ABSTRACT
The latest version of our Laboratory Information System haematology laboratory expert system that handles the output of Abbott Cell-Dyn Sapphires, CD4000s and a CD3200 full blood count analyser in three high-volume haematology laboratories is described. The three hospital laboratories use Cerner Millennium Version 2007.02 software and the expert system uses Cerner Millennium Discern Expert rules and some small Cerner Command Language in-house programs. The entire expert system is totally integrated with the area-wide database and has been built and maintained by haematology staff members, as has the haematology database. Using patient demographic data, analyser numeric results, analyser error and morphology flags and previous results for the patient, this expert system decides whether to validate the main full blood count indices and white cell differential, or if the analyser results warrant further operator intervention/investigation before verifying, whether a blood film is required for microscopic review and if abnormal results require phoning to the staff treating the patient. The principles of this expert system can be generalized to different haematology analysers and haematology laboratories that have different workflows and different software.
Subject(s)
Blood Cell Count/instrumentation , Clinical Laboratory Information Systems , Expert Systems , Hematologic Tests/instrumentation , Adult , Australia , Child , Child, Preschool , Clinical Laboratory Information Systems/instrumentation , Humans , Infant , Infant, Newborn , Male , SoftwareABSTRACT
This study was designed to assess the accuracy of end-tidal PCO2 and transcutaneous PCO2 as measurements of arterial PCO2 in extubated, spontaneously breathing patients recovering from general anesthesia. In 30 patients, measurement of arterial transcutaneous, and end-tidal PCO2 were taken simultaneously with body temperature approximately every 15 minutes over a 2-hour period. Arterial PCO2 values were corrected for body temperature. Values for PaCO2 were compared with those for PETCO2 and PsCO2 by linear regression analysis and by calculation of bias +/- precision. Thirty-six percent of the capnogram tracings obtained did not develop a plateau phase. We found poor correlation between end-tidal and arterial PCO2 regardless of the shape of the capnogram tracing, as well as poor correlation between transcutaneous and arterial PCO2. Although the measurements of bias and precision of noninvasive PCO2 monitors in this population are comparable to studies in other populations, we advise caution in relying on the routine use of PETCO2 or PsCO2 for the noninvasive assessment of respiratory depression in extubated, spontaneously breathing patients recovering from general anesthesia.
