Lactate - Abbott i-STAT 1 System Manual

Dopamine
Formaldehyde
β–Hydroxybutyrate

Lactate

Maltose
Pyruvate
Salicylate
Thiocyanate (therapeutic)
Uric Acid
Notes:
1) Acetaminophen has been shown to interfere with glucose results in the i-STAT 6+, EC8+, EC4+ and
G products, at a concentration prescribed by the CLSI guideline, 1.32 mmol/L, which represents a toxic
concentration of acetaminophen. Acetaminophen at 0.132 mmol/L, which represents the upper end of the
therapeutic concentration, has been shown not to significantly interfere with i-STAT glucose results for all
i-STAT cartridges. Acetaminophen at a test level of 1.32 mmol/L (toxic concentration) has been shown
not to significantly interfere with glucose results in the i-STAT CHEM8+ and CG8+ products.
2) 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
decreased i-STAT glucose results, while acetylcysteine at a concentration of 0.3 mmol/L did not signifi-
cantly interfere with i-STAT glucose results.
3) Bromide has been tested at two levels: the CLSI recommended level and a therapeutic plasma con-
centration 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 tested at concentrations of 2.5 and
37.5 mmol/L decreased i-STAT glucose results.
4) Hydroxyurea is a DNA synthesis inhibitor used in the treatment of various forms of cancer, sickle cell
anemia, and HIV infection. This drug is used to treat malignancies including melanoma, metastatic ovar-
ian cancer, and chronic myelogenous leukemia. It is also used in the treatment of polycythemia vera,
thrombocythemia, and psoriasis. At typical doses ranging from 500 mg to 2 g/day, concentrations of
hydroxyurea in patients' blood may be sustained at approximately 100 to 500 µmol/L. Higher concentra-
tions may be observed soon after dosing or at higher therapeutic doses.
5) The dependence of the i-STAT glucose with respect to pH is as follows: Values below 7.4 at 37°C
decrease results by approximately 0.9 mg/dL (0.05 mmol/L) per 0.1 pH units. Values above 7.4 at 37°C
increase results by approximately 0.8 mg/dL (0.04 mmol/L) per 0.1 pH units.
6) The dependence of the i-STAT glucose with respect to PO
20 mmHg (2.66 kPa) at 37°C may decrease results.
7) 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."
* It is possible that other interfering substance may be encountered. The degree of interference at concentrations other than those listed might not be
predictable.
Glu - 4
14
Art: 714177-01R
0.006
0.133
10
6.0
13
6.6
13.3
0.31
4.34
0.5
15
1.4
is as follows: Oxygen levels of less than
2
Rev. Date: 15-Jul-16