Cobas b221

Manufactured by Roche

Sourced in Germany, Switzerland, United Kingdom, United States

The Cobas b221 is a fully automated blood gas and electrolyte analyzer designed for use in hospitals and clinical laboratories. It measures key parameters such as pH, blood gases, electrolytes, and metabolites from whole blood samples. The Cobas b221 is a compact and user-friendly device that provides accurate and reliable results to support clinical decision-making.

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32 protocols using cobas b221

Hemodynamic and Pulmonary Monitoring

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Hemodynamic and pulmonary parameters were continuously monitored (Philips Healthcare and Hamilton G5 ventilator). Arterial blood gas was sampled at baseline and each PEEP level, as defined in “Lung injury,” to record pH, PaCO₂, PaO₂, and PaO₂/FiO₂ (P/F) ratios (cobas b221, Roche Diagnostics).

Andrews P.L., Sadowitz B., Kollisch-Singule M., Satalin J., Roy S., Snyder K., Gatto L.A., Nieman G.F, & Habashi N.M. (2015). Alveolar instability (atelectrauma) is not identified by arterial oxygenation predisposing the development of an occult ventilator-induced lung injury. Intensive Care Medicine Experimental, 3, 16.

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Bile Duct Cannulation and Sampling

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The common bile duct was cannulated with a 12-French biliary catheter (T-Kehr type, Redax, Italy) during NESLiP. This drainage tube was divided outside the liver and connected to a 50 mL enteral drainage bag (GBUK Group, Selby, United Kingdom), excluding air, connected to a 3-way tap to facilitate frequent sampling. There was a dead space of 1.5 mL in the cannula between the bile duct and the collection bag. Bile and perfusate samples were collected at 45, 60, 90, 120, 150, and 180 min and hourly thereafter.
Bile and perfusate biochemistry was assayed on 1 of 2 point-of-care blood gas analyzers (Cobas b221, Roche Diagnostics, Indianapolis, IN, and Siemens RAPIDpoint 500e, Camberley, United Kingdom). Directly measured parameters included pH, pCO₂, pO₂, hemoglobin oxygen saturation, together with concentrations of sodium, potassium, chloride, calcium, glucose, and lactate. Bicarbonate and hydrogen ions are derived parameters in the analyzers; pH was measured in a range between 6 and 8 on the Roche machine and between 6 and 7.8 on the Siemens machine; values >8 on the Roche machine, or >7.8 on the Siemens machine were read as “high out of range,” but we have recorded them as 8 and 7.8, respectively.

Watson C.J., Gaurav R., Swift L., Fear C., Allison M.E., Upponi S.S., Brais R, & Butler A.J. (2024). Bile Chemistry During Ex Situ Normothermic Liver Perfusion Does Not Always Predict Cholangiopathy. Transplantation, 108(6), 1383-1393.

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Comprehensive Lung Function Assessment in ILD

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At baseline and every follow‐up physical examination was performed, and a detailed medical history was taken with special emphasis on symptoms (dry/productive cough, sputum, chest pain), respiratory infections and comorbidities. Lung function measurements included functional vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/FVC and total lung capacity (TLC) by means of electric spirometer and plethysmography (PDD‐301/s, Piston, Budapest, Hungary) according to the American Thoracic Society and European Respiratory Society guidelines.¹⁶ The highest of three technically acceptable maneuvers was used. Transfer factor of the lung for carbon monoxide (TLCO) was measured with single breath CO method (PDD‐301/s, Piston, Budapest, Hungary) and coefficient (KLCO) calculated. Lung function variables were expressed as percentage of predicted values. Arterialized capillary blood gases, pH and bicarbonate levels were analyzed at rest at room temperature (Cobas b 221, Roche, Budapest, Hungary). Gender‐age‐physiology (GAP) score was calculated for all ILD patients.¹⁷

Barczi E., Nagy T., Starobinski L., Kolonics‐Farkas A., Eszes N., Bohacs A., Tarnoki A.D., Tarnoki D.L, & Müller V. (2020). Impact of interstitial lung disease and simultaneous lung cancer on therapeutic possibilities and survival. Thoracic Cancer, 11(7), 1911-1917.

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Blood Glucose Measurement Techniques

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BG levels were measured using a combination of arterial, venous or capillary samples and tested on the blood gas analyser (Cobas b221; Roche Diagnostics, UK), and the Nova StatStrip (Nova Biomedical, Massachusetts, USA).

Thomson L., Elleri D., Bond S., Howlett J., Dunger D.B, & Beardsall K. (2018). Targeting glucose control in preterm infants: pilot studies of continuous glucose monitoring. Archives of Disease in Childhood. Fetal and Neonatal Edition, 104(4), F353-F359.

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Evaluation of Vital Signs and Biomarkers in Emergency Department

Cited 2 times

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Routine blood samples were collected within 15 minutes of admission, in which creatinine, leukocytes, bilirubin, and platelets were analyzed as previously described (18 (link)). Pao₂ was analyzed in arterial blood on a Roche Cobas b221 instrument (Roche Diagnostics, Indianapolis, IN). Vital parameters (temperature, heart rate, blood pressure, Glasgow Coma Scale, oxygen saturation [Spo₂], and Fio₂) during the first hour of observation in the ED were registered. In addition to SOFA, quick SOFA (qSOFA) (3 (link)), Systemic Inflammatory Response Syndrome criteria, and National Early Warning Score were calculated (19 ). Icteric index was used to estimate bilirubin levels if the latter was missing (20 (link)). If not available, Pao₂ was estimated from Spo₂ and Fio₂ was estimated from any oxygen delivery device using the conversion tables from the Extended Prevalence of Infection in Intensive Care II study (21 (link)). Urine output was not registered. If patients deteriorated in-hospital, vital signs and blood analyses were recorded at the time point of the highest SOFA score. Comorbidities were registered and Charlson Comorbidity Index was calculated (22 (link)). Data were entered into a local database (MedInsight Version 2.17.8.0 [Oslo, Norway]). Date of death was collected from the Norwegian National Population Register.

