Abstract 210

TOPIC: Performance characteristics of the VIA LVM monitor are presented based on an IRB-approved trial conducted at six neonatal ICUs across the US. The VIA LVM is an automated, low volume, in-line, ex-vivo patient-attached blood gas and chemistry monitor. Opportunities to dramatically impact patient care through use of the VIA are discussed.

BACKGROUND: The number of neonatal transfusion is highly correlated with the number and frequency of blood samples submitted to the laboratory. The VIA system uses a reversible pump with a sensor array attached to a patient's arterial line. After initial two-point calibration, serial one-point calibrations are automatically performed. On demand, 1.5 mls of blood are drawn into the sensor. Values for pH, pCO2, pO2, Na, K, and Hct are reported in 70 seconds. All but 20 µL of blood is returned to the baby along with 0.5 ml of calibration and anticoagulant solution. The sensor may be operated up to every 10 minutes over three days. A VIA stopcock allows the same arterial line to also be used for pressure monitoring, and the infusion of other fluids.

METHODS: Study subjects included neonates with umbilical and peripheral arterial catheters inserted based on clinical indications. When a blood gas/electrolyte/Hct sample was submitted to the lab, a paired sample was analyzed by the VIA. The accuracy and precision of VIA test results were calculated using the statistical method of Bland and Altman.

RESULTS: 684 paired samples were collected from 40 patients, 665 of which were technically acceptable for comparison. Age Range: 28 weeks gestation to 6 mos. Weight range: 1200 to 5300 grams. Data reflects current testing algorithms and constants. (Table) No patient complications linked to the use of the VIA were reported during this study.

Table 1 No caption available
Full size table

CONCLUSIONS: VIA monitor data shows agreement with results from laboratory-based analyzers within limits set by CLIA, thus suggesting that the VIA LVM1 monitor may be used interchangeably with them. Advantages of VIA monitoring versus traditional phlebotomy and laboratory analysis include blood conservation with reduced patient blood loss and transfusion need; near real-time result reporting; automated operation; continuous calibration; frequent monitoring at fixed cost; and substantial reductions in pre-analytic error, blood exposure risks to staff, and infection risks to the patient.

Funded by Child Health Corporation of America and VIA Medical.