title: Pushing the limits of chemistry point-of-care testing for the management of patients under investigation for Ebola virus disease.
abstract: BACKGROUND
  With the recent outbreak in West Africa, hospitals worldwide have been developing protocols for suspect of cases of Ebola virus disease. Patients with Ebola virus disease present with a severe gastroenteritis leading to dehydration and electrolyte abnormalities and as such, routine chemistry analysis is essential for patient management. While point-of-care testing can be used with additional precautions for rapid chemistry analyses in a laboratory setting, significant delays could ensue before specimens arrive to the laboratory. This study evaluated the stability of eight chemistry analytes up to 4 h post-collection.
  
  
  METHODS
  Blood was collected by venipuncture from 20 healthy volunteers and tested at times 0, 30, 60, 90, 120 and 240 h. Approximately 100 µl of blood was dispensed into a CHEM 8+Cartridge and processed on a model 300 i-STAT 1 Analyzer (Abbott Point of Care Inc.) and ANOVA was used to assess statistical significant difference from the initial time point.
  
  
  RESULTS
  While the manufacturer recommends testing within 30 min of collection, no significant variation was observed for most analytes with time points extending up to 4 h. In contrast, glucose concentrations decreased significantly (P < 0.0001) over time at an average rate of 0.0032 mmol/L per min.
  
  
  CONCLUSIONS
  This study provides supporting data suggesting that delays up to 4 h can be tolerated, giving ample time for collection and transport of specimens to the clinical laboratory. For glucose, POC testing could still be used, taking into account the collection time and the average rate of decrease.
authors: Department of Pathology and Laboratory Medicine, Novo Scotia Health Authority (NSHA), Halifax, Nova Scotia, Canada Department of Pathology Dalhousie University, Halifax, Nova Scotia, Canada Jason.leblanc@nshealth.ca.
authors: Jason J
authors: JJ
authors: LeBlanc
authors: Department of Pathology and Laboratory Medicine, Novo Scotia Health Authority (NSHA), Halifax, Nova Scotia, Canada.
authors: Charles
authors: C
authors: Heinstein
authors: Department of Pathology and Laboratory Medicine, Novo Scotia Health Authority (NSHA), Halifax, Nova Scotia, Canada.
authors: James
authors: J
authors: MacDonald
authors: Department of Pathology and Laboratory Medicine, Novo Scotia Health Authority (NSHA), Halifax, Nova Scotia, Canada.
authors: Roy
authors: R
authors: Gallant
authors: Department of Pathology and Laboratory Medicine, Novo Scotia Health Authority (NSHA), Halifax, Nova Scotia, Canada.
authors: Catherine
authors: C
authors: Roberts
authors: Department of Pathology and Laboratory Medicine, Novo Scotia Health Authority (NSHA), Halifax, Nova Scotia, Canada.
authors: Colleen
authors: C
authors: Jackson
authors: Department of Pathology and Laboratory Medicine, Novo Scotia Health Authority (NSHA), Halifax, Nova Scotia, Canada Department of Pathology Dalhousie University, Halifax, Nova Scotia, Canada.
authors: Amy
authors: A
authors: Lou
authors: Department of Pathology and Laboratory Medicine, Novo Scotia Health Authority (NSHA), Halifax, Nova Scotia, Canada Department of Pathology Dalhousie University, Halifax, Nova Scotia, Canada.
authors: Bassam A
authors: BA
authors: Nassar
authors: Department of Pathology and Laboratory Medicine, Novo Scotia Health Authority (NSHA), Halifax, Nova Scotia, Canada Department of Pathology Dalhousie University, Halifax, Nova Scotia, Canada.
authors: Todd F
authors: TF
authors: Hatchette
mesh_terms: D019142:Hemorrhagic Fever, Ebola / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D008991:Monitoring, Physiologic; D019095:Point-of-Care Systems
keywords: Electrolytes; point-of-care testing; quality assurance and control