Point-of-care versus central testing of hemoglobin during large volume blood transfusion

Autor: Frances Mae West, Marianna LaNoue, Denine R Crittendon, Michael Baram, Alexis R. Peedin, Lilah Evans, Eugene Warnick, Brian Park, Justin Herman, Barbara M. Goldsmith, Bharat Awsare, Mary Harach, Julie Katz Karp
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Zdroj: BMC Anesthesiology, Vol 19, Iss 1, Pp 1-7 (2019)
BMC Anesthesiology
ISSN: 1471-2253
Popis: Background Point-of-care (POC) hemoglobin testing has the potential to revolutionize massive transfusion strategies. No prior studies have compared POC and central laboratory testing of hemoglobin in patients undergoing massive transfusions. Methods We retrospectively compared the results of our point-of-care hemoglobin test (EPOC®) to our core laboratory complete blood count (CBC) hemoglobin test (Sysmex XE-5000™) in patients undergoing massive transfusion protocols (MTP) for hemorrhage. One hundred seventy paired samples from 90 patients for whom MTP was activated were collected at a single, tertiary care hospital between 10/2011 and 10/2017. Patients had both an EPOC® and CBC hemoglobin performed within 30 min of each other during the MTP. We assessed the accuracy of EPOC® hemoglobin testing using two variables: interchangeability and clinically significant differences from the CBC. The Clinical Laboratory Improvement Amendments (CLIA) proficiency testing criteria defined interchangeability for measurements. Clinically significant differences between the tests were defined by an expert panel. We examined whether these relationships changed as a function of the hemoglobin measured by the EPOC® and specific patient characteristics. Results Fifty one percent (86 of 170) of paired samples’ hemoglobin results had an absolute difference of ≤7 and 73% (124 of 170) fell within ±1 g/dL of each other. The mean difference between EPOC® and CBC hemoglobin had a bias of − 0.268 g/dL (p = 0.002). When the EPOC® hemoglobin was Conclusions The EPOC® device had minor negative bias, was not interchangeable with the CBC hemoglobin, and was less reliable when the EPOC® value was
Databáze: OpenAIRE
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