Abstract
Point of care (POC) hematology testing can be valuable in triage and field settings. We assessed the accuracy between the HemoCue® WBC system and two comparative analyzers, as well as the precision of the HemoCue® WBC system in five different pinniped species: Zalophus californianus, Arctocephalus townsendi, Callorhinus urcinus, Phoca vitulina, and Mirounga angustirostris for white blood cell (WBC) quantification. In Zalophus (n = 164; 106 from U.S. Navy Marine Mammal Program (Navy); 58 from The Marine Mammal Center (TMMC)), the HemoCue® was compared to two hematology analyzers, Sysmex Xe-5000 and Vet ABC Plus. In Phoca (n = 50; TMMC), Callorhinus (n = 29; TMMC), Arctocephalus (n = 17; TMMC), and Mirounga (n = 67; TMMC), the HemoCue® was compared to Vet ABC Plus only. Bland–Altman and Passing–Bablok agreement of HemoCue® with Sysmex Xe-5000 and Vet ABC Plus analyzers were good for Zalophus, Arctocephalus, Phoca, and Mirounga but marginal with Callorhinus; bias = 0.56 × 109/L (Zalophus; Navy), −2.13 × 109/L (Zalophus; TMMC), −1.59 × 109/L (Arctocephalus), −2.48 × 109/L 0.917 (Phoca), −0.01 × 109/L (Mirounga), and −6.05 × 109/L (Callorhinus). The coefficient of variation from triplicate runs of samples were within acceptable limits for all species (2.50% ± 1.63 (Zalophus; TMMC), 3.09% ± 2.14 (Arctocephalus), 2.47% ± 1.35 (Callorhinus), 2.88% ± 1.75 (Phoca), and 3.44% ± 2.53 (Mirounga)), respectively. The presence of nucleated red blood cells (nRBC; 1–37 nRBC/100 WBC) did not significantly interfere with WBC counts in Zalophus, Callorhinus, and Phoca at the population level, but their presence should be evaluated at the individual level. The HemoCue® provides an accurate method for WBC quantification with WBC counts up to 30 × 109/L (upper limit of linearity of the analyzer) in Zalophus, Arctocephalus, Phoca, and Mirounga, but is less accurate in Callorhinus, and showed good precision in all species.
Highlights
This study demonstrates the accuracy and precision of the HemoCue® White blood cell (WBC) system in five species of pinnipeds: Zalophus, Arctocephalus, Callorhinus, Phoca, and Mirounga over a wide range of WBC counts up to 30 × 109 /L in comparison to two comparative instruments (Vet ABC Plus and Sysmex Xe-5000)
Based on the results of this study, this portable and easy-to-use Point of care (POC) WBC quantification device offers an additional diagnostic tool and potential applications to zoological and wildlife medicine, including but not limited to health assessments in the field, patient-side diagnosis of abnormal WBC counts leading to more rapid and guided treatment decisions, and in clinical facilities limited by financial resources
When compared to the Vet ABC Plus, the HemoCue® had marginal to good accuracy in all five species with the best accuracy observed in Mirounga and the lowest accuracy observed in Callorhinus
Summary
Point of care (POC) analyzers offer rapid adjunct diagnostic testing to supplement standard hematology in both human and veterinary medicine. Oceans 2022, 3 analyzers are cost-effective in resource-limited settings, and provide rapid, bed-side results allowing fast initiation of treatment [1]. In a managed care setting and for patients requiring sedation or anesthesia for diagnostics, treatments, and handling, the ability to determine WBC counts patient-side facilitates rapid initiation of treatment, potentially requiring fewer sedation and/or anesthetic events, and can help guide clinical decisionmaking and management of critically ill patients. Many health assessment studies in free-ranging wildlife species aim to determine the impact of different diseases on populations but are limited by the lack of capacity to perform a WBC count to complement a WBC differential and often must rely on blood film evaluation only [6,7]. A POC WBC count analyzer can provide individual patient-side automated hematology in rescue situations or managed care that may otherwise be impossible
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