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Shapiro KE, Buhimschi IA, Fleisher J. Accuracy of anemia screening by point-of-care hemoglobin testing in patients seeking abortion. Contraception 2021; 105:51-54. [PMID: 34517000 DOI: 10.1016/j.contraception.2021.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 08/27/2021] [Accepted: 09/01/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Accurate and timely diagnosis of anemia in pregnancy is necessary for safe management of abortion care. Screening for anemia in abortion care is often accomplished using commercially-available point-of-care tests from capillary blood, but the validity of this test has not been investigated in the context of abortion care. We sought to determine the accuracy of a capillary hemoglobin (Hb) among pregnant patients seeking induced abortion. STUDY DESIGN We conducted a retrospective study of patients seeking abortion care at the University of Illinois at Chicago. We identified 108 subjects with paired capillary Hb and venous complete blood count (CBC) hemoglobin measurements within 7 days of each other and within 14 days before abortion. Agreement analysis was performed using Passing-Bablok regression and Bland-Altman plots. RESULTS More patients were deemed anemic by capillary than by venous Hb measurement (32% vs 19%, p = 0.030). Capillary Hb correlated with venous Hb (r = 0.85, p < 0.001). The average bias for capillary Hb was -1.1 ± 1.0 g/dL. Step-wise, multivariable linear regression identified venous Hb as the only determinant of capillary Hb, and failed to identify any other predictors of bias. The agreement analysis between capillary and venous Hb by Passing-Bablok regression demonstrated systematic and proportional differences. CONCLUSION Results from capillary Hb may be biased toward diagnosing anemia and should be interpreted with caution. IMPLICATIONS Misdiagnosing anemia in abortion care can have several consequences and may prevent timely medical abortion or cause delayed procedural abortion. Clinical correlation, and possibly confirmation by venous complete blood count measurement, should be considered before clinical decision-making based solely upon the capillary point-of-care assay.
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Affiliation(s)
- Katherine E Shapiro
- Department of Obstetrics & Gynecology, University of Illinois at Chicago College of Medicine, Chicago, IL 60612, United States
| | - Irina A Buhimschi
- Department of Obstetrics & Gynecology, University of Illinois at Chicago College of Medicine, Chicago, IL 60612, United States
| | - Jonah Fleisher
- Department of Obstetrics & Gynecology, University of Illinois at Chicago College of Medicine, Chicago, IL 60612, United States.
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Red Blood Cell Transfusion in the Emergency Department: An Observational Cross-Sectional Multicenter Study. J Clin Med 2021; 10:jcm10112475. [PMID: 34199655 PMCID: PMC8199757 DOI: 10.3390/jcm10112475] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 05/29/2021] [Accepted: 05/31/2021] [Indexed: 11/17/2022] Open
Abstract
Background: We aimed to describe red blood cell (RBC) transfusions in the emergency department (ED) with a particular focus on the hemoglobin (Hb) level thresholds that are used in this setting. Methods: This was a cross-sectional study of 12 EDs including all adult patients that received RBC transfusion in January and February 2018. Descriptive statistics were reported. Logistic regression was performed to assess variables that were independently associated with a pre-transfusion Hb level ≥ 8 g/dL. Results: During the study period, 529 patients received RBC transfusion. The median age was 74 (59–85) years. The patients had a history of cancer or hematological disease in 185 (35.2%) cases. Acute bleeding was observed in the ED for 242 (44.7%) patients, among which 145 (59.9%) were gastrointestinal. Anemia was chronic in 191 (40.2%) cases, mostly due to vitamin or iron deficiency or to malignancy with transfusion support. Pre-transfusion Hb level was 6.9 (6.0–7.8) g/dL. The transfusion motive was not notified in the medical chart in 206 (38.9%) cases. In the multivariable logistic regression, variables that were associated with a higher pre-transfusion Hb level (≥8 g/dL) were a history of coronary artery disease (OR: 2.09; 95% CI: 1.29–3.41), the presence of acute bleeding (OR: 2.44; 95% CI: 1.53–3.94), and older age (OR: 1.02/year; 95% CI: 1.01–1.04). Conclusion: RBC transfusion in the ED was an everyday concern and involved patients with heterogeneous medical situations and severity. Pre-transfusion Hb level was rather restrictive. Almost half of transfusions were provided because of acute bleeding which was associated with a higher Hb threshold.
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Salmond B, Farina Z, von Rahden R, Rodseth R. Comparison of point-of-care device DiaSpect against the HemoCue and laboratory analyser in an ICU population. SOUTHERN AFRICAN JOURNAL OF ANAESTHESIA AND ANALGESIA 2021. [DOI: 10.36303/sajaa.2021.27.2.2379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Multicenter comparison of three intraoperative hemoglobin trend monitoring methods. J Clin Monit Comput 2019; 34:883-892. [PMID: 31797199 PMCID: PMC7447626 DOI: 10.1007/s10877-019-00428-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 11/20/2019] [Indexed: 01/28/2023]
Abstract
Transfusion decisions are guided by clinical factors and measured hemoglobin (Hb). Time required for blood sampling and analysis may cause Hb measurement to lag clinical conditions, thus continuous intraoperative Hb trend monitoring may provide useful information. This multicenter study was designed to compare three methods of determining intraoperative Hb changes (trend accuracy) to laboratory determined Hb changes. Adult surgical patients with planned arterial catheterization were studied. With each blood gas analysis performed, pulse cooximetry hemoglobin (SpHb) was recorded, and arterial blood Hb was measured by hematology (tHb), arterial blood gas cooximetry (ABGHb), and point of care (aHQHb) analyzers. Hb change was calculated and trend accuracy assessed by modified Bland–Altman analysis. Secondary measures included Hb measurement change direction agreement. Trend accuracy mean bias (95% limits of agreement; g/dl) for SpHb was 0.10 (− 1.14 to 1.35); for ABGHb was − 0.02 (− 1.06 to 1.02); and for aHQHb was 0.003 (− 0.95 to 0.95). Changes more than ± 0.5 g/dl agreed with tHb changes more than ± 0.25 g/dl in 94.2% (88.9–97.0%) SpHb changes, 98.9% (96.1–99.7%) ABGHb changes and 99.0% (96.4–99.7%) aHQHb changes. Sequential changes in SpHb, ABGHb and aHQHb exceeding ± 0.5 g/dl have similar agreement to the direction but not necessarily the magnitude of sequential tHb change. While Hb blood tests should continue to be used to inform transfusion decisions, intraoperative continuous noninvasive SpHb decreases more than − 0.5 g/dl could be a good indicator of the need to measure tHb.
