[en] Different blood gas analyzers are used in equine practice. Every machine needs to be validated, as they have not been designed for use in horses. The aim of this study was to compare the newly marketed GEM5000 machine to the formerly validated epoc machine for blood gas analysis in horses. In this prospective, non-blinded, comparative laboratory analyzer study, 43 equine blood samples were analyzed on both analyzers and values were compared between the two machines via Lin’s concordance analysis, Passing–Bablok regression analysis and Bland–Altman plots. Duplicate measurements were conducted on the GEM5000 machine to evaluate precision. The GEM5000 failed to achieve the required precision for tHb, Hct and iCa2+, but achieved acceptable precision for all other parameters. Concordance correlation analysis revealed poor correlation for Na+, Cl−, iCa2+, K+, Hct and tHb, while there was an at least moderate agreement for all other parameters. Passing–Bablok regression revealed significant constant bias for pCO2, pO2, Cl−, and iCa2+ and significant proportional bias for pCO2, iCa2+ and SO2. Bland–Altman analysis revealed significant systematic bias for Na+, Cl−, iCa2+, K+, Hct, tHb and SO2. This study shows that while precision of the GEM5000 is good, values should not be used interchangeably with data obtained from other blood gas analyzers.
Disciplines :
Veterinary medicine & animal health
Author, co-author :
Sandersen, Charlotte ; Université de Liège - ULiège > Fundamental and Applied Research for Animals and Health (FARAH) > FARAH: Médecine vétérinaire comparée
Dmitrovic, Petra ; Université de Liège - ULiège > Département d'Enseignement et de Clinique des animaux de Compagnie (DCC) > Anesthésiologie et réanimation des animaux de compagnie ; Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Zagreb, 10000 Zagreb, Croatia
Dupont, Julien ; Université de Liège - ULiège > Fundamental and Applied Research for Animals and Health (FARAH) > FARAH: Médecine vétérinaire comparée
Cesarini, Carla ; Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Liege, 4000 Liege, Belgium
Guyot, Hugues ; Université de Liège - ULiège > Fundamental and Applied Research for Animals and Health (FARAH) > FARAH: Productions animales durables
Serteyn, Didier ; Université de Liège - ULiège > Centres généraux > Centre de l'oxygène : Recherche et développement (C.O.R.D.)
Kirsch, Katharina ; Université de Liège - ULiège ; German Olympic Committee for Equestrian Sports, 48231 Warendorf, Germany
Language :
English
Title :
Analytical Performance Evaluation of the New GEM® Premier™ 5000 in Comparison to the Epoc® Blood Gas Analyzer in Horses
Bliskslager A.T. Jones S.L. Obstructive disorders of the gastrointestinal tract Equine Internal Medicine 3rd ed. Reed S.M. Bayly W.M. Sellon C.D. Elsevier Saunders St. Louis, MO, USA 1998 922 936
Stämpfli H. Oliver-Espinosa O. Clinical Chemistry Tests Large Animal Internal Medicine 5th ed. Smith B.P. Elsevier Saunders St. Louis, MO, USA 2014 362
Magdesian K.G. Southwood L.L. Monitoring Equine Emergency and Critical Care Medicine Southwood L.L. Wilkins P.A. CRC Press Boca Raton, FL, USA 2015 635 637
Aguilera-Tejero J.C. López I. Bas S. Bas S. Mayer-Valor R. Rodríguez M. Quantitative analysis of acid-base balance in show jumpers before and after exercise Res. Vet. Sci. 2000 68 103 108 10.1053/rvsc.1999.0341
Andrews F.M. Geiser D.R. White S.L. Williamson L.H. Maykuth P.L. Green E.M. Haematological and biochemical changes in horses competing in a 3 Star horse trial and 3-day-event Equine Vet. J. Suppl. 1995 20 57 63 10.1111/j.2042-3306.1995.tb05009.x
Foreman J.H. Waldsmith J.K. Lalum R.B. Physical, acid-base and electrolyte changes in horses competing in Training, Preliminary and Intermediate horse trials Equine Comp. Exerc. Physiol. 2004 1 99 105 10.1079/ECEP200310
Hinchcliff K.W. Kohn C.W. Geor R. McCutcheon L.J. Foreman J. Andrews F.M. Allen A.K. White S.L. Williamson L.H. Maykuth P.L. Acid:base and serum biochemistry changes in horses competing at a modified 1Star 3-day event Equine Vet. J. Suppl. 1995 20 105 110
Rose R.J. Ilkiw J.E. Martin I.C.A. Blood-gas, Acid-base and Haematological values in Horses during an Endurance ride Equine Vet. J. 1979 11 56 59 10.1111/j.2042-3306.1979.tb01300.x
Rose R.J. Ilkiw J.E. Arnold K.S. Backhouse J.W. Sampson D. Plasma biochemistry in the horse during 3-day event competition Equine Vet. J. 1980 12 132 136 10.1111/j.2042-3306.1980.tb03401.x
