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An R, Huang Y, Man Y, Valentine RW, Kucukal E, Goreke U, Sekyonda Z, Piccone C, Owusu-Ansah A, Ahuja S, Little JA, Gurkan UA. Emerging point-of-care technologies for anemia detection. LAB ON A CHIP 2021; 21:1843-1865. [PMID: 33881041 PMCID: PMC8875318 DOI: 10.1039/d0lc01235a] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Anemia, characterized by low blood hemoglobin level, affects about 25% of the world's population with the heaviest burden borne by women and children. Anemia leads to impaired cognitive development in children, as well as high morbidity and early mortality among sufferers. Anemia can be caused by nutritional deficiencies, oncologic treatments and diseases, and infections such as malaria, as well as inherited hemoglobin or red cell disorders. Effective treatments are available for anemia upon early detection and the treatment method is highly dependent on the cause of anemia. There is a need for point-of-care (POC) screening, early diagnosis, and monitoring of anemia, which is currently not widely accessible due to technical challenges and cost, especially in low- and middle-income countries where anemia is most prevalent. This review first introduces the evolution of anemia detection methods followed by their implementation in current commercially available POC anemia diagnostic devices. Then, emerging POC anemia detection technologies leveraging new methods are reviewed. Finally, we highlight the future trends of integrating anemia detection with the diagnosis of relevant underlying disorders to accurately identify specific root causes and to facilitate personalized treatment and care.
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Affiliation(s)
- Ran An
- Mechanical and Aerospace Engineering Department, Case Western Reserve University, 10900 Euclid Ave., Glennan Building, Cleveland, OH 44106, USA.
| | - Yuning Huang
- Mechanical and Aerospace Engineering Department, Case Western Reserve University, 10900 Euclid Ave., Glennan Building, Cleveland, OH 44106, USA.
| | - Yuncheng Man
- Mechanical and Aerospace Engineering Department, Case Western Reserve University, 10900 Euclid Ave., Glennan Building, Cleveland, OH 44106, USA.
| | - Russell W Valentine
- Mechanical and Aerospace Engineering Department, Case Western Reserve University, 10900 Euclid Ave., Glennan Building, Cleveland, OH 44106, USA.
| | - Erdem Kucukal
- Mechanical and Aerospace Engineering Department, Case Western Reserve University, 10900 Euclid Ave., Glennan Building, Cleveland, OH 44106, USA.
| | - Utku Goreke
- Mechanical and Aerospace Engineering Department, Case Western Reserve University, 10900 Euclid Ave., Glennan Building, Cleveland, OH 44106, USA.
| | - Zoe Sekyonda
- Biomedical Engineering Department, Case Western Reserve University, Cleveland, OH, USA
| | - Connie Piccone
- Department of Pediatric Hematology, Carle Foundation Hospital, Urbana, IL, USA
| | - Amma Owusu-Ansah
- Department of Pediatrics, Division of Hematology and Oncology, University Hospitals Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, OH, USA
| | - Sanjay Ahuja
- Department of Pediatrics, Division of Hematology and Oncology, University Hospitals Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, OH, USA
| | - Jane A Little
- Division of Hematology & UNC Blood Research Center, Department of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Umut A Gurkan
- Mechanical and Aerospace Engineering Department, Case Western Reserve University, 10900 Euclid Ave., Glennan Building, Cleveland, OH 44106, USA. and Biomedical Engineering Department, Case Western Reserve University, Cleveland, OH, USA and Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, USA
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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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A comparative quality evaluation of point-of-care methodology for testing hemoglobin in blood donors by two different technologies. ACTA ACUST UNITED AC 2020. [DOI: 10.1016/j.cmrp.2020.03.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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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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Chaudhary R, Dubey A, Sonker A. Techniques used for the screening of hemoglobin levels in blood donors: current insights and future directions. J Blood Med 2017; 8:75-88. [PMID: 28740442 PMCID: PMC5503668 DOI: 10.2147/jbm.s103788] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Blood donor hemoglobin (Hb) estimation is an important donation test that is performed prior to blood donation. It serves the dual purpose of protecting the donors' health against anemia and ensuring good quality of blood components, which has an implication on recipients' health. Diverse cutoff criteria have been defined world over depending on population characteristics; however, no testing methodology and sample requirement have been specified for Hb screening. Besides the technique, there are several physiological and methodological factors that affect accuracy and reliability of Hb estimation. These include the anatomical source of blood sample, posture of the donor, timing of sample and several other biological factors. Qualitative copper sulfate gravimetric method has been the archaic time-tested method that is still used in resource-constrained settings. Portable hemoglobinometers are modern quantitative devices that have been further modified to reagent-free cuvettes. Furthermore, noninvasive spectrophotometry was introduced, mitigating pain to blood donor and eliminating risk of infection. Notwithstanding a tremendous evolution in terms of ease of operation, accuracy, mobility, rapidity and cost, a component of inherent variability persists, which may partly be attributed to pre-analytical variables. Hence, blood centers should pay due attention to validation of test methodology, competency of operating staff and regular proficiency testing of the outputs. In this article, we have reviewed various regulatory guidelines, described the variables that affect the measurements and compared the validated technologies for Hb screening of blood donors along with enumeration of their merits and limitations.
