1. Tuda G Kemri/Wellcome Trust Research Programvs
Tuda G
Kemri/Wellcome Trust Research Program

2. At the end of the day…..
You should acknowledge the importance of Equipment Evaluation on:
Patient safety
Cost of Test
Volume of sample
TAT
Service contract

3. Why measure Blood Gas ?
Check for severe breathing problems and lung diseases, such as asthma, cystic fibrosis or chronic obstructive pulmonary disease.
See how well treatment for lung diseases is working.
Find out if you need extra oxygen or help with breathing (mechanical ventilation).
Find out if you are receiving the right amount of oxygen when you are using oxygen in the hospital.
Measure the acid-base level in the blood of people who have heart failure, kidney failure, uncontrolled diabetes, sleep disorders, severe infections, or after a drug overdose.

4. Cartridge based technology
Minimal maintenance
Ease of use
Improved sample management to detect clots
Minimal reagent system.
Allows for Interface with the existing Laboratory information system to transmit test results.

5. How does the Cartridge based work?
Potentiometric
pH,Pco2,Na,K,Ca2+
Amperometry
Pco2,Glucose,Lactate
Conductivity
Hematocrit

6. Which is a better Equipment?pH
pC02
LEVEL 2
348
500
GEM 1
7.362
7.337
7.36
5.12
5.226
5.2 2
7.353 ??
7.35
5.41
5.46 3
7.358
7.322
5.43
5.772
5.33 4
7.373
7.346
7.37
5.15
5.369
5.07 5
7.339
5.38
5.356
MEAN
7.3612
7.336
7.356
5.298
5.278 SD CV
LEVEL 3
7.532
7.522
7.54
2.98
2.951
3.12
7.527
7.517
3.06
3.016
7.526
7.515
2.938
7.518
3.04
3.029
7.539
7.53
7.56
2.91
2.847
2.99
7.5302
7.5204
7.544
3.01
2.9562
3.094

7. How does the pH compare with the Gold standard?
Premier 3000
Rapid point 500

8. How does the Pco2 Compare with the Gold standard?
Premier 3000
Rapid point 500

9. How similar is Rapid point 500 from 348 Rapid lab for pH?
Premier 3000
Gold standard
New method
A+B
A+B/2
(A+B/2)/Gold std
% Similarity
6.219
6.8
13.019
6.5095
6.973
6.95
13.923
6.9615
6.745
13.545
6.7725
7.129
7.11
14.239
7.1195
6.229
13.029
6.5145
6.733
6.84
13.573
6.7865
7.121
7.1
14.221
7.1105
6.981
6.97
13.951
6.9755
6.949
6.91
13.859
6.9295
6.636
13.436
6.718
6.894
13.734
6.867
6.979
13.929
6.9645
6.844
13.644
6.822
7.363
7.35
14.713
7.3565
7.15
14.26
7.13
6.963
6.94
13.903
6.9515
7.284
7.28
14.564
7.282
7.18
7.17
14.35
7.175
7.02
6.99
14.01
7.005
7.33
7.32
14.65
7.325
7.293
14.573
7.2865
7.046
14.066
7.033
GOLD standard
New Method
A+B
A+B/2
(A+B/2)/Gold std
% Similarity
7.129
7.103
14.232
7.116
7.121
7.11
14.231
7.1155
6.981
6.944
13.925
6.9625
6.949
6.914
13.863
6.9315
6.979
6.912
13.891
6.9455
7.363
7.348
14.711
7.3555
7.15
7.123
14.273
7.1365
6.963
6.925
13.888
7.284
7.278
14.562
7.281
7.18
7.165
14.345
7.1725
7.02
14.001
7.0005
7.293
7.274
14.567
7.2835

10. How different are the two machines?
Attribute
IINSTRUMENTATION Laboratory ( GEM PREMIER 3000)
SIEMENS HEALTHCARE (RAPIDPOINT 500)
No of disposable reagent system units in standard package 1
1 measurement and 1 wash-waste cartridge; I AQC Cartridge
Reagent unit storage requirements
Room Temperature
measurement and AQC Cartridge refrigeration, wash/waste cartridge; room temperature 9 months
Calibration frequency
automated continuous with iQM
One point ;30 mins; two point 2 hours
Internal QC program recommended
Internal ,automated, continuous quality management
1 AQC cartridge; fully user programmable
Sample size for complete panel of analyte results
135 – 150uL
100uL
Time from sample introduction to result availability
85 seconds
Approx. 60 seconds
Optimal throughput when analyzer calibrated ,awaiting specimens
20 samples per hour
25 samples per hour
No of samples analyzed per one disposable reagent, electrode system
35,75,150,300,450,and 600 test cartridge
100(coming soon),250,400,750 samples
Time required for maintenance by lab personnel
None (disposable cartridge)
Monthly;1-minute cartridge replacement
Service center performs diagnostics through modem
No (but can through VPN)
Yes ,via internet connection and Siemens remote service
Analyzer connections
GEMweb,GEMWeb Plus, Impact for critical care
Directly to LIS/HIS, data management system, which connects to LIS/HIS
Internet standards supported
ASTM protocol
LIS3
Hardware and software for data management system
Impact for critical care
Rapidcomm data management

11. Comparison of Cost per Test.
348 RAPIDLAB
RAPIDLAB 500 (310 TEST)
Cost items
Replacement Period
Total cost
No of patients tests
Cost per Test (ksh)
QC Level 1,2 and 3
30 days
300
191.84
348 Buffer pack
3 months
900
61.11
348 Wash and CD Pack
35.39
348 sodium electrode
6 months
80,615.83
1800
44.78
348 Potassium electrode
62,517.60
34.73
348 PCO2 electrode
114,199.68
63.44
348 PO2 electrode
78,089.39
43.38
348 chloride electrode
65,947.98
36.63
348 pH sensor
56,908.00
31.61
348 Ref sensor
42.67
Gas Cartridge
49.01
Consumables/tubing
217008
120.56
16% VAT
77.44
TOTAL
832.59
Cost items
Replacement Period
Total cost
No of patients tests
Cost per Test (ksh)
Measurement Cartridge
28 days
110000
310
354.83
Wash/Waste Cartridge
30 days
39600
127.74
AQC Cartridge
35552
114.68
16% VAT
95.92
TOTAL
693.17

12. Which machine would you procure?
Rapid point 500
Premier 3000
Cost items
Replacement Period
Total cost
No of patients tests
Cost per Test (ksh)
Measurement Cartridge
28 days
32480
160
203
Wash/Waste Cartridge
30 days
39600
247.5
AQC Cartridge
35552
222.2
16% VAT
176.88
TOTAL
849.58
Cost items
Part No
Replacement Period
Total cost
No of patients tests
Cost per Test (ksh)
GEM CVP MULTIPAK 21
18,792
296
63.48
Printer Paper GEM 3000
5508
6032
20.34
GEM 3K BG/HCT 300 TESTS IQM CARTRIDGE
70760
239.05
TOTAL
322.87

13. Conclusion
It is not advisable to accept on faith a new product, be it a piece of equipment, new reagent, a diagnostic kit or device unless a comprehensive technical audit on the new equipment is performed prior to use.
Both machines are attractive alternative to the traditional bench top analyzers for use in the laboratory and point care setting however Siemens 348 is still superior in Linearity test.
The main determining factor considered on the choice of the most suitable Blood gas analyzer was the cost of reagents.