Assessment of haemoglobin measurement by several methods – blood gas analyser, capillary and venous HemoCue^®, non‐invasive spectrophotometry and laboratory assay – in term and preterm infants

Abstract

A laboratory haematology analyser is the gold standard for measuring haemoglobin concentration but has disadvantages, especially in neonates. This study compared alternative blood-sparing and non-invasive methods of haemoglobin concentration measurement with the gold standard. Haemoglobin concentrations were measured using a laboratory haematology analyser (reference method), blood gas analyser, HemoCue â using venous and capillary blood samples and a newly developed non-invasive sensor for neonates < 3 kg. A total of 63 measurements were performed. Body weight (2190 (1820-2520 [967-4450]) g) and haemoglobin concentration (12.3 (10.6-15.2 [8.2-20.5]) g.dl À1 ) varied widely. Bias/limits of agreement between the alternative methods and reference method were À0.1/À1.2 to 1.0 g.dl À1 (blood gas analyser), À0.4/À1.8 to 1.1 g.dl À1 (HemoCue, venous blood), 0.7/À1.9 to 3.2 g.dl À1 (HemoCue, capillary blood) and À1.2/À4.3 to 2 g.dl À1 (non-invasive haemoglobin measurement). Perfusion index, body weight and fetal haemoglobin concentration did not affect the accuracy of the alternative measurement methods, and these were successfully applied in term and preterm infants. However, the accuracies of non-invasive haemoglobin measurement and HemoCue of capillary blood especially lacked sufficient agreement with that of the reference method to recommend these methods for clinical decision making.

Agreement between Noninvasive Hemoglobin and Laboratory Hemoglobin Measurements in Neonates: A Systematic Review and Meta-Analysis

“…This study comprises ten prospective comparative studies from different parts of the world, i.e., four studies from India [16][17][18][19], two studies from Germany [20,21], one study each from Republic of Korea [22], UK [23], USA [24], and Turkey [25]. Masimo radical-pulse co-oximetry (MRPCO) was used in all enrolled studies except two studies [20,23] where Mediscan-2000 was used.…”

“…Seven studies included both preterm and term neonates, and three studies [22][23][24] enrolled neonates with average gestational age below 32 weeks including extreme low birth weight neonates (birth weight <1,000 g). Hb testing was conducted within the first postnatal week in three studies [16,17,24], the rest of seven studies were conducted beyond the first postnatal week of life, whereas three studies [20,21,23] included mostly preterm neonates beyond 2 weeks of age. The clinical condition of neonates during Hb testing was informed in all studies except Jung et al [22].…”

“…The clinical condition of neonates during Hb testing was informed in all studies except Jung et al [22]. Stable neonates, i.e., without any circulatory insufficiency, were enrolled in seven studies [16, 17, 19-21, 23, 25], and sick neonates were enrolled for Hb estimation in rest three studies [17, 18, 24]. Bhat et al [17] informed separately about sick and stable neonates.…”

Design and Rationale of the Biomarker Center of the Household Air Pollution Intervention Network (HAPIN) Trial

“…This method is superior to traditional immunoassays because of limited interference, especially by fetal Hb (Rohlfing et al 2008). Although less precise than the immunoassay and other standard reference methods (Rohlfing et al 2008;Wittenmeier et al 2019), we will also measure Hb (HemoCue ® Hb 201 system, HemoCue ® AB) and HbA1c (A1CNow+ system, Chek Diagnostics) using point-of-care devices during visits in order to provide immediate results back to the pregnant women (i.e., Hb), children (i.e., Hb at the 6-and 12-month visits), and OAW (i.e., HbA1c) on data forms that they can share with their physicians. We believe that immediately sharing some results is of value to the participants and will help keep them engaged in the study.…”

¿La medición de hemoglobina es más costo-efectiva que el uso del hemograma automatizado?

“…El índice de perfusión, el peso corporal y la concentración de Hb fetal no afectaron la precisión de los métodos alternativos, y fueron aplicados de manera satisfactoria en infantes a término y a pretérmino. Sin embargo, las precisiones de los métodos no invasivo y la medición de Hb capilar por HemoCue® carecen de suficiente concordancia con el método de referencia 32 .…”