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Affiliation(s)
- Rajendra Chaudhary
- Department of Transfusion Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences
| | - Anju Dubey
- Department of Transfusion Medicine, T.S. Misra Medical College and Hospital
| | - Atul Sonker
- Department of Transfusion Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
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Chin-Yee B, Lazo-Langner A, Butler-Foster T, Hsia C, Chin-Yee I. Blood donation and testosterone replacement therapy. Transfusion 2017; 57:578-581. [PMID: 28150363 DOI: 10.1111/trf.13970] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 10/22/2016] [Accepted: 10/24/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Polycythemia is the most common adverse effect of testosterone replacement therapy (TRT) and may predispose patients to adverse vascular events. Current Canadian guidelines recommend regular laboratory monitoring and discontinuing TRT or reducing the dose if the hematocrit exceeds 54% (hemoglobin ≥180 g/L). This threshold has been interpreted by some physicians and patients to indicate the need for phlebotomy or blood donation while on TRT. STUDY DESIGN AND METHODS We reviewed all male blood donors in Southwestern Ontario at Canadian Blood Services from December 2013 to March 2016 who self-identified or were found on donor screening to be on TRT. Hemoglobin concentration was measured at the time of donation or clinic visit and with each subsequent appointment in repeat donors. RESULTS We identified 39 patients on TRT who presented for blood donation over a 2-year period. The mean hemoglobin level at all clinic visits was 173 g/L (range, 134-205 g/L; n = 108). Hemoglobin concentrations of 180 g/L or more (calculated hematocrit, ≥54%) were measured at 25% of appointments. Of the 27 repeat donors, 12 (44%) had persistently elevated hemoglobin levels (≥180 g/L) at subsequent donations. CONCLUSION Hemoglobin concentrations were elevated in donors on TRT, and significant numbers had hemoglobin levels above those recommended by current guidelines. These data also suggest that repeat blood donation was insufficient to maintain a hematocrit below 54%. Our findings raise concerns about the persistent risk of vascular events in these donors, particularly when coupled with the misperception by patients and health care providers that donation has reduced or eliminated the risks of TRT-induced polycythemia.
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Affiliation(s)
- Benjamin Chin-Yee
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Alejandro Lazo-Langner
- Division of Hematology, Department of Medicine, Schulich School of Medicine, Western University.,Department of Epidemiology, Schulich School of Medicine, Western University
| | | | - Cyrus Hsia
- Division of Hematology, Department of Medicine, Schulich School of Medicine, Western University
| | - Ian Chin-Yee
- Division of Hematology, Department of Medicine, Schulich School of Medicine, Western University.,Canadian Blood Services, London, Ontario, Canada
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Dubey A, Murti S. Validation of a hemoglobinometer for use in outdoor blood donation camps. Asian J Transfus Sci 2016; 10:164-5. [PMID: 27605859 PMCID: PMC4993091 DOI: 10.4103/0973-6247.187943] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- Anju Dubey
- Department of Transfusion Medicine, All Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Saurabh Murti
- Department of Transfusion Medicine, All Institute of Medical Sciences, Rishikesh, Uttarakhand, India
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Kamel H, Vassallo RR. When visual inspection of the palpebral conjunctivae falls short …. Transfusion 2016; 56:1932-6. [PMID: 27500917 DOI: 10.1111/trf.13717] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 05/31/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Hany Kamel
- Blood Systems, Medical Affairs, Scottsdale, AZ
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Kim H, Song S, Yim J, Kim HO, Joo C. Hemoglobin assay in anemic patients with a photothermal spectral-domain optical coherence reflectometric sensor. Clin Chim Acta 2015; 439:71-6. [DOI: 10.1016/j.cca.2014.10.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Revised: 09/27/2014] [Accepted: 10/01/2014] [Indexed: 10/24/2022]
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Gómez-Simón A, Plaza EM, Torregrosa JM, Ferrer-Marín F, Sánchez-Guiu I, Vicente V, Lozano ML, Rivera J. Evaluation of two-step haemoglobin screening with HemoCue for blood donor qualification in mobile collection sites. Vox Sang 2014; 107:343-50. [DOI: 10.1111/vox.12165] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Revised: 04/16/2014] [Accepted: 05/08/2014] [Indexed: 11/30/2022]
Affiliation(s)
- A. Gómez-Simón
- Centro Regional de Hemodonación; Servicio de Hematología y Oncología Médica; IMIB; Universidad de Murcia; Murcia Spain
| | - E. M. Plaza
- Centro Regional de Hemodonación; Servicio de Hematología y Oncología Médica; IMIB; Universidad de Murcia; Murcia Spain
| | - J. M. Torregrosa
- Centro Regional de Hemodonación; Servicio de Hematología y Oncología Médica; IMIB; Universidad de Murcia; Murcia Spain
| | - F. Ferrer-Marín
- Centro Regional de Hemodonación; Servicio de Hematología y Oncología Médica; IMIB; Universidad de Murcia; Murcia Spain
| | - I. Sánchez-Guiu
- Centro Regional de Hemodonación; Servicio de Hematología y Oncología Médica; IMIB; Universidad de Murcia; Murcia Spain
| | - V. Vicente
- Centro Regional de Hemodonación; Servicio de Hematología y Oncología Médica; IMIB; Universidad de Murcia; Murcia Spain
| | - M. L. Lozano
- Centro Regional de Hemodonación; Servicio de Hematología y Oncología Médica; IMIB; Universidad de Murcia; Murcia Spain
| | - J. Rivera
- Centro Regional de Hemodonación; Servicio de Hematología y Oncología Médica; IMIB; Universidad de Murcia; Murcia Spain
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