Discordant Hemoglobin Values Determined by Blood Gas Analyzer and Hematology Analyzer Synchronously Is a Warning for Inappropriate Blood Sampling

Abstract

A patient may have two contemporary hemoglobin test results; one received from a hematology analyzer and the other from a blood gas analyzer. Such results may pose a dilemma if validated without investigation. A 27-year-old female patient presented to the emergency department because of worsening dyspnea and hemoptysis. Her hemogram revealed Hb 4.5 g/dL; Hct 16.1% while blood gas analysis showed Hb 8.1 g/dL; Hct 25.3%. The results were evaluated to be suspicious. All results were rejected and new requests were made. Hb 9.8 g/dL; Hct 31.9% were seen in repeated hemogram while blood gas analysis showed Hb 10.2 g/dL; Hct 31.5%. It was understood that the nurse used the vein with an intravenous fluid for sampling the first hemogram. A multitude of factors affect the accuracy of hemoglobin concentration measurements. Literature suggests that hemoglobin values of hematology analyzers and blood gas analyzers should be in harmony. Any discordance must be an alarm to stop and review the test results before validation.