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KMID : 1155520180130030323
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Anesthesia and Pain Medicine
2018 Volume.13 No. 3 p.323 ~ p.328
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Downward bias of conductivity based point-of-care hemoglobin measurement compared with optical methods
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Heo Min-Hee
Kim Jun-Hyun
Kim Kyung-Woo
Cho Ho-Jae
Choe Won-Joo
Kim Kyung-Tae
Kim Ji-Yeon
Lee Sang-Il
Park Jang-Su
Kim Jung-Won
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Abstract
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Background: Point-of-care (POC) arterial blood gas analysis (ABGA) is widely used for checking hemoglobin (Hb) level. However, there is the tendency of downward bias of conductivity-based POC ABGA Hb measurement compared with optical methods. Authors tried to correct that bias by linear regression equation.
Methods: We retrospectively collected a total of 86 Hb result pairs during surgeries. Hb measured by the Sysmex XE-2100 in the laboratory was set as the gold standard and was compared with that measured by the GEM Premier 3500. Data were compared using the Bland-Altman analysis, the reliability of transfusion decision was assessed using three-zone error grid. The linear regression analysis was performed to find out the relation between the Hb results of POC ABGA and those of laboratory based test.
Results: The bias of the Hb measured between Sysmex XE-2100 and GEM Premier 3500 was ?0.9 g/dl (P < 0.001, 95% confidence interval, ?1.038 to ?0.665 g/dl). The percentage error was 16.4%. According to error grid methodology, zone A, B and C encompassed 89.5%, 10.5% and 0% of data pairs. After adjusting the POC ABGA Hb values, the bias of the Hb measured by two methods was 0 g/dl (P = 0.991). The percentage error was 18.2%. The zone A, B and C encompassed 91.9%, 8.1% and 0% of data pairs.
Conclusions: Hb measurements obtained with reference to conductivity via a POC ABGA were significantly lower than those obtained via optical methods. This bias may deserve attention of anesthesiologists when POC ABGA Hb level is used as a transfusion guideline.
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KEYWORD
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Blood gas analysis, Hemoglobins, Point-of-care testing
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