Accuracy and precision of a new, portable, handheld blood gas analyzer, the IRMA®

Objective. The accuracy and precision of the new IRMA® (Immediate Response Mobile Analysis System, Diametrics, Inc.®, St. Paul, MN) handheld blood gas analyzer was compared with that of two benchtop blood gas analyzers. The IRMA consists of a notebook-sized machine and disposable cartridges, each containing a pH, a CO₂ and an O₂ electrode, and provides bedside (point-of-care) blood gas analysis. Methods. A total of 172 samples (arterial and mixed venous) were obtained from 25 informed, consenting patients undergoing cardiopulmonary bypass. The pH, PCO₂ and PO₂ of each sample was determined on four blood gas analyzers: NOVA Statlabs Profile 5 (NOVA Biomedical, Waltham, MA), the ABL-50 (Radiometer, West Lake, OH), and two IRMA machines. Linear regression and bias ± precision were determined, comparing each of the analyzers with the NOVA. Results. All three machines showed a similar, high degree of correlation with the NOVA for pH, PCO₂, and PO₂. The bias and precision of the IRMA machines compared with the NOVA was similar to that of the ABL compared with the NOVA for pH (NOVA:ABL - 0.005 ± 0.011; NOVA: IRMA 1 = 0.0026 ± 0.025; NOVA:IRMA 2 = 0.0021 ± 0.025), for PCO₂ (NOVA:ABL = -1.4 ± 1.3 mmHg; NOVA:IRMA 1 = 1.3 ± 1.9 mmHg; NOVA: IRMA 2 = -1.2 ± 2.1 mmHg) and PO₂ (NOVA:ABL = 3.6 ± 21.1 mmHg; NOVA: IRMA 1 = 3.4 ± 19.9 mmHg; NOVA: IRMA 2 = 6.3 ± 20.9 mmHG). The bias found for pH, PCO₂, and PO₂ was not affected by extremes of temperature (range 25.5-40°C) or hematocrit (range 11-44%) for any machine. Conclusions. The new technology incorporated in the IRMA blood gas analyzer provides results with an accuracy that is similar to that of benchtop analyzers, but with all of the advantages of point-of-care analysis.