457560 of Laboratory AutomationSanchis-Gomar et al. 2012 JLAXXX10.1177/2211068212457560Journal Hemoglobin Point-of-Care Testing: The HemoCue System Journal of Laboratory Automation XX(X) 1–8 © 2012 Society for Laboratory Automation and Screening DOI: 10.1177/2211068212457560 http://jala.sagepub.com Fabian Sanchis-Gomar1, José Cortell-Ballester2, Helios Pareja-Galeano1, Giuseppe Banfi3, and Giuseppe Lippi4 Abstract Besides the use of traditional laboratory resources, the diagnosis of anemia can also be accomplished by assessing hemoglobin (Hb) concentration with point-of-care testing (POCT) devices such as the HemoCue test systems. In several situations, these devices might suitably replace traditional laboratory testing, including several areas of health care where a very rapid Hb measurement might be required to make immediate therapeutic decisions. The use of these devices, however, should fulfill some basic criteria, including economic, clinical, and regulatory issues; appropriate training of the users and knowledge of test requirements, performance, limitations, and potential interferences; the use of venous and arterial sampling, when possible; and a rigorous quality assessment, which should be under the responsibility of laboratory professionals. Because of its optimal performance along with the fact that the HemoCue is probably one of the most commonly used devices worldwide, the aim of this article is to review the literature data about the performance of this test system as compared with laboratory reference testing estimations and according to the biological matrix. Keywords delivery of health care, hemoglobin concentration, anemia, automated hemocytometers, blood donors Introduction Besides the use of traditional laboratory resources, the diagnosis of anemia can also be accomplished by assessing hemoglobin (Hb) concentration with point-of-care testing (POCT) devices such as the HemoCue (HemoCue, Ängelholm, Sweden) test systems. In several situations, these devices might suitably replace traditional laboratory testing, including several areas of health care where a very rapid Hb measurement might be required to make immediate therapeutic decisions. For instance, it could be imperative in patients who require critical venous access, especially neonates and those undergoing chemotherapy due to the low amount of blood required by these devices, as well as in natural disasters or in sports medicine. The reference method for Hb measurement is still based in analysis on automated hematology analyzers, although the widespread use of automated hemocytometers entails major costs for blood tubes and reagents, as well as greater volumes of blood and a longer turnaround time. Electronic and portable hemoglobinometers such as HemoCue provide fast Hb results with a high degree of quality and can be operated using battery or mains electricity. Several HemoCue systems, such as B-Hemoglobin, Hb 201+, 201 DM, Hb 301, and Donor Hb Checker, are available on the market (Table 1). Hb 201+ and 201 DM employ the azide-methemoglobin method,1 whereas Hb 301 and Donor Hb Checker are modified versions,2 which use microcuvettes that are significantly cheaper. The measurement range is 0 to 256 g/L, and results are obtained within 10 to 60 s. The manufacturer suggests that capillary, venous, or arterial whole blood in ethylenediaminetetraacetic acid (EDTA) anticoagulant can be used as the sample (www. hemocue.com). Although many other instruments are available worldwide for mobile collection settings, including STAT–Site MHgb (Stanbio Laboratory, Boerne, TX), Hgb Pro Professional Hemoglobin Testing System (ITC, Edison, NJ), D-10 Hemoglobin Testing (Bio-Rad Laboratories, Hercules, CA), and CompoLab HB system (Fresenius Kabi AG, Bad Homburg, Germany), scientific literature data and 1 University of Valencia, Fundación Investigación Hospital Clínico Universitario/INCLIVA,Valencia, Spain 2 Hospital La Fe,Valencia, Spain 3 University of Milan, Milan, Italy 4 Academic Hospital of Parma, Parma, Italy Received June 25, 2012. Corresponding Author: Fabian Sanchis-Gomar, Department of Physiology, Faculty of Medicine, University of V alencia, Av. Blasco Ibañez, 15,Valencia, 46010 Spain Email: [email protected] Downloaded from jla.sagepub.com by guest on November 22, 2012 2 Downloaded from jla.sagepub.com by guest on November 22, 2012 0–256 Capillary, venous, or arterial Capillary, venous, or arterial Capillary, venous, or arterial Capillary or venous HemoCue Hb 201 System HemoCue Hb 201 DM System HemoCue Hb 301 System HemoCue Donor Hb Checker System 10 10 10 10 10 1000 500 Analyzer: 350; docking station: 566 350 1000 15–40 10–40 15–30 15–30 15–30 No further calibration Calibration Daily basis; control microcuvette No further calibration Built-in “self-test” No further calibration Built-in “self-test” No further calibration Built-in “self-test” No further calibration Daily basis; control microcuvette Operating Temperature, Weight, g °C Quality Control ICSH, International Council for Standardization in Haematology. 