Research Article
Volume 9 Issue 3 - 2020
Comparison of Hb Measurements between POCT and Laboratory Hb Measurements in Pediatric Intensive Care Unit
Puneet N Singh* and Andrew H Numa
Pediatric Intensive Care Unit, Sydney Children's Hospital, Sydney, Australia
*Corresponding Author: Puneet N Singh, Pediatric Intensive Care Unit, Sydney Children's Hospital, Sydney, Australia.
Received: January 20, 2020; Published: February 08, 2020




Abstract

Background: The analysis of biochemical parameters at or near the bedside is a rapidly evolving field in laboratory diagnosis. We studied whether hemoglobin measurements by noninvasive pulse co-oximetry (SpHb) and blood gas analyzer could provide clinically acceptable absolute accuracy in critically ill children compared to the reference standard, the automated laboratory analyzer, in a pediatric intensive care unit.

Methods: Data were prospectively collected in critically ill patients at metropolitan teaching hospital in Sydney, Australia. Hemoglobin measurements by two point-of-care tests i.e. noninvasive hemoglobin measurements (SpHb) and blood gas analyzer were recorded and were then compared with hemoglobin measured via reference standard laboratory automated analyzer. The agreement between these methods were evaluated by linear regression and Bland and Altman analysis.

Results: Data was collected on 84 patients aged from 1 day and 17.99 years (median 1.93 years). The overall correlation of the SpHb (Masimo Radical 7) and the laboratory Hemoglobin (Sysmex XE-5000) was 0.81 (< 0.0001) with a mean difference of 0.37 g/dL (95% confidence interval, -2.23 - +2.98), which may affect the utility of using co-oximetry values alone to guide clinical management. Almost perfect correlation was observed when comparing results from blood gas analyzer (Radiometer ABL800 FLEX) and the laboratory hemoglobin analyzer with coefficient of correlation 0.98 (P < 0.0001) with a mean difference of 0.04 g/dL (95% confidence interval, -0.81 - +0.73).

Conclusion: SpHb monitoring is a novel technology and the results correlate well but with large confidence interval. Further studies are needed in critically ill pediatric patients and in children with severe anemia. In the meantime, blood gas analyzer is a good alternative to the reference standard laboratory hemoglobin for the rapid assessment of Hb among critically ill children.

Keywords: Hemoglobin; Co-Oximeter; Masimo Radical-7; Blood Gas Analyzer; Point-of-Care test; Pediatric Intensive Care

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Citation: Puneet N Singh and Andrew H Numa. “Comparison of Hb Measurements between POCT and Laboratory Hb Measurements in Pediatric Intensive Care Unit”. EC Paediatrics 9.3 (2020): 01-08.

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