Downward bias of conductivity based point-of-care hemoglobin measurement compared with optical methods.
10.17085/apm.2018.13.3.323
- Author:
Min Hee HEO
1
;
Jun Hyun KIM
;
Kyung Woo KIM
;
Ho Jae CHO
;
Won Joo CHOE
;
Kyung Tae KIM
;
Ji Yeon KIM
;
Sang Il LEE
;
Jang Su PARK
;
Jung Won KIM
Author Information
1. Department of Anesthesiology and Pain Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea. ishmael1@naver.com
- Publication Type:Original Article
- Keywords:
Blood gas analysis;
Hemoglobins;
Point-of-care testing
- MeSH:
Bias (Epidemiology)*;
Blood Gas Analysis;
Linear Models;
Methods*;
Point-of-Care Systems*;
Point-of-Care Testing;
Retrospective Studies
- From:Anesthesia and Pain Medicine
2018;13(3):323-328
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Point-of-care (POC) arterial blood gas analysis (ABGA) is widely used for checking hemoglobin (Hb) level. However, there is the tendency of downward bias of conductivity-based POC ABGA Hb measurement compared with optical methods. Authors tried to correct that bias by linear regression equation. METHODS: We retrospectively collected a total of 86 Hb result pairs during surgeries. Hb measured by the Sysmex XE-2100 in the laboratory was set as the gold standard and was compared with that measured by the GEM Premier 3500. Data were compared using the Bland-Altman analysis, the reliability of transfusion decision was assessed using three-zone error grid. The linear regression analysis was performed to find out the relation between the Hb results of POC ABGA and those of laboratory based test. RESULTS: The bias of the Hb measured between Sysmex XE-2100 and GEM Premier 3500 was −0.9 g/dl (P < 0.001, 95% confidence interval, −1.038 to −0.665 g/dl). The percentage error was 16.4%. According to error grid methodology, zone A, B and C encompassed 89.5%, 10.5% and 0% of data pairs. After adjusting the POC ABGA Hb values, the bias of the Hb measured by two methods was 0 g/dl (P = 0.991). The percentage error was 18.2%. The zone A, B and C encompassed 91.9%, 8.1% and 0% of data pairs. CONCLUSIONS: Hb measurements obtained with reference to conductivity via a POC ABGA were significantly lower than those obtained via optical methods. This bias may deserve attention of anesthesiologists when POC ABGA Hb level is used as a transfusion guideline.
