Reliability of Point-of-Care Hematocrit Measurement During Liver Transplantation

Abstract

Hematocrit measured using the POC device tends to be lower than the laboratory hematocrit measured during LT. Commonly encountered laboratory abnormalities during LT include hypoalbuminemia, hypoproteinemia, and hyperglycemia, which may contribute to falsely low-measured POC hematocrit. Careful consideration of these confounders may help reduce overtransfusion that occurs due to falsely low-measured POC hematocrit.

Comparison of two point‐of‐care measurements of hemoglobin against standard laboratory values during pediatric liver transplantation: A retrospective review

“…We calculated that a sample size of 86 was required to achieve 95% power to detect a difference of 1 g/dl between the null hypothesis of 10 g/dl and the alternative hypothesis of 9 g/dl, which is consistent with recently published POC performance studies 8,9 and complies with recommendations for how to incorporate an error grid analysis into this type of study. 16,17 The D'Agostino Pearson test was used to confirm normality, a condition that supports the use of Bland-Altman analysis.…”

“…Another limitation of this study is that we are unable to comment on whether concomitant albumin levels affect the performance of these devices, which has been demonstrated in other studies in the context of liver transplantation. 9 There has also been evidence to suggest that type of resuscitative fluid also affects the performance of these POC devices, particularly those that employ conductometric analysis, such as the iSTAT, 27 which was not examined within the scope of this study. Lastly, while most lab draws were arterial, there were some lab values that were drawn from the central venous catheter when the arterial line was poorly functioning, or during a critical portion of the procedure when continuous blood pressure management was required.…”

“…20 This decision is consistent with other contemporary POC device studies. 8,9 The difference between the core lab CBC and the POC device is plotted on the y-axis.…”

Influence of Transfusion on the Risk of Acute Kidney Injury: ABO-Compatible versus ABO-Incompatible Liver Transplantation

“…To reduce the transfusion amount in ABO-i LT, we could adopt a restrictive transfusion policy by decreasing the transfusion threshold. Although there is no established consensus regarding intraoperative transfusion, the pRBC transfusion threshold in our institution during liver transplantation was around 20% in hematocrit [38]. This threshold could be lowered further depending on the baseline status of recipients or the mixed venous oxygen concentrations.…”

Metabolism-Driven High-Throughput Cancer Identification with GLUT5-Specific Molecular Probes

“…Point-of-care (POC) and POC-healthcare technologies (POCHT) that monitor changes in the intracellular mechanisms to report disease development have gained prominence in clinical and consumer implementations owing to the ease of access to information, low cost, and self-management of health and wellbeing [ 1 , 2 , 3 , 4 , 5 ]. The marked improvement in microfluidics, molecular diagnostics, and nucleic acid chemistries [ 6 , 7 , 8 ] to identify cancer-relevant biomarkers [ 9 ] has led to an increased interest in POC/POCHT for cancer.…”