105–190 0–256 0–256 0–256 Range, g/L HemoCue Capillary, B-Hemoglobin venous, or System arterial Sample Sample Volume, µL Table 1. Summary of Technical Characteristics of the Different HemoCue Hemoglobinometer Models Method Principle Correlation of 0.99 Vanzetti Modified azidemetwhen compared with (1966)1 hemoglobin reaction; double-wavelength the reference method measuring method, 570 (ICSH method) nm and 880 nm Correlation of 0.99 Vanzetti Modified azidemetwhen compared with (1966)1 hemoglobin reaction; double-wavelength the reference method measuring method, 570 (ICSH method) nm and 880 nm Correlation of 0.99 Vanzetti Modified azidemetwhen compared with (1966)1 hemoglobin reaction; double-wavelength the reference method measuring method, 570 (ICSH method) nm and 880 nm Absorbance of whole Correlation of 0.99 van when compared with Kampen blood at an Hb/HbO2 isobestic point; doublethe reference method and (ICSH method) Zijlstra wavelength measuring (1983)2 method, 506 nm and 880 nm Absorbance of whole Correlation of 0.99 van when compared with Kampen blood at an Hb/HbO2 isobestic point; doublethe reference method and (ICSH method) Zijlstra wavelength measuring (1983)2 method, 506 nm and 880 nm Accuracy 3 Sanchis-Gomar et al. on-field evaluation of non-HemoCue test systems are extremely limited or even lacking for some of them. As such, its optimal performance along with the fact that the HemoCue is probably one of the most commonly used devices worldwide has led us to focus this review article on this test system. Although the HemoCue was found to have good sensitivity and specificity for anemia,3,4 these conclusions were reached without much consideration about the conditions under which the test is supposed to be performed. Accordingly, high humidity has been shown to bias HemoCue microcuvette function as well as Hb measurements.5 Experimental evidence also attests that some discrepancies exist between capillary, venous, and arterial sample Hb determinations. Similarly, various and even controversial results have been reported for accuracy and reliability. Therefore, the aim of the article is to review the literature data about the performance of HemoCue devices since we note that there are discrepancies in published literature so far, and there is evident need for summarization of all findings. HemoCue Experimental Evidence In 1998, Hb values obtained using the HemoCue (the specific model was not reported) were compared with results obtained by the Coulter Max-M (Beckman Coulter, Brea, CA) in a clinical laboratory. Hb was measured in 52 arterial blood samples from 13 patients during aortic surgery. No significant differences were observed between test results (p = 0.1). Thus, it was also found that the lower and upper limits of agreement between the two analyzers were –0.37 and +0.45 g/dL, which led the authors to conclude that the HemoCue provided Hb results comparable with the laboratory reference method and was hence useful for nearpatient testing.6 Another study was carried out to determine whether HemoCue (the specific model was not specified) may be useful in a neonatal unit to measure Hb as compared with a laboratory method (i.e., Coulter STKS; Beckman Coulter). Samples were collected by venipuncture, by heel prick, or from arterial lines. Again, the concordance of measures between the HemoCue and laboratory testing was excellent (limits of agreement of the two methods were between –4.8 and +9.8 g/L) over a broad range of Hb values.7 Another study compared Hb values determined with the HemoCue (the model was not specified) with those assessed using laboratory instrumentation. Venous blood specimens were collected, and good agreement was found between the HemoCue and Technicon H3 (Bayer Technicon, Tarrytown, NY), since the bias was within 10 g/L in 95% of measures, and in no case did the variation exceed 20 g/L.8 Hb was also measured in venous, earstick, and fingerstick samples using the HemoCue (B-Hemoglobin) and an automatic hematology analyzer (Abbott