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Whitehead RD, Mei Z, Mapango C, Jefferds MED. Methods and analyzers for hemoglobin measurement in clinical laboratories and field settings. Ann N Y Acad Sci 2019; 1450:147-171. [PMID: 31162693 DOI: 10.1111/nyas.14124] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 04/22/2019] [Accepted: 05/02/2019] [Indexed: 01/17/2023]
Abstract
This paper describes and compares methods and analyzers used to measure hemoglobin (Hb) in clinical laboratories and field settings. We conducted a literature review for methods used to measure Hb in clinical laboratories and field settings. We described methods to measure Hb and factors influencing results. Automated hematology analyzer (AHA) was reference for all Hb comparisons using evaluation criteria of ±7% set by College of American Pathologists (CAP) and Clinical Laboratory Improvement Amendments (CLIA). Capillary fingerprick blood usually produces higher Hb concentrations compared with venous blood. Individual drops produced lower concentrations than pooled capillary blood. Compared with the AHA: (1) overall cyanmethemoglobin (1.0-8.0 g/L), WHO Colour Scale (0.5-10.0 g/L), paper-based devices (5.0-7.0 g/L), HemoCue® Hb-201 (1.0-16.0 g/L) and Hb-301 (0.5-6.0 g/L), and Masimo Pronto® (0.3-14.0 g/L) overestimated concentrations; (2) Masimo Radical®-7 both under- and overestimated concentrations (0.3-104.0 g/L); and (3) other methods underestimated concentrations (2.0-16.0 g/L). Most mean concentration comparisons varied less than ±7% of the reference. Hb measurements are influenced by several analytical factors. With few exceptions, mean concentration bias was within ±7%, suggesting acceptable performance. Appropriate, high-quality methods in all settings are necessary to ensure the accuracy of Hb measurements.This paper describes and compares methods and analyzers used to measure hemoglobin (Hb) in clinical laboratories and field settings. With few exceptions, mean concentration bias was within ±7%, suggesting acceptable performance. Appropriate, high-quality methods in all settings are necessary to ensure the accuracy of Hb measurements.
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Affiliation(s)
- Ralph D Whitehead
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Zuguo Mei
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Carine Mapango
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Maria Elena D Jefferds
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
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Toppo M, Pal DK, Gour D, Melwani V, Dubey M, Mishra A. Comparison of Performance of Digital Hemoglobinometer over Automated Hematology Analyzer for Hemoglobin Estimation and Its user-friendliness among the Pregnant Women in Selected District Hospitals of Madhya Pradesh. Indian J Community Med 2019; 44:31-34. [PMID: 30983710 PMCID: PMC6437795 DOI: 10.4103/ijcm.ijcm_216_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Context: There is a need for a simple screening method for the detection of anemia that can be used by public health workers in the field. Aims: The aim of this study was to compare two methods for hemoglobin estimation, i.e., automated hematology analyzer and Digital Hemoglobinometer, and to find out the sensitivity and specificity of Digital Hemoglobinometer for the estimation of hemoglobin. Subjects and Methods: A hospital-based cross-sectional study was carried out for 6 months from April to September 2017 in a District Hospital of five High Priority Districts of Madhya Pradesh. Two hundred and sixty antenatal females per district were selected for the study. Results: The mean hemoglobin by autoanalyzer is 10.19, and that by Digital Hemoglobinometer device is 9.89. Overall, sensitivity of Digital Hemoglobinometer for hemoglobin estimation was calculated to be 89.4% and specificity was calculated to be 63.6%. Positive predictive value was found to be 82.6% and negative predictive value was 75.8% compared against AutoAnalyser (gold standard). Conclusions: As the Digital Hemoglobinometer device has high sensitivity and specificity and good diagnostic accuracy, it must be used at the community level in resource-poor setting for hemoglobin estimation. In primary health-care conditions, Digital Hemoglobinometer can significantly reduce misdiagnosis of anemia compared with clinical assessment alone.
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Affiliation(s)
- Manju Toppo
- Department of Community Medicine, Gandhi Medical College, Bhopal, Madhya Pradesh, India
| | - Dinesh Kumar Pal
- Department of Community Medicine, Gandhi Medical College, Bhopal, Madhya Pradesh, India
| | - Devendra Gour
- Department of Community Medicine, Gandhi Medical College, Bhopal, Madhya Pradesh, India
| | - Veena Melwani
- Department of Community Medicine, Gandhi Medical College, Bhopal, Madhya Pradesh, India
| | - Manju Dubey
- Department of Community Medicine, AIIMS, Raipur, Chhattisgarh, India
| | - Archana Mishra
- Maternal and Child Health, NHM, Government of MP, Madhya Pradesh, India
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Dainton C, Shah N, Chu CH. Prevalence of Portable Point of Care Tests Used on Medical Service Trips in Latin America and the Caribbean. Ann Glob Health 2018. [PMID: 30779524 PMCID: PMC6748262 DOI: 10.29024/aogh.2385] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: Short-term, primary care medical service trips (MSTs) frequently use inexpensive, portable point of care (POC) tests to guide diagnosis and treatment of patients in low-resource settings. However, the degree to which different POC tests are carried by organizations serving remote communities is currently unknown. Objective: The aim of this study was to determine the prevalence of various POC tests used by MST-sending organizations operating in Latin America. Methods: We surveyed 166 organizations operating mobile MSTs in Latin America and the Caribbean on the types of POC tests carried on their brigades. Findings: Forty-eight organizations responded (response rate: 28.9%). The most commonly carried tests were glucometers (40/48; 83.3%), urine dipsticks (31/48; 77.1%), and urine pregnancy tests (32/48; 66.7%). Fewer groups carried hemoglobinometers (16/48; 33.3%), malaria diagnostic tests (18/48; 37.5%), tests for sexually transmitted infection (8/48; 16.7%), or portable ultrasound (19/48; 40.0%). Conclusions: These tests may be useful for field diagnosis, but clinicians should understand the performance limitations of each test compared to its gold standard. When combined with knowledge of local epidemiology, these exploratory results will be useful in resource planning, guidelines development for MSTs, and in establishing minimum recommendations for diagnostic resources that should be available on MSTs.
