Abstract：
BACKGROUND: Point of care (POC) analyzers are an integral part of the patient care. Transfuse can be an emergency decision, not being a benign act, it is necessary to ensure that the hemoglobin value measured by the POC are comparable with the reference analyzer. The objective is to compare the analytical performance of three POCs: ABL800 Flex, Hemocue and iSTAT and a central laboratory analyzer: XN-10 and the impact on the transfusion decision.
METHODS: An in vitro study was performed in 50 patients for whom a hemogram had been prescribed on the XN-10, the hemoglobin determination was performed in parallel on the three POCs. Then, retrospective study was performed to compare the hemoglobin values returned for matched samples in routine practice, 5505 for ABL800 Flex, 55 for Hemocue and 70 for iSTAT were analyzed.
RESULTS: In vitro study shows systematic biases in the measurement of hemoglobin between the different analyzers, overestimation for the ABL800 Flex and the Hemocue, underestimation for the iSTAT. These biases are accentuated in current practice for iSTAT but decreased for ABL800 Flex. In the transfusion decision range from 70 to 100 g/L, there were 8.6% of clinically discordant results between the reference method and ABL, 34.8% for Hemocue and 21.4% for iSTAT.
CONCLUSIONS: In addition to systematic biases, many additional factors may be involved for variation in hemoglobin measurement with POC. Thus, in the case of urgent transfusion decisions, sending a hemogram on a central laboratory analyzer seems to be essential, while being compatible with a life-threatening emergency.
METHODS: An in vitro study was performed in 50 patients for whom a hemogram had been prescribed on the XN-10, the hemoglobin determination was performed in parallel on the three POCs. Then, retrospective study was performed to compare the hemoglobin values returned for matched samples in routine practice, 5505 for ABL800 Flex, 55 for Hemocue and 70 for iSTAT were analyzed.
RESULTS: In vitro study shows systematic biases in the measurement of hemoglobin between the different analyzers, overestimation for the ABL800 Flex and the Hemocue, underestimation for the iSTAT. These biases are accentuated in current practice for iSTAT but decreased for ABL800 Flex. In the transfusion decision range from 70 to 100 g/L, there were 8.6% of clinically discordant results between the reference method and ABL, 34.8% for Hemocue and 21.4% for iSTAT.
CONCLUSIONS: In addition to systematic biases, many additional factors may be involved for variation in hemoglobin measurement with POC. Thus, in the case of urgent transfusion decisions, sending a hemogram on a central laboratory analyzer seems to be essential, while being compatible with a life-threatening emergency.
摘要：
背景：现场护理（POC）分析仪是患者护理不可或缺的一部分。输血可能是一个紧急决定，不是良性行为，有必要确保POC测得的血红蛋白值与参考分析仪相当。目的是比较三个POC的分析性能：ABL800Flex，血液和iSTAT和中央实验室分析仪：XN-10和对输血决策的影响。
方法：对50名患者进行了体外研究，这些患者在XN-10上进行了血象检查，在三个POC上平行进行了血红蛋白测定。然后，进行了回顾性研究，以比较常规实践中匹配样本返回的血红蛋白值，用于ABL800Flex的5505，分析了55的Hemocue和70的iSTAT。
结果：体外研究表明，不同分析仪之间的血红蛋白测量存在系统偏差，对ABL800Flex和Hemocue的高估，低估了ISTAT。这些偏见在iSTAT的当前实践中得到了加剧，但在ABL800Flex中有所减少。在从70到100g/L的输血决定范围内，参考方法和ABL之间有8.6%的临床不一致结果，Hemocue为34.8%，iSTAT为21.4%。
结论：除了系统偏见之外，POC血红蛋白测量的变化可能涉及许多其他因素。因此，在紧急输血决定的情况下，在中央实验室分析仪上发送血象似乎是必不可少的，同时与危及生命的紧急情况兼容。
方法：对50名患者进行了体外研究，这些患者在XN-10上进行了血象检查，在三个POC上平行进行了血红蛋白测定。然后，进行了回顾性研究，以比较常规实践中匹配样本返回的血红蛋白值，用于ABL800Flex的5505，分析了55的Hemocue和70的iSTAT。
结果：体外研究表明，不同分析仪之间的血红蛋白测量存在系统偏差，对ABL800Flex和Hemocue的高估，低估了ISTAT。这些偏见在iSTAT的当前实践中得到了加剧，但在ABL800Flex中有所减少。在从70到100g/L的输血决定范围内，参考方法和ABL之间有8.6%的临床不一致结果，Hemocue为34.8%，iSTAT为21.4%。
结论：除了系统偏见之外，POC血红蛋白测量的变化可能涉及许多其他因素。因此，在紧急输血决定的情况下，在中央实验室分析仪上发送血象似乎是必不可少的，同时与危及生命的紧急情况兼容。