Cell-Dyn 3500; Abbott Diagnostics, Abbott Park, IK). It was found that earstick Hb results were considerably higher than the fingerstick and venous results (i.e., the mean overestimation of the earstick hemoglobin measurement was 7.8%, with mean bias between 7 and 28 g/L in 95% of cases), so it was concluded that earstick collections for Hb assessment are not advisable in routine practice. The mean Hb concentration in the fingerstick samples was instead slightly higher than that recorded in venous samples (Pearson’s correlation coefficient r = 0.93, with bias exceeding the limit of ±10 g/L in 9% of samples). Thus, the use of fingerstick samples led to overestimation of the actual Hb concentration, although in the authors’ opinion, this bias was still acceptable.9 To assess the reliability of point-of-care Hb determination with HemoCue (B-Hemoglobin model) and to analyze its usefulness for the initial diagnosis of anemia, Hb was measured in 20 venous blood samples diluted with saline to obtain a wide range of Hb, as well as in venous and capillary blood samples from 247 primary health care patients. In this case, all HemoCue results were compared with those obtained by laboratory instrumentation (Pentra 120 Retic ABX; HORIBA Ltd., Kyoto, Japan). In diluted samples, Hb values obtained with the HemoCue and Pentra 120 were not significantly different (mean bias −0.1 ± 3.2 g/L) and showed an excellent correlation (r = 0.992; p < 0.01). HemoCue provided accurate values if at least 4 µL of blood was loaded into the microcuvette. Moreover, no significant differences were observed when Hb was measured in venous and capillary blood samples. It was hence concluded that the HemoCue may provide accurate and reliable values in a broad range of Hb, so it can reasonably be used for the initial screening of anemia in primary health care.10 Another group assessed predonation venous Hb in blood donors by capillary blood samples analyzed by the HemoCue (model not reported) and laboratory instrumentation (Coulter MaxM; Beckman Coulter). The imprecision (i.e., mean coefficient of variation, CV) for the HemoCue was 2.3% ± 0.7%. HemoCue showed good agreement with venous Hb (r = 0.892), although HemoCue test results exhibited a positive bias (i.e., overestimation) of 7.8 ± 7.3 g/L (in 95% of the cases, the results of the capillary blood sample varied from those obtained in venous specimens, in a range between –6.8 and 22.5 g/L), which led the authors to conclude that capillary Hb measurement by this portable hemoglobinometer might be unreliable since it could potentially affect both donor safety and the blood supply.11 On the other hand, the comparability of the HemoCue (Hb 301) measurements with a Sysmex XE 2100 (Sysmex, Kobe, Japan) was assessed by analyzing more than 300 routine venous blood samples. A bias greater than 7% occurred in 4% of cases (i.e., 13/300), and in only 3 cases (i.e., 1%), the bias exceeded 10%, which was considered the threshold Downloaded from jla.sagepub.com by guest on November 22, 2012 4 Journal of Laboratory Automation XX(X) for clinical significance by the authors. These results supported the conclusion that the HemoCue may be a suitable strategy for blood donor screening. Additional advantages were listed, including the lower cost of Hb 301 microcuvettes as compared with other models and the robustness against adverse climatic conditions.9 Other authors have compared capillary blood HemoCue test results (model not specified) with those obtained by a Sysmex SE 9500 in venous samples collected in patients with gastrointestinal bleeding. The mean bias between the HemoCue and Sysmex SE 9500 was –0.6 ± 8.7 g/L and exceeded 10 g/L in 21% of cases, which prompted the authors to advise against the routine use of the capillary HemoCue alone for making therapeutic decisions.10 It also has been investigated whether the HemoCue (HemoCue B-Hemoglobin) might be suitable to assess Hb in suction fluid obtained at elective caesarean section. The comparison of Hb values obtained in 30 women with the HemoCue and laboratory analysis (regrettably, the type of hemocytometer was not specified throughout the article) exhibited a bias of –0.13 mg/L (limit of agreement between –3.9 and 3.6 mg/L), thereby revealing a good degree of agreement.12 In another study, the authors compared the accuracy of results obtained on fingerstick blood samples by the HemoCue (201+ Hb model) with those obtained on venous blood samples with a ABX Pentra 60 (HORIBA, Ltd.) in 969 unselected potential female donors. It