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Affiliation(s)
- Christopher Dainton
- McMaster University.,Grand River Hospital, Kitchener.,Medical Service Trip.com, CA
| | - Nikki Shah
- McMaster University School of Medicine, CA
| | - Charlene H Chu
- Toronto Rehabilitation Institute, University Health Network, CA
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8
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Dainton C, Shah N, Chu CH. Prevalence of Portable Point of Care Tests Used on Medical Service Trips in Latin America and the Caribbean. Ann Glob Health 2018; 84:736-742. [PMID: 30779524 PMCID: PMC6748262 DOI: 10.9204/aogh.2385] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023] Open
Abstract
BACKGROUND Short-term, primary care medical service trips (MSTs) frequently use inexpensive, portable point of care (POC) tests to guide diagnosis and treatment of patients in low-resource settings. However, the degree to which different POC tests are carried by organizations serving remote communities is currently unknown. OBJECTIVE The aim of this study was to determine the prevalence of various POC tests used by MST-sending organizations operating in Latin America. METHODS We surveyed 166 organizations operating mobile MSTs in Latin America and the Caribbean on the types of POC tests carried on their brigades. FINDINGS Forty-eight organizations responded (response rate: 28.9%). The most commonly carried tests were glucometers (40/48; 83.3%), urine dipsticks (31/48; 77.1%), and urine pregnancy tests (32/48; 66.7%). Fewer groups carried hemoglobinometers (16/48; 33.3%), malaria diagnostic tests (18/48; 37.5%), tests for sexually transmitted infection (8/48; 16.7%), or portable ultrasound (19/48; 40.0%). CONCLUSIONS These tests may be useful for field diagnosis, but clinicians should understand the performance limitations of each test compared to its gold standard. When combined with knowledge of local epidemiology, these exploratory results will be useful in resource planning, guidelines development for MSTs, and in establishing minimum recommendations for diagnostic resources that should be available on MSTs.
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Affiliation(s)
- Christopher Dainton
- McMaster University, CA
- Grand River Hospital, Kitchener, CA
- Medical Service Trip.com, CA
| | - Nikki Shah
- McMaster University School of Medicine, CA
| | - Charlene H. Chu
- Toronto Rehabilitation Institute-University Health Network, CA
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Burtman DT, Stolze A, genaamd Dengler SEK, Vonk AB, Boer C. Minimally Invasive Determinations of Oxygen Delivery and Consumption in Cardiac Surgery: An Observational Study. J Cardiothorac Vasc Anesth 2018; 32:1266-1272. [DOI: 10.1053/j.jvca.2017.06.042] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Indexed: 11/11/2022]
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Bansal PG, Toteja GS, Bhatia N, Gupta S, Kaur M, Adhikari T, Garg AK. Comparison of haemoglobin estimates using direct & indirect cyanmethaemoglobin methods. Indian J Med Res 2017; 144:566-571. [PMID: 28256465 PMCID: PMC5345303 DOI: 10.4103/0971-5916.200882] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Background & objectives: Estimation of haemoglobin is the most widely used method to assess anaemia. Although direct cyanmethaemoglobin method is the recommended method for estimation of haemoglobin, but it may not be feasible under field conditions. Hence, the present study was undertaken to compare indirect cyanmethaemoglobin method against the conventional direct method for haemoglobin estimation. Methods: Haemoglobin levels were estimated for 888 adolescent girls aged 11-18 yr residing in an urban slum in Delhi by both direct and indirect cyanmethaemoglobin methods, and the results were compared. Results: The mean haemoglobin levels for 888 whole blood samples estimated by direct and indirect cyanmethaemoglobin method were 116.1 ± 12.7 and 110.5 ± 12.5 g/l, respectively, with a mean difference of 5.67 g/l (95% confidence interval: 5.45 to 5.90, P<0.001); which is equivalent to 0.567 g%. The prevalence of anaemia was reported as 59.6 and 78.2 per cent by direct and indirect methods, respectively. Sensitivity and specificity of indirect cyanmethaemoglobin method were 99.2 and 56.4 per cent, respectively. Using regression analysis, prediction equation was developed for indirect haemoglobin values. Interpretation & conclusions: The present findings revealed that indirect cyanmethaemoglobin method overestimated the prevalence of anaemia as compared to the direct method. However, if a correction factor is applied, indirect method could be successfully used for estimating true haemoglobin level. More studies should be undertaken to establish agreement and correction factor between direct and indirect cyanmethaemoglobin methods.
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Affiliation(s)
- Priyanka Gupta Bansal
- Centre for Promotion of Nutrition Research & Training with Special Focus on North-East, Tribal & Inaccessible Population (Indian Council of Medical Research), New Delhi, India
| | - Gurudayal Singh Toteja
- Centre for Promotion of Nutrition Research & Training with Special Focus on North-East, Tribal & Inaccessible Population (Indian Council of Medical Research), New Delhi, India
| | - Neena Bhatia
- Department of Food & Nutrition, Lady Irwin College, University of Delhi, New Delhi, India
| | - Sanjeev Gupta
- Department of Environmental Studies, National Institute of Occupational Health, Ahmedabad, India
| | - Manpreet Kaur
- Centre for Promotion of Nutrition Research & Training with Special Focus on North-East, Tribal & Inaccessible Population (Indian Council of Medical Research), New Delhi, India
| | - Tulsi Adhikari
- National Institute of Medical Statistics, New Delhi, India
| | - Ashok Kumar Garg
- Technical Division, National Accreditation Board for Testing & Calibration Laboratories, New Delhi, India
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García-Soler P, Camacho Alonso JM, González-Gómez JM, Milano-Manso G. Noninvasive hemoglobin monitoring in critically ill pediatric patients at risk of bleeding. Med Intensiva 2016; 41:209-215. [PMID: 28034464 DOI: 10.1016/j.medin.2016.06.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 05/10/2016] [Accepted: 06/28/2016] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To determine the accuracy and usefulness of noninvasive continuous hemoglobin (Hb) monitoring in critically ill patients at risk of bleeding. DESIGN An observational prospective study was made, comparing core laboratory Hb measurement (LabHb) as the gold standard versus transcutaneous hemoglobin monitoring (SpHb). SETTING Pediatric Intensive Care Unit of a tertiary University Hospital. PATIENTS Patients weighing >3kg at risk of bleeding. INTERVENTIONS SpHb was measured using the Radical7 pulse co-oximeter (Masimo Corp., Irvine, CA, USA) each time a blood sample was drawn for core laboratory analysis (Siemens ADVIA 2120i). VARIABLES Sociodemographic characteristics, perfusion index (PI), pleth variability index, heart rate, SaO2, rectal temperature, low signal quality and other events that can interfere with measurement. RESULTS A total of 284 measurements were made (80 patients). Mean LabHb was 11.7±2.05g/dl. Mean SpHb was 12.32±2g/dl (Pearson 0.72, R2 0.52). The intra-class correlation coefficient was 0.69 (95%CI 0.55-0.78)(p<0.001). Bland-Altman analysis showed a mean difference of 0.07 ±1.46g/dl. A lower PI and higher temperature independently increased the risk of low signal quality (OR 0.531 [95%CI 0.32-0.88] and 0.529 [95%CI 0.33-0.85], respectively). CONCLUSIONS SpHb shows a good overall correlation to LabHb, though with wide limits of agreement. Its main advantage is continuous monitoring of patients at risk of bleeding. The reliability of the method is limited in cases with poor peripheral perfusion.