Viu J. Jose-Cunilleras E. Armengou L. Cesarini C. Tarancón I. Rios J. Monreal L. Acid-base imbalances during a 120 km endurance race compared by traditional and simplified strong ion difference methods Equine Vet. J. Suppl. 2010 42 76 82 10.1111/j.2042-3306.2010.00213.x
Williamson L.H. Andrews F.M. Maykuth P.L. White S.L. Green E.M. Biochemical changes in Three-day-event horses at the beginning, middle and end of Phase C and after Phase D Equine Vet. J. Suppl. 1996 22 92 98 10.1111/j.2042-3306.1996.tb05036.x
Kirsch K. Sandersen C. Traditional and quantitative analysis of acid-base and electrolyte imbalances in horses competing in cross-country competitions at 2-star to 5-star level J. Vet. Intern. Med. 2020 34 909 921 10.1111/jvim.15708 31985090
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 e0211104 10.1371/journal.pone.0211104
Bardell D. West E. Senior M.J. Evaluation of a new handheld point-of-care blood gas analyser using 100 equine blood samples Vet Anaesth. Analg. 2017 44 77 85 10.1111/vaa.12392
Elmeshreghi T.N. Grubb T.L. Greene S.A. Ragle C.A. Wardrop J.A. Comparison of Enterprise Point-of-Care and Nova Biomedical Critical Care Xpress analyzers for determination of arterial pH, blood gas, and electrolyte values in canine and equine blood Vet. Clin. Pathol. 2018 47 415 424 10.1111/vcp.12635
Westgard J.O. Carey R.N. Wold S. Criteria for judging precision and accuracy in method development and evaluation Clin. Chem. 1974 20 825 833 10.1093/clinchem/20.7.825
Center for Disease Control and Prevention (CDC) Centers for Medicare and Medical Services (CMS) HHS Medicare, Medicaid, and CLIA programs: Laboratory requirements relating to quality systems and certain personnel qualifications: Final rule Fed. Regist. 2003 68 3640 3714
Lin L.I. A concordance correlation coefficient to evaluate reproducibility Biometrics 1989 45 255 268 10.2307/2532051 2720055
McBride G.B. A Proposal for Strength-of-Agreement Criteria for Lin’s Concordance Correlation Coefficient NIWA Client Report; HAM 2005-062 National Institute of Water & Atmospheric Research Ltd. Hamilton, New Zealand 2005
Bland J.M. Altman D.G. Statistical method for assessing agreement between two methods of clinical measurement Lancet 1986 1 307 310 10.1016/S0140-6736(86)90837-8
Bland J.M. Altman D.G. Measuring agreement in method comparison studies Stat. Methods Med. Res. 1999 8 135 160 10.1177/096228029900800204
Passing H. Bablok W. A new biometrical procedure for testing the equality of measurements from two different analytical methods. Application of linear regression procedures for method comparison studies in Clinical Chemistry, Part I J. Clin. Chem. Clin. Biochem. 1983 21 709 720 10.1515/cclm.1983.21.11.709
Matburger A.C. Henke J. Hirschberger J. Matburger S. Henke W. Evaluation des tragbaren i-STAT®-Blutgasanalysegerätes im klinischen Einsatz beim Hund Tierärztl Prax. 2000 28 132 137
Kennedy S.A. Constable P.D. Sen I. Couëtil L. Effects of syringe type and storage conditions on results of equine blood gas and acid-base analysis Am. J. Vet. Res. 2012 73 979 987 10.2460/ajvr.73.7.979
Picandet V. Jeanneret S. Lavoie J.P. Effects of syringe type and storage temperature on results of blood gas analysis in arterial blood of horses J. Vet. Intern. Med. 2007 21 476 481 10.1111/j.1939-1676.2007.tb02993.x 17552454
Mion M.M. Bragato G. Zaninotto M. Alessandroni J. Bernardini S. Plebani M. Analytical performance evaluation of the new GEM® Premier™ 5000 analyzer in comparison to the GEM® Premier™ 4000 and the RapidPoint® 405 systems Clin. Chim. Acta 2018 486 313 319 10.1016/j.cca.2018.08.019 30118673
Krouwer J.S. Tholen D. Garber C. Goldschmidt H.M. Kroll M.H. Linnet K. Meier K. Robinowitz M. Kennedy J.W. Method Comparison and Bias Estimation Using Patient Samples Approved Guideline 2nd ed. Clinical and Laboratory Standards Institute Malvern, PA, USA 2010
Hughes J. Bardell D. Determination of reference intervals for equine arterial blood-gas, acid-base and electrolyte analysis Vet. Anaesth. Analg. 2019 46 765 771 10.1016/j.vaa.2019.04.015
Taylor L.E. Kronfeld D.S. Ferrante P.L. Wilson J.A. Tiegs W. Blood-gas measurements adjusted for temperature at three sites during incremental exercise in the horse J. Appl. Physiol. 1998 85 1030 1036 10.1152/jappl.1998.85.3.1030
Bisson J. Younker J. Correcting arterial blood gases for temperature: (When) is it clinically significant? Nurs. Crit. Care 2006 11 232 238 10.1111/j.1478-5153.2006.00177.x 16983854
Linnet K. Necessary sample size for method comparison studies based on regression analysis Clin. Chem. 1999 45 882 894 10.1093/clinchem/45.6.882
