Abstract
Purpose
Accuracy of measurement of low hemoglobin concentrations using the HemoCue®, a B-hemoglobin photometer (HemoCue AB, Angelholm, Sweden) may exhibit significant variability. Infusion of hemoglobin-based oxygen carriers (HBOC) results in low concentrations of plasma hemoglobin. Our study assessed B-hemoglobin photometer measurement accuracy of three HBOC: (hemoglobin glutamer-200 (bovine; Oxyglobin®, Biopure Corp., Cambridge, MA, USA); hemoglobin glutamer-250 (bovine; Hemopure®, Biopure Corp, Cambridge, MA, USA), and hemoglobin-raffimer, (human; Hemolink™, Hemosol, Inc., Toronto, Ontario, Canada).
Methods
In the laboratory, 45 split canine plasma samples were mixed with hemoglobin glutamer-200 (8.13, 16.25, 32.5 g·L−1 concentrations), 45 samples were mixed with hemoglobin glutamer-250 (8.13, 16.25, 32.5 g·L−1 concentrations), 45 with hemoglobin-raffimer (12.5, 25.0, 50.0 g·L−1 concentrations), and measured. Plasma samples without HBOC served as control. Hemoglobin concentration was determined by a laboratory analyzer (Coulter Corporation, Hiafeah, FL, USA) and B-hemoglobin photometer (HemoCue®, Ångelholm, Sweden). Two independent technicians performed blinded sample measurements and randomly tested each sample five times. Results were analyzed according to Bland and Altman analysis.
Results
B-hemoglobin photometer demonstrated high repeatability for all three HBOCs. Repeatability coefficients were 0.37 g·L−1 and 0.48 g·L−1 for hemoglobin glutamer-200, 0.39 g·L−1 and 0.4 g·L−1 for hemoglobin glutamer-250 and 1.07 g·L−1 and 0.85 g·L−1 for hemoglobin-raffimer. An acceptable agreement was found between the B-hemoglobin photometer and the laboratory analyzer for all three HBOCs tested.
Conclusion
The B-hemoglobin photometer accurately determined the concentration of three HBOC solutions dissolved in canine plasma.
Résumé
Objectif
La précision des mesures de faibles concentrations d’hémoglobine réalisées avec le HemoCue®, photomètre pour B-hémoglobine (HemoCue AB, Angelholm, Suède), peut afficher une variabilité significative. Une perfusion de transporteurs d’oxygène à base d’hémoglobine (TOBH) entraîne de faibles concentrations d’hémoglobine plasmatique. Notre étude a évalué la précision du photomètre pour B-hémoglobine de trois TOBH : (l’hémoglobine glutamère-200 (bovine; Oxyglobin®, Biopure Corp., Cambridge, MA, USA) ; l’hémoglobine glutamère-250 (bovine; Hemopure®, Biopure Corp, Cambridge, MA, USA) et l’hémoglobine-raffimère (humaine; HemolinkTM, Hemosol, Inc., Toronto, Ontario, Canada).
Méthode
Au laboratoire, 45 échantillons divisés de plasma canin ont été combinés à de l’hémoglobine glutamère-200 (des concentrations de 8,13 - 16,25 - 32,5 g·L−1), 45 avec de l’hémoglobine glutamère-250 (8,13 - 16,25 - 32,5 g·L−1) et 45 avec de l’hémoglobine-raffimère (12,5 - 25,0 - 50,0 g·L−1), puis mesurés. Les échantillons plasmatiques sans TOBH constituaient les témoins. La concentration d’hémoglobine a été déterminée à l’aide d’un analyseur de laboratoire (Coulter Corporation, Hiafeah, FL, USA) et du photomètre pour B-hémoglobine (HemoCue®, Ångelholm, Sweden). Deux techniciens objectifs ont mesuré les échantillons sansen connaître la nature et ont testé chacun cinq fois de façon aléatoire. Les résultats ont été analysés à partir des méthodes de Bland et Altman.