was found that the sensitivity of the HemoCue was only 56%, and the instrument failed to detect a relevant number of anemic donors (up to 36%). Furthermore, the results of capillary Hb showed a trend toward higher values than in venous blood (overestimation of 5.9%). Finally, a poor linear correlation among ABX Pentra 60 and HemoCue was also reported (Pearson’s correlation coefficient r = 0.716).13 A new study assessed the reliability of Hb values in venous blood measured with the HemoCue (B-Hemoglobin) in patients with gastrointestinal hemorrhage and compared them with those measured on venous blood with a laboratory instrument (the model was not reported in the article). Overall, a good correlation was observed (i.e., Pearson’s correlation coefficient r = 0.979), and the bias was –1.0 g/L (95% confidence interval [CI], –6.9 to 4.9 g/L). HemoCue was hence considered a quick and reliable method for Hb assessment in both the acute and stable phases of gastrointestinal bleeding.14 On the other hand, Richards et al.15 compared Hb values measured in venous and capillary samples (toe and thumb) in patients undergoing caesarean section under neuraxial anesthesia using the HemoCue (model not reported) and laboratory instrumentation (again, the analyzer model was not reported). In this study, the mean bias versus results obtained in venous blood samples tested in the laboratory was –2 ± 16 g/L (HemoCue, capillary blood from toe), –1 ± 18 g/L (HemoCue, capillary blood from thumb), and –2 ± 16 g/L (HemoCue, venous blood). Afterward, a new study was carried out to assess the accuracy of HemoCue measurements (model not reported) as compared with the Sysmex KX 21 in 535 blood donors. The HemoCue Hb values obtained in capillary and venous blood were also compared. The authors found that the correlation coefficient between capillary HemoCue and cell counter values was 0.40, identical to that between capillary and venous HemoCue. Nevertheless, the correlation coefficient between the venous HemoCue and cell counter was 0.91.16 More recently, a study compared Hb test results obtained with the HemoCue (201+ Hb model) and Radical 7 (Masimo Corp., Irvine, CA) in 44 patients with acute surgical hemorrhage after induction of anesthesia, during surgery according to the requirements of the anesthesiologist, and finally after the transfer of the patient to the recovery room. A good correlation was found between HemoCue and Radical 7 values when analyzing capillary blood (r = 0.85, p < 0.001), with a mean bias of –1.7 ± 10.5 g/L.17 Another group compared the accuracy of the HemoCue (model not reported) with a Beckman Coulter co-oximeter in arterial blood samples of patients who received general anesthesia for spine surgery. In 77 of the 78 Hb measurements (i.e., 98.7%) obtained in these patients, the HemoCue values exhibited a bias lower than 10 g/L as compared with the co-oximeter.18 This led the authors to conclude that arterial HemoCue values might be virtually interchangeable with those obtained with standard co-oximetry. Accuracy and reproducibility of the HemoCue (BHemoglobin model) for Hb determination were compared with results obtained on a Sysmex XE 2100 in children undergoing major surgery. A total of 256 arterial blood samples were collected at several intraoperative time points. HemoCue exhibited good reproducibility and negligible bias when compared with the XE 2100. Potential clinically significant differences were observed beyond a range of 20 g/L in only two cases (i.e., 0.8%). It was concluded that the HemoCue showed reliable test results in the intraoperative setting.19 Likewise, researchers assessed whether the noninvasive Hb measurement with the HemoCue (Hb 301) may provide clinically acceptable accuracy in critically ill patients when compared with a Sysmex XT 2000i. A total of 471 arterial blood samples from 65 patients were collected and analyzed, and a capillary measurement was also performed at bedside using the same device. The mean bias between HemoCue test results obtained on capillary blood and those obtained on arterial blood samples with the Sysmex XT 2000i was 2 g/L (95% CI, 1–3 g/L), and the correlation was 0.76. Discrepancies between values greater than 10 g/L were reported in 33% of cases. Similar data were obtained when comparing test results obtained on arterial blood, since the bias between HemoCue and Sysmex XT 2000i was –1 g/L (95% CI, –0.2 to 0.2 g/L), with a correlation of 0.88 and discrepancies between values greater than 10 g/L being reported in 31% of