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Affiliation(s)
- P García-Soler
- Unidad de Cuidados Intensivos Pediátricos, Hospital Regional Universitario, Málaga, España.
| | - J M Camacho Alonso
- Unidad de Cuidados Intensivos Pediátricos, Hospital Regional Universitario, Málaga, España
| | - J M González-Gómez
- Unidad de Cuidados Intensivos Pediátricos, Hospital Regional Universitario, Málaga, España
| | - G Milano-Manso
- Unidad de Cuidados Intensivos Pediátricos, Hospital Regional Universitario, Málaga, España
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Zatloukal J, Pouska J, Kletecka J, Pradl R, Benes J. Comparison of the accuracy of hemoglobin point of care testing using HemoCue and GEM Premier 3000 with automated hematology analyzer in emergency room. J Clin Monit Comput 2016; 30:949-956. [PMID: 26507548 DOI: 10.1007/s10877-015-9799-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 10/22/2015] [Indexed: 11/30/2022]
Abstract
The laboratory analysis provides accurate, but time consuming hemoglobin level estimation especially in the emergency setting. The reliability of time-sparing point of care devices (POCT) remains uncertain. We tested two POCT devices accuracy (HemoCue®201+ and Gem®Premier™3000) in routine emergency department workflow. Blood samples taken from patients admitted to the emergency department were analyzed for hemoglobin concentration using a laboratory reference Beckman Coulter LH 750 (HBLAB), the HemoCue (HBHC) and the Gem Premier 3000 (HBGEM). Pairwise comparison for each device and HbLAB was performed using correlation and the Bland-Altman methods. The reliability of transfusion decision was assessed using three-zone error grid. A total of 292 measurements were performed in 99 patients. Mean hemoglobin level were 115 ± 33, 110 ± 28 and 111 ± 30 g/l for HbHC, HbGEM and HbLAB respectively. A significant correlation was observed for both devices: HbHC versus HbLAB (r2 = 0.93, p < 0.001) and HBGEM versus HBLAB (r2 = 0.86, p < 0.001). The Bland-Altman method revealed bias of -3.7 g/l (limits of agreement -20.9 to 13.5) for HBHC and HBLAB and 2.5 g/l (-18.6 to 23.5) for HBGEM and HBLAB, which significantly differed between POCT devices (p < 0.001). Using the error grid methodology: 94 or 91 % of values (HbHC and HbGEM) fell in the zone of acceptable difference (A), whereas 0 and 1 % (HbHC and HbGEM) were unacceptable (zone C). The absolute accuracy of tested POCT devices was low though reaching a high level of correlation with laboratory measurement. The results of the Morey´s error grid were unfavorable for both POCT devices.
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Affiliation(s)
- Jan Zatloukal
- Department of Anesthesiology and Intensive Care, The Faculty of Medicine, The University Hospital, Plzen - Charles University Prague, alej Svobody 80, 304 60, Plzeň, Czech Republic.
| | - Jiri Pouska
- Department of Anesthesiology and Intensive Care, The Faculty of Medicine, The University Hospital, Plzen - Charles University Prague, alej Svobody 80, 304 60, Plzeň, Czech Republic
| | - Jakub Kletecka
- Department of Anesthesiology and Intensive Care, The Faculty of Medicine, The University Hospital, Plzen - Charles University Prague, alej Svobody 80, 304 60, Plzeň, Czech Republic
| | - Richard Pradl
- Department of Anesthesiology and Intensive Care, The Faculty of Medicine, The University Hospital, Plzen - Charles University Prague, alej Svobody 80, 304 60, Plzeň, Czech Republic
| | - Jan Benes
- Department of Anesthesiology and Intensive Care, The Faculty of Medicine, The University Hospital, Plzen - Charles University Prague, alej Svobody 80, 304 60, Plzeň, Czech Republic
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Barcat L, Dekens C, Caron-Lesenechal E, Degorre C, Cauliez A, Riou B, Vasseur A, Gromada V, Leke A, Bach V, Tourneux P. [Evaluation of the measurement of hemoglobin by the Hemocue System® in the preterm neonate less than 28 days old]. Arch Pediatr 2016; 23:255-60. [PMID: 26795359 DOI: 10.1016/j.arcped.2015.12.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2015] [Revised: 11/18/2015] [Accepted: 12/05/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND Hemoglobin (Hb) measurement is essential for the monitoring of anemia in preterm neonates to assess if any bleeding (pulmonary, cerebral, digestive) is present. EDTA samples require 500 μL vs. 10 μL for the Hemocue(®) system. This system has been evaluated and validated in adults and children but not in preterm neonates with fetal hemoglobin. The aim of the study was to compare Hb measurement with the Hemocue(®) system vs. the EDTA laboratory system on fetal Hb in preterm neonates. MATERIALS AND METHODS This was a prospective study conducted in the preterm intensive care unit in the Amiens Hospital. Preterm neonates, before 28 days of life, requiring EDTA (Hb) measurement were included. Two Hemocues(®) were performed at the same time. Postnatal age (correlated to the fetal hemoglobin level decrease), blood sample site, and other factors that could influence the Hb result were evaluated. RESULTS Seventy-six EDTA and 152 Hemocue(®) samples from 38 preterm neonates were included. The term was 28.1±3.7 weeks of gestation, the birth weight was 1215.5±657 g. We found a good correlation between the Hemocue(®) and EDTA samples (Hemocue(®)=EDTA*0.94-0.4; R(2)=0.63; P<0.001). The influence of confounding factors was insignificant. CONCLUSION The use of the Hemocue(®) system showed a good correlation with the EDTA measurement of fetal Hb, with a moderate bias (-0.2±1.5 g/dL), which remained stable for the first 28 days of life.
