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  THE BVA-100: frequently asked questions

 
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Frequently asked questions about
the BVA-100:

What are the advantages of the BVA-100?

Blood volumes are easy to perform.

The most accurate blood volume determinations available.

The most rapidly obtained blood volume.

Elimination of all the complex steps of preparing and precisely matching standards and injectates.

Provision of accurate norms, based on the standards of Feldschuh and Enson.

Can I repeat a blood volume on a patient, and if so, how long must I wait?

Yes. A patient may have a repeat blood volume as soon after a previous blood v olume as desired. The procedure is repeated exactly as the first, including obtaining a control and injecting a new dosage of tracer. The BVA software evaluates and establishes a new control with higher radioactivity.

What about upgrades to the BVA-100 system?

As part of its commitment to providing the most sophisticated, easy to use software, Daxor is constantly developing upgrades to its software. Whenever upgrades for blood volume measurements become available, they will be provided at no additional charge to purchasers of the BVA-100 blood volume analysis system.

Can the BVA-100 be interfaced with a Laboratory Information System?

The hardware and software for bi-directional interfaces are currently under development. When completed, these upgrades will be provided to users of the BVA-100.

How much radiation does the patient receive?

An extremely small amount (10-25 microcuries) of HSA-I 131 is required for this procedure. The whole body exposure to the patient is less than 1/2 of a typical chest x-ray, or less than what the exposure would be on a flight New York to Boston.

Is this procedure safe for children or pregnant women?

Since I-131 is excreted in human milk during lactation, formula feedings should be substituted for breast feedings. Safety and effectiveness in children have not been established.

Has there been any reported allergic or other reaction?

No reaction of any kind has been observed with HSA I-131 from blood volume studies. The two components are human albumin, a natural human protein, and iodine. Despite hearing that people are allergic to iodine, this simply isn't the case. Everyone needs and uses iodine in their thyroid gland. People with these "allergies" to iodine have had blood volumes performed without any reaction. The dosage of HSA I-131 for blood volume measurement is extremely small in comparison to other tests which utilize iodine.

Why are multiple samples required to perform an accurate blood volume measurement?

In order to produce a straight line, a minimum of three (3) points must be obtained. A fourth (4th) point is required for the event that one point is erroneous. A fifth (5) point affords a high degree of security of achieving optimal accuracy. Under special circumstances, such as in an emergent situation, 1 or 2 points can be employed to obtain a preliminary blood volume. The remaining points must still be obtained to assure the validity of the initial preliminary measurement.

How often do you collect the samples?

The recommended collection times are every five to six minutes, after an initial waiting period of 10 to 12 minutes. Other time intervals are also acceptable.

What if an error occurs or I can't collect all the samples?

The BVA-100 system was designed with redundancies. If one of the blood collections cannot be performed, the BVA-100 can accommodate a smaller number of collection points. One simply has to change the protocol to the actual number of collections obtained and the BVA does the rest. In the case of errors, such as those from poor or improper pipetting, or in any case where the sample result is out of range, the BVA-100 drops the erroneous result and calculates the blood volume with the remaining acceptable blood collections.

How much blood is required to obtain a blood volume?

A blood volume will require between 30 and 40 ml (about 1 ounce) of blood, utilizing 5 ml collection tubes. Under special circumstances, even smaller quantities of blood can be utilized. Such circumstances may occur when multiple blood volumes are anticipated, or a blood volume is being obtained on a small child. In this case, a single sample per collection can be obtained. In these instances, the utmost care must be exerted in correctly pipetting each sample.

What special waste disposal needs are there?

It depends on the policies of each individual institution, though the residual radioactivity is so l ow that it is not detectable from normal background radiation using standard detectors at their highest settings. For all practical purposes, disposal may be carried out as with normal medical waste.

What are the advantages of I-131 as compared to I-125 ?

I-131 has several strong advantages over I-125: (1) A much shorter half-life (8.08 versus 60 days). (2) Superior signal intensity due to larger gamma peak, and hence less interference. (The higher gamma emissions of I-131 are, for the most part, mitigated by the extremely small dosage being employed.

Is blood volume determination a reimbursable test?

Yes. Blood Volume Analysis has been available for over 50 years. As a consequence, billing codes have been available since their inception. The reason blood volumes were so rarely performed was because of the prolonged turnaround time (as much as 4-10 hours) and intensive labor requirements.

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