Comparison of Massimo Pronto-7 and Hemocue Hb 201+ with Laboratory Haemoglobin Estimation: A Clinical Study

Abstract

We prospectively studied agreement in haemoglobin estimation between two point-of-care devices (Pronto-7® Pulse CO-Oximetry™, Masimo Corporation, Irvine, California, USA and HemoCue® Hb 201+, HemoCue, Angelholm, Sweden) and an automated laboratory analyser (Sysmex XE5000, Sysmex Corporation, Kobe, Japan). Venous blood sampling and finger co-oximeter readings were performed on 141 pregnant women undergoing routine mid-trimester haemoglobin assessment. Three replicate measures were performed and analysis used Bayesian-based variance component modelling to provide estimates of repeatability, between person within method bias and precision. Repeatability, assessed by coefficient of variation, was higher for Pronto-7® (2.3%) compared to HemoCue® (5.2%). Fixed bias (mean difference, device - laboratory) was +1.18 (standard deviation 1.19) g/dl and - 0.01 (standard deviation 1.34) g/dl for Pronto-7® and HemoCue® respectively, with no statistical evidence of proportional bias. Based upon a single device reading, the 95% prediction limits for Pronto-7® were −1.2 to 3.6 g.dl-1 and HemoCue® were −2.7 to 2.7 g/dl. For both devices precision was not meaningfully improved by averaging replicate readings. However, repeated readings may allow detection of aberrant results. Overall both devices are imprecise and 95% prediction limits wide. We present further prediction limits, derived from the posterior distribution and adjusted for any fixed bias for set levels of probability (certainty). These may be used to support clinical decisions when using these point-of-care devices.

Tranexamic Acid in Pertrochanteric Femoral Fracture: Is it a Safe Drug or Not?

“…30,31 By reducing blood loss, the use of TXA reduces hospital costs by reducing the need of transfusions, reducing laboratory costs and hospital days. 32 The values obtained in this study regarding mortality predictor markers and possible DVT are in line with recent literature, as demonstrated by the values of Fischer et al 20 and Wiseman et al 21 In the fi rst case, the three biomarkers taken into consideration are associated with all of the causes of mortality, and are involved in various pathophysiological mechanisms, including infl ammation and in maintaining the homeostasis. The alfa-1 acid glycoprotein is an acute phase protein that increases in response to infections and infl ammation.…”

“…19 The risk thrombo-embolic markers (D-dimer and fi brinogen) were also evaluated at patients' arrival, after surgery, at discharge, after the fi rst and third months. [20][21] Patients were discharged with instructions to perform a CBC-electrolyte control within 4 days and to show them to their GP or doctor of the host health facility for rehabilitation. All patients were instructed to: use partial load of up to 50% of body weight for the operated limb, do isometric exercises, venous pump exercises, and breathing exercises for 40 days.…”

Noninvasively Measured Hemoglobin Concentration Reflects Arterial Hemoglobin Concentration Before but Not After Cardiopulmonary Bypass in Patients Undergoing Coronary Artery or Valve Surgery

“…Since its introduction on the market more than half a decade ago, non-invasive SpHb has been the focus of numerous studies in pediatric, 11–15 spine, 16–18 trauma, 19, 20 obstetric, 21–23 urological, 24 abdominal surgery, 25, 26 emergency, 27–29 critically ill 30–32 and other patient groups 33–40 as well as a few review articles. 1–3 …”

Patient Blood Management Bundles to Facilitate Implementation

“…In addition, this will mitigate the diagnostic-associated blood loss postsurgery. Noninvasive screening monitoring of hemoglobin may further reduce workload, blood loss, and costs for anemia screening, although further technical developments are needed to optimize precision [69]. An anemia clinic and/or a PBM nurse practitioner with delegated authority to carry out specified clinical procedures are additional ways to comply with the PBM concept.…”