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Affiliation(s)
- L Barcat
- Service de réanimation pédiatrique, pôle femme-couple-enfant, CHU d'Amiens, 80054 Amiens cedex 1, France; PériTox (UMI 01), faculté de médecine, université Picardie - Jules-Verne, 80000 Amiens, France
| | - C Dekens
- Service de réanimation pédiatrique, pôle femme-couple-enfant, CHU d'Amiens, 80054 Amiens cedex 1, France
| | - E Caron-Lesenechal
- Service de réanimation pédiatrique, pôle femme-couple-enfant, CHU d'Amiens, 80054 Amiens cedex 1, France
| | - C Degorre
- Service de réanimation pédiatrique, pôle femme-couple-enfant, CHU d'Amiens, 80054 Amiens cedex 1, France
| | - A Cauliez
- Service de réanimation pédiatrique, pôle femme-couple-enfant, CHU d'Amiens, 80054 Amiens cedex 1, France
| | - B Riou
- Service de réanimation pédiatrique, pôle femme-couple-enfant, CHU d'Amiens, 80054 Amiens cedex 1, France
| | - A Vasseur
- Service de réanimation pédiatrique, pôle femme-couple-enfant, CHU d'Amiens, 80054 Amiens cedex 1, France
| | - V Gromada
- Service de réanimation pédiatrique, pôle femme-couple-enfant, CHU d'Amiens, 80054 Amiens cedex 1, France
| | - A Leke
- Service de réanimation pédiatrique, pôle femme-couple-enfant, CHU d'Amiens, 80054 Amiens cedex 1, France; PériTox (UMI 01), faculté de médecine, université Picardie - Jules-Verne, 80000 Amiens, France
| | - V Bach
- PériTox (UMI 01), faculté de médecine, université Picardie - Jules-Verne, 80000 Amiens, France
| | - P Tourneux
- Service de réanimation pédiatrique, pôle femme-couple-enfant, CHU d'Amiens, 80054 Amiens cedex 1, France; PériTox (UMI 01), faculté de médecine, université Picardie - Jules-Verne, 80000 Amiens, France.
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Abstract
PURPOSE OF REVIEW Determination of hemoglobin (Hb) concentration is essential for the detection of anemia and hemorrhage and is widely used to evaluate a patient for a possible blood transfusion. Although commonly accepted as intrinsic to the process, traditional laboratory measurements of Hb are invasive, intermittent, and time-consuming. Noninvasive Hb (NIHb)-monitoring devices have recently become available and promise the potential for detecting sudden changes in a patient's Hb level. In addition to reduced delays in clinical intervention, these devices also allow for a reduction in patient discomfort, infection risk, required personnel, and long-term costs. Unfortunately, it has been shown that many clinical factors can influence their accuracy. RECENT FINDINGS Many studies have been published on the accuracy and precision of NIHb-monitoring devices in various clinical settings. A recent meta-analysis has shown a small mean difference but wide limits of agreement between NIHb and laboratory measurements, indicating that caution should be used by physicians when making clinical decisions based on this device. SUMMARY NIHb measurements may currently be considered to be a supplemental tool for monitoring trends in Hb concentration, but are not currently developed enough to replace an invasive approach. Moreover, further studies are still required before implementing NIHb in the clinical decision-making process. Specifically, no studies have demonstrated that this technology improves clinical outcomes or patient safety.
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Broderick AJ. Point-of-care haemoglobin measurement - state of the art or a bleeding nuisance? Anaesthesia 2015; 70:1225-9. [PMID: 26374281 DOI: 10.1111/anae.13231] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- A J Broderick
- Green Lane Department of Anaesthesia, Auckland City Hospital, Auckland, New Zealand.
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Hiscock R, Kumar D, Simmons SW. Systematic Review and Meta-Analysis of Method Comparison Studies of Masimo Pulse Co-Oximeters (Radical-7™ or Pronto-7™) and HemoCue® Absorption Spectrometers (B-Hemoglobin or 201+) with Laboratory Haemoglobin Estimation. Anaesth Intensive Care 2015; 43:341-50. [DOI: 10.1177/0310057x1504300310] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We assessed agreement in haemoglobin measurement between Masimo pulse co-oximeters (Rad-7™ and Pronto-7™) and HemoCue® photometers (201+ or B-Hemoglobin) with laboratory-based determination and identified 39 relevant studies (2915 patients in Masimo group and 3084 patients in HemoCue group). In the Masimo group, the overall mean difference was -0.03 g/dl (95% prediction interval -0.30 to 0.23) and 95% limits of agreement -3.0 to 2.9 g/dl compared to 0.08 g/dl (95% prediction interval -0.04 to 0.20) and 95% limits of agreement -1.3 to 1.4 g/dl in the HemoCue group. Only B-Hemoglobin exhibited bias (0.53, 95% prediction interval 0.27 to 0.78). The overall standard deviation of difference was larger (1.42 g/dl versus 0.64 g/dl) for Masimo pulse co-oximeters compared to HemoCue photometers. Masimo devices and HemoCue 201+ both provide an unbiased, pooled estimate of laboratory haemoglobin. However, Masimo devices have lower precision and wider 95% limits of agreement than HemoCue devices. Clinicians should carefully consider these limits of agreement before basing transfusion or other clinical decisions on these point-of-care measurements alone.
