Where are we at with point‐ of‐ care testing in haematology?

Abstract

Summary Point‐of‐care testing (POCT) in haematology has continued to grow in popularity and uptake throughout the world. The increasing demand to reduce the turnaround time of test results, coupled with rapid improvements in technology, have led to the development of several devices that are designed for use in different clinical settings, with the hope of improving patient care. The most used POCT in haematology is measurement of haemoglobin concentration. Other POCT devices (used primarily in developing countries) for malaria screening and CD4+ T‐lymphocytes for quantification of human‐immunodeficiency‐virus are becoming the cornerstone for the diagnosis and management of these disorders. New devices are also available for red cell indices, white blood cell count and platelets. In this review clinical studies that validate the use of such devices will be discussed, as well as the advantages and disadvantages of POCT in haematology. A disadvantage of POCT is a lack of training, poor standardization in obtaining blood samples and insufficient internal/external quality assessment. As there is every reason to expect that POCT use will increase in all pathology disciplines, including haematology, it is imperative that systems are put in place to oversee these issues.

Considerations for point-of-care diagnostics: evaluation of acridine orange staining and postprocessing methods for a three-part leukocyte differential test

“…1,2 For example, a three-part leukocyte differential test, which yields a percentage count among the three main cell populations (granulocytes, lymphocytes, and monocytes), could indicate a myriad of abnormalities such as sepsis, malignancy, or infection based on perturbations of the count. 3,4 A five-part differential test is also available and would provide more information including a count of the basophils and eosinophils; however, a three-part differential is typically sufficient for most tests with the assumption that basophil and eosinophil levels are normal and, thus, are not required to be reported.…”

“…7,8 In recent years, a small impedance-based bench-top system that reduces overall system cost and size has been approved for clinical use as a POC device. 1 For this device and other similar devices, miniaturizing the system using the combination of an impedance technique (Coulter principle) and microfluidics (microchannels) is a common approach to reduce cost and complexity by simply minimizing optical components and reagents. 10,13,21,22 Some disadvantages to impedance-based measurements include electrolysis, gas formation, and the need for red blood cell (RBC) lysis and dilution reagents, all of which add design complexity and, potentially, operational cost.…”

Modern banking, collection, compatibility testing and storage of blood and blood components

“…The donor's haemoglobin level is assessed before each donation, generally by a semi-quantitative, gravimetric method, using a drop of capillary blood in a copper sulphate solution, but this may be supplemented by use of portable haemoglobinometers [7]. The EU blood directive states a haemoglobin standard of 135 g.l…”

Point of Care Testing and Transfusion Safety in Resource Limited Settings: A Review

“…A review was recently published [7] which details the options available for POCT in hematology. Essentially they are divided in single parameter, i.e.…”