Accuracy of point-of-care-testing (POCT) for determining hemoglobin concentrations
Accuracy of point-of-care-testing (POCT) for determining hemoglobin concentrations
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DOI：
10.1034/j.1399-6576.2002.460809.x
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发表时间：
2002-09-01
影响因子：
2.1
通讯作者：
Schmucker, P
中科院分区：
文献类型：
--
作者：
Gehring, H;Hornberger, C;Schmucker, P
背景资料：虽然床旁检测（POCT）越来越多地被用作决定围手术期红细胞输注的基础，但目前还没有关于Hb浓度测量准确性的有效标准。然而，对于临床应用，这些测量值的置信限（+/-2 SD）应接近5 g/l。本研究的目的是评估即时检测血红蛋白浓度的准确性和精密度（cHb，g/l）测量。方法：从50名需要重症监护治疗的术后患者中抽取50份血液样本，从桡动脉插管中抽取到2 ml肝素化注射器中（在圆锥中含有湿的肝素钠），在含有50 IE肝素锂的2-ml Monclutte中，和在含有1.6 mg EDTA钾/ml血液的2.7-ml比色皿中。POCT组由两个血气分析仪（ABL（TM）625和725，Radiometer，Copenhagen）、HemoCue（（R））系统（Mallinckrodt Medical，德国）和自动血液学分析仪（M-2000（（R），Sysmex，德国）组成。氰化高铁血红蛋白法作为参考“金标准”程序。使用干和湿肝素化血液样本对血气分析仪和HemoCue（（R））系统进行测试。结果：参考测量的血红蛋白浓度范围为73.9至159.4 g/l。自动血细胞分析仪方法确实显示了较高cHb值的小但系统性偏差。对于血气分析仪和HemoCue（（R））系统程序，首次测量或平均数据均无系统偏倚偏差。Bland & Altman分析显示湿肝素化样品的散射较大。结论：POCT系统的上述要求，即置信限应接近5 g/l cHb，适用于血气分析仪（第一次测量和2的平均值）、HemoCue（（R））系统（3的平均值）和自动血液分析仪的干肝素化样品。
Background: While point-of-care testing (POCT) is being used increasingly as a basis for deciding on perioperative erythrocyte transfusion, no valid standards currently exist concerning the accuracy of Hb concentration measurements. For clinical employment, however, the confidence limits (+/-2 SD) of these measurements should lie close to 5 g/l. The aim of the present study was to evaluate the accuracy and precision of point-of-care testing for blood hemoglobin concentration (cHb in g/l) measurements in critically ill patients.Methods: Fifty blood samples from 50 postoperative patients requiring intensive care treatment were withdrawn from a cannula in the radial artery into a 2-ml heparinized syringe (containing wet sodium heparinate in the conus), in a 2-ml Monovette with 50 IE lithium heparinate, and into a 2.7-ml cuvette with 1.6 mg potassium EDTA/ml blood. The POCT battery consisted of two blood gas analyzers (ABL(TM) 625 and 725, Radiometer, Copenhagen), the HemoCue ((R)) system (Mallinckrodt Medical, Germany), and an automated hematology analyzer (M-2000((R)), Sysmex, Germany). The cyanmethemoglobin method served as the reference 'gold standard' procedure. The blood gas analyzer and HemoCue((R)) systems were tested using dry and wet heparinized blood samples.Results: Hemoglobin concentrations of the reference measurements ranged from 73.9 to 159.4 g/l. The automated hematology analyzer method did reveal a small but systematic deviation for higher cHb values. For the blood gas analyzer and HemoCue((R)) system procedures there was no systematic deviation of bias for either the first measurement or the averaged data. Bland & Altman analysis revealed a larger scattering for the wet heparinized samples.Conclusions: The above-stated requirement for POCT systems, i.e. that the confidence limits should lie close to 5 g/l cHb, held true for the dry heparinized samples of the blood gas analyzer (1st measurement and mean of 2), the HemoCue((R)) system (mean of 3) and the automated hematology analyzer.