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Affiliation(s)
- R. Hiscock
- Department of Anaesthesia, Mercy Hospital for Women, Heidelberg, Victoria
| | - D. Kumar
- Department of Anaesthesia, Mercy Hospital for Women, Heidelberg, Victoria
| | - S. W. Simmons
- Department of Anaesthesia, Mercy Hospital for Women, Heidelberg, Department of Pharmacology, University of Melbourne, Victoria
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Evaluation of two methods to measure hemoglobin concentration among women with genetic hemoglobin disorders in Cambodia: a method-comparison study. Clin Chim Acta 2014; 441:148-55. [PMID: 25542983 DOI: 10.1016/j.cca.2014.12.021] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Revised: 12/11/2014] [Accepted: 12/16/2014] [Indexed: 11/23/2022]
Abstract
BACKGROUND Genetic hemoglobin (Hb) E variants are common in Cambodia and result in an altered and unstable Hb molecule. We evaluated two methods to measure Hb concentration among individuals with and without Hb variants using a hemoglobinometer (HemoCue) and a hematology analyzer (Sysmex XT-1800i). METHODS We determined the bias and concordance between the methods among 420 Cambodian women (18-45 y). RESULTS Bias and concordance appeared similar between methods among women with no Hb disorders (n=195, bias=2.5, ρc=0.68), women with Hb E variants (n=133, bias=2.5, ρc=0.78), and women with other Hb variants (n=92, bias=2.7, ρc=0.73). The overall bias was 2.6g/l, resulting in a difference in anemia prevalence of 11.5% (41% using HemoCue and 29.5% using Sysmex, p<0.001). Based on visual interpretation of the concordance plots, the HemoCue device appears to underestimate Hb concentrations at lower Hb concentrations and to overestimate Hb concentrations at higher Hb concentrations (in comparison to the Sysmex analyzer). CONCLUSIONS Bias and concordance were similar across groups, suggesting the two methods of Hb measurement were comparable. We caution field staff, researchers and policy makers in the interpretation of data and the impact that bias between methods can have on anemia prevalence rates.
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Giraud B, Frasca D, Debaene B, Mimoz O. Comparison of haemoglobin measurement methods in the operating theatre. Br J Anaesth 2013; 111:946-54. [DOI: 10.1093/bja/aet252] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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20
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Benítez Cantero JM, Jurado García J, Ruiz Cuesta P, González Galilea A, Muñoz García-Borruel M, García Sánchez V, Gálvez Calderón C. [Early evaluation of anaemia in patients with acute gastrointestinal bleeding: venous blood gas analysis compared to conventional laboratory]. Med Clin (Barc) 2013; 141:332-7. [PMID: 23103108 DOI: 10.1016/j.medcli.2012.07.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2012] [Revised: 07/10/2012] [Accepted: 07/12/2012] [Indexed: 11/18/2022]
Abstract
BACKGROUND AND OBJECTIVE Evaluation of patients with acute gastrointestinal bleeding (AGB) requires early clinical evaluation and analysis. The aim of this study is to evaluate early concordance of hemoglobin (Hb) and hematocrit (HTC) levels determined by conventional venous blood gas analysis (VBG) and by conventional Laboratory in Emergencies (LAB). PATIENTS AND METHODS Observational and prospective study of patients admitted in the Gastrointestinal Haemorrhage Unit with both high and low AGB. Demographic and clinical variables and simultaneous venous blood samples were obtained to determine Hb and HTC by VBG and LAB. Concordance in both methods was analysed by intra-class correlation coefficient (ICC) and Bland-Altman analysis. RESULTS One hundred and thirty-two patients were included: 87 (65.9%) males, average age 66.8 years. VBG overestimated Hb in 0.49 g/dl (95% confidence interval: 0.21-0.76) with respect to LAB. Concordance was very high in Hb (ICC 0.931) and high in HTC (0.899), with the Bland-Altman graphs showing both concordance and overestimation of Hb levels determined by VBG. In 19 patients (14.39%), Hb by VBG exceeded in more than 1g/dL the final determination obtained by LAB. CONCLUSIONS Early determination of Hb and HTC in patients with AGB by VBG provides reliable results in the initial evaluation of anaemia. VBG systematically overestimates Hb values by less than 0.5 g/dl, and therefore clinical and hemodynamic evaluation of the bleeding patient should prevail over analytical results.
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21
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Factors affecting hemoglobin measurement. J Clin Monit Comput 2013; 27:499-508. [PMID: 23529342 DOI: 10.1007/s10877-013-9456-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Accepted: 03/20/2013] [Indexed: 12/18/2022]
Abstract
A review of the literature shows that current "standard" laboratory measurements for hemoglobin are subject to numerous factors that affect both accuracy and reliability. In addition, total hemoglobin concentration measurements are subject to numerous factors that affect the "true" hemoglobin value. This article discusses both the physiologic factors that influence hemoglobin levels and the technical aspects and variability among the different measurement methodologies currently available.
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Patel AJ, Wesley R, Leitman SF, Bryant BJ. Capillary versus venous haemoglobin determination in the assessment of healthy blood donors. Vox Sang 2013; 104:317-23. [PMID: 23294266 DOI: 10.1111/vox.12006] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2012] [Revised: 10/19/2012] [Accepted: 11/16/2012] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND OBJECTIVES To determine the accuracy of fingerstick haemoglobin assessment in blood donors, the performance of a portable haemoglobinometer (HemoCue Hb 201+) was prospectively compared with that of an automated haematology analyzer (Cell-Dyn 4000). Haemoglobin values obtained by the latter were used as the 'true' result. MATERIAL AND METHODS Capillary fingerstick samples were assayed by HemoCue in 150 donors. Fingerstick samples from two sites, one on each hand, were obtained from a subset of 50 subjects. Concurrent venous samples were tested using both HemoCue and Cell-Dyn devices. RESULTS Capillary haemoglobin values (HemoCue) were significantly greater than venous haemoglobin values (HemoCue), which in turn were significantly greater than venous haemoglobin values by Cell-Dyn (mean ± SD: 14.05 ± 1.51, 13.89 ± 1.31, 13.62 ± 1.23, respectively; P < 0.01 for all comparisons among groups). Nine donors (6%) passed haemoglobin screening criteria (≥ 12.5 g/dl) by capillary HemoCue, but were deferred by Cell-Dyn values (false-pass). Five donors (3%) were deferred by capillary sampling, but passed by Cell-Dyn (false-fail). Substantial variability in repeated fingerstick HemoCue results was seen (mean haemoglobin 13.72 vs. 13.70 g/dl, absolute mean difference between paired samples 0.76 g/dl). Hand dominance was not a factor. CONCLUSIONS Capillary samples assessed via a portable device yielded higher haemoglobin values than venous samples assessed on an automated analyzer. False-pass and false-fail rates were low and acceptable in the donor screening setting, with 'true' values not differing by a clinically significant degree from threshold values used to assess acceptability for blood donation.
