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KMID : 1100820240140010039
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Laboratory Medicine Online
2024 Volume.14 No. 1 p.39 ~ p.42
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Clinical Utility of Cellular Hemoglobin as a Compatible Marker to the Saline Replacement Method for Hemoglobin Measurement in Lipemic Samples
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Park Soo-Eung
Kim Hey-Jin
Lee Jin-Kyung
Hong Young-Jun
Oh Ae-Chin
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Abstract
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Hemoglobin transports oxygen and carbon dioxide and is often measured via turbidimetry. However, lipemia interferes with turbidimetry results; therefore, the saline replacement method is required to overcome this interference. The ADVIA® 2120i hematology system (Siemens Healthineers, Germany) measures cellular hemoglobin using the mean cellular hemoglobin concentration, measured via flow cytometry. Lipemia does not interfere with flow cytometry results. De-identified lipemic samples assessed with ADVIA® 2120i from March 2018 to March 2023 were analyzed for hemoglobin and cellular hemoglobin levels in comparison with age-matched controls. Similarly, patient sex and age were compared. First, analysis of variance and a post-hoc analysis were performed to compare mean hemoglobin, cellular hemoglobin, and saline-replacement hemoglobin levels in lipemic samples. Subsequently, receiver operating characteristic curve analysis was performed to elucidate the specific cutoff hemoglobin minus cellular hemoglobin level in lipemic and control samples. Complete blood count was performed for 667,532 samples, 394 (0.06%) of which were lipemic. In lipemic samples, the mean hemoglobin and cellular hemoglobin levels differed significantly (P<0.001). However, the mean cellular and saline-replacement hemoglobin levels did not differ significantly (P=0.990). A cutoff hemoglobin minus cellular hemoglobin level of 0.35 g/dL had a sensitivity of 90.9% and specificity of 97.5%. The results suggest that when ADVIA® 2120i-measured hemoglobin minus cellular hemoglobin level is ≥0.35 g/dL in lipemic samples, cellular hemoglobin levels can be used in the final report of hemoglobin level without performing saline replacement method.
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KEYWORD
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Hemoglobin, Automated hematology analyzers, Cellular hemoglobin, Saline replacement, Lipemic interference
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