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Laboratory interpretative comments and guidance: clinical and operative outcomes on moderate to severe hyponatraemia patient management
  1. Blanca Montero-San-Martín1,
  2. Paloma Oliver1,
  3. Pilar Fernandez-Calle1,
  4. Juan J Sánchez-Pascuala Callau1,
  5. Mariana Díaz Almirón2,
  6. María J Alcaide Martín1,
  7. Belen Fernández-Puntero1,
  8. Marta Duque Alcorta1,
  9. José M Valero Recio3,
  10. Alejandro Martín Quirós3,
  11. María de Ceano-Vivas la Calle4,
  12. Julia Martín Sánchez4,
  13. Begoña Rivas Becerra5,
  14. Cristina Vega Cabrera5,
  15. Marta Melgosa Hijosa6,
  16. Antonio Buno Soto1
  1. 1Department of Laboratory Medicine, La Paz University Hospital, Madrid, Spain
  2. 2Department of Biostatistics, La Paz University Hospital, Madrid, Spain
  3. 3Department of Adult Emergency, La Paz University Hospital, Madrid, Spain
  4. 4Department of Pediatric Emergency, La Paz University Hospital, Madrid, Spain
  5. 5Department of Nephrology, La Paz University Hospital, Madrid, Spain
  6. 6Department of Pediatric Nephrology, La Paz University Hospital, Madrid, Spain
  1. Correspondence to Dr Paloma Oliver, Laboratory Medicine, La Paz University Hospital, Madrid 28046, Spain; palomam.oliver{at}salud.madrid.org

Abstract

Aims Hyponatraemia is the most common body fluid disorders but often goes unnoticed. Our laboratory incorporated a standardised procedure to help clinicians detect moderate/severe hyponatraemia. The study aims were to evaluate the outcomes on patient care and clinicians’ satisfaction.

Methods The study, observational and retrospective, included 1839 cases, adult and paediatric patients, with sodium concentration <130 mmol/L. The procedure consisted of interpretative comments in the emergency and core laboratories report and the point-of-care testing blood gas network report. We evaluated hyponatraemia length in two equal periods: before and after the implementation. We conducted a survey addressed to the staff of the clinical settings involved to know their satisfaction.

Results The median hyponatraemia length decreased significantly from 4.95 hours (2.08–16.57) in the first period to 2.17 hours (1.06–5.39) in the second period. The lack of hyponatraemia patients follow-up was significantly less after the procedure implementation. The survey was answered by 92 (60 senior specialists and 32 residents) out of 110 clinicians surveyed. Ninety of them (98%) answered positively.

Conclusions We have demonstrated the reduction in the time for diagnosing and management by physicians, the higher uniformity in the time required to solve hyponatraemia episodes following our laboratory procedure and the clinicians’ satisfaction.

  • automation
  • biochemistry
  • electrolytes
  • point-of-care testing
  • quality assurance
  • healthcare

Data availability statement

All data relevant to the study are included in the article. We collected study data from the laboratory information system of our hospital.

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Data availability statement

All data relevant to the study are included in the article. We collected study data from the laboratory information system of our hospital.

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Footnotes

  • Handling editor Tahir S Pillay.

  • Contributors BM-S-M, PO, PF-C and JJS-PC conceived of the presented idea, developed the theory, performed the computations, assessed the results and wrote the manuscript. MDA has done the biostatistics analysis. MJAM, BF-P, MDA, JMVR, AMQ, MdC-VlC, JMS, BRB, CVC and MMH reviewed the research and manuscript. ABS supervised the project and reviewed the research and manuscript. All authors discussed the results and commented on the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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