title: Clinical performance of an in-line, ex vivo point-of-care monitor: a multicenter study.
abstract: BACKGROUND
  The management of critically ill infants and neonates includes frequent determination of arterial blood gas, electrolyte, and hematocrit values. An objective of attached point-of-care patient monitoring is to provide clinically relevant data without the adverse consequences associated with serial phlebotomy.
  
  
  METHODS
  We prospectively determined the mean difference (and SD of the difference) from laboratory methods of an in-line, ex vivo monitor, the VIA LVM Blood Gas and Chemistry Monitoring System (VIA LVM Monitor; Metracor Technologies, Inc.), in 100 critically ill neonates and infants at seven children's hospitals. In doing so, we examined monitor stability with continuous use. In vivo patient test results from laboratory benchtop analyzers were compared with those from the VIA LVM Monitor on paired samples. In a separate in vitro comparison, benchtop analyzer and monitor test results were compared on whole-blood split samples.
  
  
  RESULTS
  A total of 1414 concurrent, paired-sample measurements were obtained. The mean differences (SD of differences) from laboratory methods and r values for the combined data for the VIA LVM Monitor from the seven sites were 0.001 (0.026) and 0.97 for pH, 0.7 (3.6) mmHg and 0.94 for PCO(2), 4.2 (9.6) mmHg and 0.98 for PO(2), 0.0 (2.9) mmol/L and 0.87 for sodium, 0.1 (0.2) mmol/L and 0.96 for potassium, and 0.3% (2.9%) and 0.90 for hematocrit. Performance results were similar among the study sites with increasing time of monitor use and between in vivo paired-sample and in vitro split-sample test results.
  
  
  CONCLUSIONS
  The VIA LVM Monitor can be used to assess critically ill neonates and infants.
authors.affiliation: Department of Pathology, Children's Hospital of San Diego, San Diego, CA 92123, USA.
authors.forename: Glenn F
authors.initials: GF
authors.lastname: Billman
authors.forename: Amy B
authors.initials: AB
authors.lastname: Hughes
authors.forename: Golde G
authors.initials: GG
authors.lastname: Dudell
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Waldman
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Adcock
authors.forename: Dan M
authors.initials: DM
authors.lastname: Hall
authors.forename: Edmund N
authors.initials: EN
authors.lastname: Orsini
authors.forename: Adolph J
authors.initials: AJ
authors.lastname: Koska
authors.forename: Linda J
authors.initials: LJ
authors.lastname: Van Marter
authors.forename: Neil N
authors.initials: NN
authors.lastname: Finer
authors.forename: Jeff C
authors.initials: JC
authors.lastname: Kulhavy
authors.forename: Ronald D
authors.initials: RD
authors.lastname: Feld
authors.forename: John A
authors.initials: JA
authors.lastname: Widness
mesh_terms: D016638:Critical Illness; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008991:Monitoring, Physiologic / Q000295:instrumentation*; D019095:Point-of-Care Systems; D011446:Prospective Studies; D012494:Sampling Studies