Christensen E.E., Prebensen C.H., Martinsen A.B., Stiff E.T., Hoff R., Kvale D, & Holten A.R. (2023). Mortality and Sequential Organ Failure Assessment Score in Patients With Suspected Sepsis: The Impact of Acute and Preexisting Organ Failures and Infection Likelihood. Critical Care Explorations, 5(2), e0865.

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Lactate Production in Silenced Cells

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LDHA-silenced Ishikawa cells, THESC cells and their counterpart controls were cultured for 24 h, trypsinized and counted. The lactic acid concentration in the collected medium was determined with a blood gas analyzer (Cobas B 221; Roche Diagnostics). Lactate production is presented as the amount of lactate normalized to cell number.

Zheng J., Dai Y., Lin X., Huang Q., Shi L., Jin X., Liu N., Zhou F, & Zhang S. (2021). Hypoxia-induced lactate dehydrogenase A protects cells from apoptosis in endometriosis. Molecular Medicine Reports, 24(3), 637.

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Hemodynamic and Oxygen Metabolism Monitoring

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Cardiac output (CO), global end-diastolic volume index (GEDI), stroke volume (SV), cardiac function index (CFI), index of left ventricular contractility (dPmax), SV variation (SVV), pulse pressure variation (PPV), heart rate (HR), and mean arterial pressure (MAP) were measured by transpulmonary thermodilution and pulse contour analysis at baseline and at the end of each interval. All hemodynamic parameters were indexed for body surface area or bodyweight. Central venous catheter was used for the injection of cold saline boluses for the thermodilution measurements. The average of three measurements following 10 mL bolus injections of ice-cold 0.9% saline was recorded. Central venous pressure (CVP) was measured via central venous catheter at the same times as the other hemodynamic variables.
For blood gas measurements the right femoral artery served as the site for arterial blood gas sampling and the central venous line was used for taking central venous blood gas samples, which were analyzed by cooximetry (Cobas b 221, Roche Ltd., Basel, Switzerland) simultaneously at baseline and at the end of each step. From these parameters the following variables were calculated:

\begin{matrix} Delivery  of  oxygen ({D O}_{2}) \\ = C I * (H b * 1.34 * {S a O}_{2} + 0.003 * P a O_{2}), \\ Oxygen  consumption ({V O}_{2}) \\ = C I \\ * ({C a O}_{2} - (H b * 1.34 * {S_{c v} O}_{2} + 0.003 * {P_{c v} O}_{2})), \\ Oxygen  extraction = \frac{{V O}_{2}}{{D O}_{2}} . \end{matrix}

Tánczos K., Németh M., Trásy D., László I., Palágyi P., Szabó Z., Varga G, & Kaszaki J. (2015). Goal-Directed Resuscitation Aiming Cardiac Index Masks Residual Hypovolemia: An Animal Experiment. BioMed Research International, 2015, 160979.

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Cellular Metabolic Profiling Assay

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Metabolic activities of cells were monitored from medium samples collected 48 h after plating. Glucose and lactate concentrations were measured using a Cobas b221 blood gas analyzer (Roche Diagnostics, Indianapolis, IN).

Schmelzer E., Over P., Gridelli B, & Gerlach J.C. (2016). Response of Primary Human Bone Marrow Mesenchymal Stromal Cells and Dermal Keratinocytes to Thermal Printer Materials In Vitro. Journal of Medical and Biological Engineering, 36, 153-167.

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Femoral Artery Blood Sampling for ABG

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At the end of each experiment, blood (0.5 mL) was collected from the right femoral artery for blood gas analysis. Care was taken to avoid air bubbles. Arterial blood gas (ABG) levels were immediately measured by using a blood gas analyzer (Cobas b 221; Roche Diagnostics GmbH, D-68298, Mannheim, Germany).

Şen V., Güzel A., Selimoğlu Şen H., Ece A., Uluca Ü., Söker S., Doğan E., Kaplan İ, & Deveci E. (2014). Preventive Effects of Dexmedetomidine on the Liver in a Rat Model of Acid-Induced Acute Lung Injury. BioMed Research International, 2014, 621827.

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Monitoring Vital Signs during Hyperthermic Treatment

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Blood chemistries, complete blood counts, free hemoglobin, CO, and PA wedge pressure (PAWP) were measured at the following time-points: 1) baseline, 2) therapy start, 3) therapy middle (1 hour of 42 °C hyperthermia), 4) therapy end (2 hours of 42 °C hyperthermia), and 5) cool 39 (when 39 °C was achieved). Arterial blood gases and electrolytes were measured every 15 minutes using a blood gas analyzer (Cobas b221, Roche Diagnostics, Indianapolis, IN). Hemodynamics were continuously monitored, and urine output was measured hourly. Continuous intravenous infusion of lactated Ringer’s (744±205 ml/hr) was used to maintain blood volume for stable hemodynamics. Supplemental calcium chloride (100 mg/ml, i.v.) or potassium chloride (10-80 mEq, i.v.) was used as needed to correct hypocalcemia or hypokalemia, respectively. A furosemide bolus (10-50 mg, i.v.) was given if hourly urine output was less than 50 ml.

Ballard-Croft C., Wang D., Rosenstein K., Wang J., Pollock R., Morris J.A, & Zwischenberger J.B. (2014). Venovenous Perfusion-Induced Systemic Hyperthermia: Five Day Sheep Survival Studies. The Journal of thoracic and cardiovascular surgery, 148(5), 2360-2366.

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