Reliability of HemoCue in patients with gastrointestinal bleeding
Reliability of HemoCue in patients with gastrointestinal bleeding
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DOI：
10.1007/s00134-006-0461-6
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发表时间：
2007-02-01
影响因子：
38.9
通讯作者：
Tenaillon, Alain
中科院分区：
文献类型：
--
作者：
Van de Louw, Andry;Lasserre, Nadine;Tenaillon, Alain
目的：HemoCue通常用于管理出血患者，但很少有研究评价其在该人群中的准确性。我们在消化道出血患者中比较了HemoCue与血液血红蛋白的实验室测定。设计和设置：一项前瞻性观察性研究，在一家城市综合医院的14床内科外科ICU和急诊科进行。患者：94名因消化道出血入住急诊科或ICU的患者。干预措施：入院时抽血测量实验室血红蛋白，同时通过HemoCue测量毛细血管血红蛋白。记录住院单位和是否存在受损的生命体征（心动过速和/或低血压和/或休克）。测量和结果：HemoCue和血红蛋白之间的平均差异（偏倚）为-0.06 g/dl，标准差（精度）为0.87 g/dl。(95% CI -1.8至1.68）。在21%的病例中，HemoCue和血红蛋白之间的差异大于1 g/dl。ICU和急诊科患者之间的偏倚具有可比性。HemoCue的准确性不受生命体征受损或血红蛋白水平低于9 g/dl或7 g/dl的影响。结论：虽然我们证明了HemoCue和血液血红蛋白测定之间的低偏倚，但仍可能发生较大的HemoCue与血红蛋白差异，因此仅基于毛细血管HemoCue的治疗决策应非常谨慎。
Objective: HemoCue is routinely used to manage bleeding patients, but few studies have evaluated its accuracy in this population. We compared HemoCue with laboratory determination of blood hemoglobin in patients with gastrointestinal bleeding.Design and setting: A prospective observational study in a 14-bed medicosurgical ICU and an emergency department in an urban general hospital.Patients: 94 patients admitted to the emergency department or to the ICU for gastrointestinal bleeding.Interventions: Blood was drawn at admission to measure laboratory hemoglobin and capillary hemoglobin was measured simultaneously by HemoCue. The unit of hospitalization and the presence or absence of impaired vital signs (tachycardia and/or hypotension and/or shock) were recorded.Measurements and results: The mean difference between HemoCue and hemoglobin (bias) was -0.06 g/dl and standard deviation (precision) 0.87 g/dl. (95% CI -1.8 to 1.68). Discrepancies between HemoCue and hemoglobin were greater than 1 g/dl in 21% of cases. Bias was comparable between patients admitted to the ICU and those in the emergency department. The accuracy of HemoCue was not affected by the presence of impaired vital signs or by a hemoglobin level below 9 g/dl or 7 g/dl.Conclusions: Although we demonstrated a low bias between HemoCue and blood hemoglobin determination, large HemoCue vs. hemoglobin differences may still occur, and therefore therapeutic decisions based upon capillary HemoCue alone should be very cautious.