CRIT-LINE: a noninvasive tool to monitor hemoglobin levels in pediatric hemodialysis patients
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The national average for achieving the KDOQI-recommended hemoglobin (Hgb) target level of 11–12 g/dL is low with the current anemia management protocol of measuring Hgb levels every 2–4 weeks to guide intervention. The objective of this study was to correlate initial Hgb readings from the CRIT-LINE monitor with actual serum Hgb levels in pediatric patients on hemodialysis (HD).
Data were collected from pediatric HD patients who had Hgb tests ordered for routine and/or clinical reasons. Hgb concentrations were read with the CRIT–LINE after 0.5 or 1 L of blood had been processed by HD in patients with a body weight of ≤20 or >20 kg, respectively. Ultrafiltration was kept at a minimum until the CRIT-LINE Hgb was read.
In total, 217 Hgb readings from 23 HD patients were analyzed. Results showed a statistically significant correlation between CRIT-LINE readings and laboratory Hgb measurements (r = 0.94, p < 0.0001) using Pearson correlation coefficients for well-distributed data. The mean Hgb levels measured by CRIT-LINE and the laboratory were 11.12 ± 1.63 and 11.31 ± 1.69 g/dL, respectively.
The CRIT-LINE monitor is an accurate instrument for monitoring Hgb levels in HD patients. Further studies will be needed to evaluate whether using CRIT-LINE Hgb levels to guide anemia management will improve the percentage of children with Hgb levels within target.
KeywordsCRIT-LINE Anemia Children Hemodialysis Hemoglobin
We thank all dialysis nurses, staff and patients in the participating hemodialysis unit for their support and assistance in conducting this study, especially Kathleen Cagan, RN, Vivien Paquia, RN, Dennis Zorills, RN, Germaine Wilkom, RN, Jeanne Shaffer, RN and Paul Bayona, RN.
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