The evaluation of point-of-care testing for determining hemoglobin levels in geriatric intensive care patients

Abstract

AbstractBackgroundThe aim of the present study was to compare hemoglobin (Hb) levels determined by point-of-care testing (POCT) HemoCue® and arterial blood gas analyzer using an automated hematology analyzer in critically ill geriatric patients.MethodsForty geriatric patients requiring intensive care treatment were included in the study. Arterial blood sample was analyzed using HemoCue® (HemoCue®; Hb 201+, Angelholm, Sweden) (HbHemoCueArterial), blood gas analyzer (Techno Medica, Gastat1800 series, Japan) (HbBGA) and an automated hematology analyzer (Cell Dyne 3700 System, Abbott Laboratories, USA) (HbLab) as a reference method. Capillary blood measurements were performed (HbHemoCueCapillary) using HemoCue® at bedside. Bland-Altman analysis was applied to the results.ResultsWe found a positive correlation between the Hb measurements of HemoCueCapillary, HemoCueArterial and automated hematology analyzer (r-values were 0.799 and 0.922, respectively) and p<0.001. There was also a positive correlation between the Hb measurements of blood gas analyzer and automated hematology analyzer (r = 0.878) and p<0.001. The bias and limits of agreement were 0.32 and −2.5±3.14 g/dL for the HbHemoCueCapillary, 0.64 and −1.03±2.31 g/dL for the HbHemoCueArterial and −1.2 and −4.45±2.05 g/dL for the HbBGA. Inotropic agent administration did not affect the Hb values in all groups.ConclusionsBoth HemoCueCapillary and HemoCueArterial are sufficiently accurate and correlated with automated hematology analyzer in geriatric critically ill patients if used correctly. In terms of Hb levels, arterial and capillary blood sample measurements with HemoCue® provided more clinically acceptable accuracy than blood gas analysis system.