: Discordance between bicarbonate results from different analysis methods may lead to different determinations as to whether or not a patient meets the biochemical definition for diagnosis and resolution of DKA.
diabetic ketoacidosis, diagnosis, bicarbonate values
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© 2019 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/BY-NC-ND/4.0/).
DOI of Published Version
J Clin Transl Endocrinol. 2019 Aug 16;18:100205. doi: 10.1016/j.jcte.2019.100205. eCollection 2019 Dec. Link to article on publisher's site
Journal of clinical and translational endocrinology
Goundan PN, Willard DL, Sahin-Efe A, Fan SL, Alexanian SM. (2019). Comparison of bicarbonate values from venous blood gas and chemistry panels measured at the time of diagnosis and resolution of diabetes ketoacidosis. Open Access Publications by UMMS Authors. https://doi.org/10.1016/j.jcte.2019.100205. Retrieved from https://escholarship.umassmed.edu/oapubs/3985
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.
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