Résultats
Le photomètre pour B-hémoglobine a démontré une grande fidélité pour les trois TOBH. Les coefficients de répétabilité ont été de 0,37 g·L−1 et de 0,48 g·L−1 pour l’hémoglobine glutamère-200 ; 0,39 g·L−1 et 0,4 g·L−1 pour l’hémoglobine glutamère-250 et 1,07 g·L−1 et 0,85 g·L−1 pour l’hémoglobine-raffimère. Il y avait une concordance acceptable entre le photomètre pour B-hémoglobine et l’analyseur de laboratoire en regard des trois TOBH testés.
Conclusion
Le photomètre pour B-hémoglobine a permis de déterminer avec exactitude la concentration de trois solutions de TOBH dissoutes dans du plasma canin.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
HemoCue® (B-Hemoglobin Photometer). Operating Manual. Ångelholm, Sweden.
Jaeger M, Ashbury T, Adams M, Duncan P. Perioperative on-site haemoglobin determination: as accurate as laboratory values? Can J Anaesth 1996; 43: 795–8.
Jahr JS, Lurie F, Xi S, et al. A novel approach to measuring circulating blood volume: the use of a hemoglobin-based oxygen carrier in a rabbit model. Anesth Analg 2001;92: 609–14.
Jahr JS, Lurie F, Gosselin R, Lin JS, Wong L, Larkin E. Effects of a hemoglobin-based oxygen carrier (HBOC-201) on coagulation testing. Clin Lab Sci 2000; 13: 210–4.
Kasper SM, Walter M, Grune F, Bischoff A, Kasper SM, Erasmi H, Buzello W. Effects of a hemoglobin-based oxygen carrier (HBOC-201) on hemodynamics and oxygen transport in patients undergoing preoperative hemodilution for elective abdominal aortic surgery. Anesth Analg 1996; 83: 921–7.
Manning, JE, Katz LM, Brownstein MR, Pearce LB, Gawryl MS, Baker CC. Bovine hemoglobin-based oxygen carrier (HBOC-201) for resuscitation of uncontrolled, exsanguinating liver injury in swine. Shock 2000; 13: 152–9.
Bland JM, Altman DG. Measuring agreement in method comparison studies. Stat Methods Med Res 1999; 8: 135–60.
Lardi AM, Hirst C, Mortimer AJ, McCollum CN. Evaluation of the HemoCue for measuring intraoperative haemoglobin concentrations: a comparison with the Coulter Max-M. Anaesthesia 1998; 53: 349–52.
Rippmann CE, Nett PC, Popovic D, Seifert B, Pasch T, Spahn DR. Hemocue, an accurate bedside method of hemoglobin measurement? J Clin Monit 1997; 13: 373–7.
McNulty SE, Torjman M, Grodecki W, Marr A, Schieren H. A comparison of four bedside methods of hemoglobin assessment during cardiac surgery. Anesth Analg 1995; 81: 1197–202.
Jahr JS, Lurie F, Driessen B, et al. Validation of oxygen saturation measurements in a canine model of hemoglobin based oxygen carrier (HBOC) infusion. Clin Lab Sci 2000; 13: 173–9.
Jahr JS, Driessen B, Lurie F, Tang Z, Louie RF, Kost G Oxygen saturation measurements in canine blood containing hemoglobin glutamer-200 (bovine): in vitro validation of the Nova CO-oximeter. Vet Clin Path 2001; 30: 39–45.
Mantha S, Roizen MF, Fleisher LA, Thisted R, Foss J. Comparing methods of clinical measurement: reporting standards for Bland and Altman analysis. Anesth Analg 2000; 90: 593–602.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Jahr, J.S., Lurie, F., Driessen, B. et al. The HemoCue®, a point of care B-hemoglobin photometer, measures hemoglobin concentrations accurately when mixedin vitro with canine plasma and three hemoglobin-based oxygen carriers (HBOC). Can J Anesth 49, 243–248 (2002). https://doi.org/10.1007/BF03020522
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF03020522