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Affiliation(s)
- A J Patel
- Department of Transfusion Medicine, Clinical Center, National Institutes of Health, Bethesda, MD, USA
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Skelton VA, Wijayasinghe N, Sharafudeen S, Sange A, Parry NS, Junghans C. Evaluation of point-of-care haemoglobin measuring devices: a comparison of Radical-7™ pulse co-oximetry, HemoCue®and laboratory haemoglobin measurements in obstetric patients*. Anaesthesia 2012; 68:40-5. [DOI: 10.1111/anae.12039] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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25
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Sanchis-Gomar F, Cortell-Ballester J, Pareja-Galeano H, Banfi G, Lippi G. Hemoglobin point-of-care testing: the HemoCue system. ACTA ACUST UNITED AC 2012; 18:198-205. [PMID: 22961038 DOI: 10.1177/2211068212457560] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Besides the use of traditional laboratory resources, the diagnosis of anemia can also be accomplished by assessing hemoglobin (Hb) concentration with point-of-care testing (POCT) devices such as the HemoCue test systems. In several situations, these devices might suitably replace traditional laboratory testing, including several areas of health care where a very rapid Hb measurement might be required to make immediate therapeutic decisions. The use of these devices, however, should fulfill some basic criteria, including economic, clinical, and regulatory issues; appropriate training of the users and knowledge of test requirements, performance, limitations, and potential interferences; the use of venous and arterial sampling, when possible; and a rigorous quality assessment, which should be under the responsibility of laboratory professionals. Because of its optimal performance along with the fact that the HemoCue is probably one of the most commonly used devices worldwide, the aim of this article is to review the literature data about the performance of this test system as compared with laboratory reference testing estimations and according to the biological matrix.
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Affiliation(s)
- Fabian Sanchis-Gomar
- University of Valencia, Fundación Investigación Hospital Clínico Universitario/INCLIVA, Valencia, Spain.
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Precision of noninvasive hemoglobin-level measurement by pulse co-oximetry in patients admitted to intensive care units for severe gastrointestinal bleeds*. Crit Care Med 2012; 40:2576-82. [DOI: 10.1097/ccm.0b013e318258fb4f] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Briggs C, Kimber S, Green L. Where are we at with point- of- care testing in haematology? Br J Haematol 2012; 158:679-90. [DOI: 10.1111/j.1365-2141.2012.09207.x] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2012] [Accepted: 05/17/2012] [Indexed: 12/31/2022]
Affiliation(s)
- Carol Briggs
- Department of haematology; University College London Hospital; London
| | - Simon Kimber
- Institute of Healthcare Science; Manchester Metropolitan University; Manchester
| | - Laura Green
- Barts and the London NHS Trust & NHSBT; London; UK
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Adam I, Ahmed S, Mahmoud MH, Yassin MI. Comparison of HemoCue® hemoglobin-meter and automated hematology analyzer in measurement of hemoglobin levels in pregnant women at Khartoum hospital, Sudan. Diagn Pathol 2012; 7:30. [PMID: 22436620 PMCID: PMC3342090 DOI: 10.1186/1746-1596-7-30] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2012] [Accepted: 03/21/2012] [Indexed: 11/10/2022] Open
Abstract
Background Assessment of hemoglobin is one of the most reliable indicators for anemia, and is widely used to screen for anemia among pregnant women. The HemoCue® has been widely used for as a point-of-care device for hemoglobin estimation in health facilities. Previous studies showed contradictory results regarding the accuracy of HemoCue®. Methods This was a hospital-based cross sectional study carried- out among pregnant women at Khartoum hospital in Sudan to find out whether the measurement of hemoglobin concentration by HemoCue® using venous or capillary samples was comparable to that of the automated hematology analyzer as standard. Bland and Altman method was used to compare the measurements with an acceptable difference of ± 1.0 g/dl. Results Among the 108 subjects in this study the mean (SD) level of hemoglobin level using HemoCue® venous sample, HemoCue® capillary sample and automated hematology analyzer were 12.70 (1.77), 12.87 (2.04) and 11.53 (1.63) g/dl, respectively. Although the correlations between the measurements were all significant there was no agreement between HemoCue® and automated hematology analyzer. The bias + SD (limits of agreement) for HemoCue® venous versus hematology analyzer was 1.17 ± 1.57 (-1.97, 4.31) g/dl, HemoCue® capillary versus hematology analyzer was 1.34 ± 1.85 (-2.36, 5.04) g/dl, and HemoCue® venous versus HemoCue® capillary samples was 017 ± 1.90 and (3.97-3.63) g/dl. Conclusion Hemoglobin concentration assessment by HemoCue® using either venous or capillary blood samples has shown unacceptable agreement with automated hematology analyzer. Virtual slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/8797022296725036
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Affiliation(s)
- Ishag Adam
- Faculty of Medicine, University of Khartoum, P,O, Box 102, Khartoum, Sudan.
