Abbott i-STAT 1 System Manual page 412

Notes:
1) Acetylcysteine has been tested at two levels: the CLSI recommended level and a concentration of
0.30 mmol/L. The latter is 3 times the peak plasma therapeutic concentration associated with treatment to
reverse acetaminophen poisoning. APOC has not identified a therapeutic condition that would lead to levels
consistent with the CLSI recommended level. Acetylcysteine at a concentration of 10.2 mmol/L increased
i-STAT chloride results, while an acetylcysteine concentration of 0.30 mmol/L did not significantly interfere
with i-STAT chloride results.
2) Bromide has been tested at two levels: the CLSI recommended level and a therapeutic plasma
concentration level of 2.5 mmol/L. The latter is the peak plasma concentration associated with halothane
anesthesia, in which bromide is released. APOC has not identified a therapeutic condition that would lead
to levels consistent with the CLSI recommended level. Bromide at a concentration of 37.5 mmol/L and
2.5 mmol/L increased i-STAT chloride results.
3) Salicylate has been shown to interfere at a concentration proscribed by the CLSI guideline,
4.34 mmol/L, which represents a toxic concentration. Salicylate at 0.5 mmol/L, which represents the up-
per end of the therapeutic concentration, has been shown not to significantly interfere with i-STAT chloride
results.
4) Nithiodote (sodium thiosulfate) is indicated for the treatment of acute cyanide poisoning. The journal
article titled "Falsely increased chloride and missed anion gap elevation during treatment with sodium
thiosulfate" indicated that sodium thiosulfate could be used in the treatment of calciphylaxis indicating that
"the highest concentration likely to be seen in plasma [is] after infusion of a 12.5 g dose of sodium thio-
sulfate pentahydrate. Assuming that the 12.5 g dose of sodium thiosulfate pentahydrate is distributed in
a typical blood volume of 5 L with a hematocrit of 40%, the peak sodium thiosulfate plasma concentration
expected is 16.7 mmol/L."
15
*It is possible that other interfering substances may be encountered. The degree of interference at concentrations other than those listed might not be
predictable.
CL - 4
Art: 714175-01O Rev. Date: 15-Jul-16