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Nguyen BV, Vincent JL, Nowak E, Coat M, Paleiron N, Gouny P, Ould-Ahmed M, Guillouet M, Arvieux CC, Gueret G. The Accuracy of Noninvasive Hemoglobin Measurement by Multiwavelength Pulse Oximetry After Cardiac Surgery. Anesth Analg 2011; 113:1052-7. [DOI: 10.1213/ane.0b013e31822c9679] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Accuracy of a continuous noninvasive hemoglobin monitor in intensive care unit patients*. Crit Care Med 2011; 39:2277-82. [DOI: 10.1097/ccm.0b013e3182227e2d] [Citation(s) in RCA: 140] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Seguin P, Kleiber A, Chanavaz C, Morcet J, Mallédant Y. Determination of capillary hemoglobin levels using the HemoCue system in intensive care patients. J Crit Care 2011; 26:423-7. [DOI: 10.1016/j.jcrc.2010.08.012] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2010] [Revised: 08/16/2010] [Accepted: 08/23/2010] [Indexed: 11/16/2022]
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Nkrumah B, Nguah SB, Sarpong N, Dekker D, Idriss A, May J, Adu-Sarkodie Y. Hemoglobin estimation by the HemoCue® portable hemoglobin photometer in a resource poor setting. BMC Clin Pathol 2011; 11:5. [PMID: 21510885 PMCID: PMC3095531 DOI: 10.1186/1472-6890-11-5] [Citation(s) in RCA: 90] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2011] [Accepted: 04/21/2011] [Indexed: 11/26/2022] Open
Abstract
Background In resource poor settings where automated hematology analyzers are not available, the Cyanmethemoglobin method is often used. This method though cheaper, takes more time. In blood donations, the semi-quantitative gravimetric copper sulfate method which is very easy and inexpensive may be used but does not provide an acceptable degree of accuracy. The HemoCue® hemoglobin photometer has been used for these purposes. This study was conducted to generate data to support or refute its use as a point-of-care device for hemoglobin estimation in mobile blood donations and critical care areas in health facilities. Method EDTA blood was collected from study participants drawn from five groups: pre-school children, school children, pregnant women, non-pregnant women and men. Blood collected was immediately processed to estimate the hemoglobin concentration using three different methods (HemoCue®, Sysmex KX21N and Cyanmethemoglobin). Agreement between the test methods was assessed by the method of Bland and Altman. The Intraclass correlation coefficient (ICC) was used to determine the within subject variability of measured hemoglobin. Results Of 398 subjects, 42% were males with the overall mean age being 19.4 years. The overall mean hemoglobin as estimated by each method was 10.4 g/dl for HemoCue, 10.3 g/dl for Sysmex KX21N and 10.3 g/dl for Cyanmethemoglobin. Pairwise analysis revealed that the hemoglobin determined by the HemoCue method was higher than that measured by the KX21N and Cyanmethemoglobin. Comparing the hemoglobin determined by the HemoCue to Cyanmethemoglobin, the concordance correlation coefficient was 0.995 (95% CI: 0.994-0.996, p < 0.001). The Bland and Altman's limit of agreement was -0.389 - 0.644 g/dl with the mean difference being 0.127 (95% CI: 0.102-0.153) and a non-significant difference in variability between the two measurements (p = 0.843). After adjusting to assess the effect of other possible confounders such as sex, age and category of person, there was no significant difference in the hemoglobin determined by the HemoCue compared to Cyanmethemoglobin (coef = -0.127, 95% CI: -0.379 - 0.634). Conclusion Hemoglobin determined by the HemoCue method is comparable to that determined by the other methods. The HemoCue photometer is therefore recommended for use as on-the-spot device for determining hemoglobin in resource poor setting.
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Affiliation(s)
- Bernard Nkrumah
- Kumasi Centre for Collaborative Research in tropical Medicine, Kumasi, Ghana.
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Estimation of blood haemoglobin concentration using the HemoCue® during caesarean section: the effect of sampling site. Int J Obstet Anesth 2010; 19:67-70. [DOI: 10.1016/j.ijoa.2009.05.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2008] [Revised: 02/15/2009] [Accepted: 05/13/2009] [Indexed: 11/17/2022]
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Zhou X, Yan H, Xing Y, Dang S, Zhuoma B, Wang D. Evaluation of a portable hemoglobin photometer in pregnant women in a high altitude area: a pilot study. BMC Public Health 2009; 9:228. [PMID: 19591672 PMCID: PMC2717084 DOI: 10.1186/1471-2458-9-228] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2009] [Accepted: 07/11/2009] [Indexed: 04/18/2024] Open
Abstract
BACKGROUND Anemia is a widespread public health problem associated with an increased risk of morbidity and mortality, especially in pregnant women. This study examined the agreement between a portable hemoglobin photometer and a laboratory analyzer in determining hemoglobin level in pregnant women. METHODS This study recruited 69 pregnant women in Tibet, China. Capillary blood samples were taken to measure hemoglobin concentration using the hemoglobin photometer and the laboratory analyzer. Limit of agreement, concordance and intraclass correlation coefficient were used to evaluate the agreement. Laboratory measurement was considered as the standard reference method. Sensitivity and specificity were calculated to assess the error in screening for anemia. RESULTS Mean difference between the two methods was -2.1 g/l. wide 95% limits of agreement were found (-22.6 g/l to 18.4 g/l). The intraclass correlation coefficient was 0.795, and concordance correlation coefficient was 0.793. Sensitivity and specificity were 94.9% and 76.7% respectively. Positive predictive value was 84.1%, and negative predictive value was 92.0%. CONCLUSION This hemoglobin photometer is not recommended for determining hemoglobin concentration in pregnancy in a high altitude area.
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Affiliation(s)
- Xiaoyan Zhou
- Department of Epidemiology and Health Statistics, Xi'an Jiaotong University College of Medicine, Xi'an, PR China
| | - Hong Yan
- Department of Epidemiology and Health Statistics, Xi'an Jiaotong University College of Medicine, Xi'an, PR China
| | - Yuan Xing
- Department of Epidemiology and Health Statistics, Xi'an Jiaotong University College of Medicine, Xi'an, PR China
| | - Shaonong Dang
- Department of Epidemiology and Health Statistics, Xi'an Jiaotong University College of Medicine, Xi'an, PR China
| | - Bianba Zhuoma
- Obstetrics and Gynecology Department, Lhasa People's Hospital, Lhasa, PR China
| | - Duolao Wang
- Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
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Fiabilidad de la medición de la hemoglobina por HemoCue® en pacientes con hemorragia gastrointestinal. GASTROENTEROLOGIA Y HEPATOLOGIA 2009; 32:334-8. [DOI: 10.1016/j.gastrohep.2009.01.173] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2008] [Accepted: 01/28/2009] [Indexed: 11/23/2022]
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Antonelli M, Azoulay E, Bonten M, Chastre J, Citerio G, Conti G, De Backer D, Lemaire F, Gerlach H, Groeneveld J, Hedenstierna G, Macrae D, Mancebo J, Maggiore SM, Mebazaa A, Metnitz P, Pugin J, Wernerman J, Zhang H. Year in review in Intensive Care Medicine, 2007. III. Ethics and legislation, health services research, pharmacology and toxicology, nutrition and paediatrics. Intensive Care Med 2008; 34:598-609. [PMID: 18309475 DOI: 10.1007/s00134-008-1053-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2008] [Accepted: 02/18/2008] [Indexed: 11/26/2022]
Affiliation(s)
- Massimo Antonelli
- Department of Intensive Care and Anesthesiology, Policlinico Universitario A. Gemelli, Largo A. Gemelli, 8, 00168, Rome, Italy.
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