cases.20 Downloaded from jla.sagepub.com by guest on November 22, 2012 5 Sanchis-Gomar et al. Hb values measured using the HemoCue (Hb 201+) were compared with those obtained with the Beckman Coulter LH 750. One hundred fifty blood samples were obtained from 79 adult patients hospitalized in a surgical intensive care unit who required an urgent Hb determination. Arterial and venous blood was analyzed using both HemoCue and the automated laboratory analyzer, whereas capillary blood samples were also simultaneously obtained by fingerstick and analyzed with the HemoCue. The mean absolute bias between the HemoCue and Beckman Coulter LH 750 was 1 g/L (95% CI, –19 to 22 g/L) in arterial blood, 1 g/L (95% CI, –25 to 26 g/L) in venous blood, and 11 g/L (95% CI, –36 to 58 g/L) in capillary (HemoCue) and venous/arterial blood (Beckman Coulter LH 750). Edema was found to be the only independent variable explaining the discordance between capillary values obtained with the HemoCue and those in venous or arterial blood obtained with the hemocytometer (odds ratio 6.6; 95% CI, 2.0–22.2). These results led the authors to advise against the use of the HemoCue in critically patients, especially in the presence of edema and for capillary blood.21 The accuracy of the HemoCue (Hb201+) in patients receiving antiviral therapy after liver transplantation was also assessed. Moreover, its usefulness in terms of cost saving and time saving was evaluated. The Hb measurements were performed in 16 patients either in venous blood with a Siemens ADVIA 120 (Siemens Healthcare Diagnostics, Tarrytown, NY) or in capillary blood using the HemoCue. Paired HemoCue measurements were also performed to assess the imprecision of this device. Time requirements and cost of both procedures were finally recorded and compared. The HemoCue displayed optimal reproducibility and good correlation with the standard method (r = 0.89). The accuracy for detecting anemia (i.e., Hb ≤100 g/L) was excellent, as attested by the area under the receiver operator characteristic curve (AUC, 0.96). Even more interesting, the use of the HemoCue in this cohort of patients was associated with significant economic and time savings per patient during follow-up.22 The suitability of the HemoCue as a POCT device for Hb estimation in mobile blood donations and critical care areas was also assessed. For this purpose, venous blood was collected from study participants drawn from five groups (i.e., preschool children, schoolchildren, pregnant women, nonpregnant women, and men) and immediately processed for Hb measurement with the HemoCue B-Hemoglobin, Sysmex KX21N, and the reference cyanmethemoglobin test. The overall mean Hb was 104 g/L with the HemoCue, 103 g/L with the Sysmex KX21N, and 103 g/L with the cyanmethemoglobin test. A very high agreement was found for Hb test results obtained with the HemoCue and the cyanmethemoglobin test (r = 0.995; mean bias, 1.3 g/L; 95% CI, 1.0–1.5 g/L). After adjustment for possible confounders (e.g., gender, age, and category of person), no significant difference was also observed between the HemoCue and the cyanmethemoglobin test. A high concordance of measures was also found between the HemoCue and Sysmex KX21N, with a mean bias of 1.5 g/L (95% CI, –3.9 to 6.9 g/L) and a nonsignificant difference in variability between the two measurements (p = 0.391). It was hence suggested that the HemoCue might reliably be used as an emergent device in critical areas as well as in those with limited resources.23 In a recent study, the authors compared predonation capillary and venous Hb levels of 8910 first-time donors presenting for whole-blood donation. Hb testing was performed both on fingerstick samples with the HemoCue (Donor Hb Checker model) and on venous blood samples with the Sysmex SE 9000. In the vast majority of blood donors, the capillary (HemoCue) and venous (SE 9000) Hb values differed less than 10 g/L, whereas the difference exceeded 20 g/L in 86 donors (1.0%) and 30 g/L or more in 10 donors (0.1%). Pragmatically, the categorization as having enough or insufficient Hb for blood donation was concordant between capillary and venous measurements in 93.3% of females and 98.7% of males.24 The reliability of Hb measurements made with the HemoCue (Hb 201+), compared with those made with a Sysmex XE 2100, was assessed in critically ill patients. One hundred ninety-eight patients were included, and a total of 1166 Hb determinations were measured using arterial blood samples. Simultaneously, a capillary (finger or ear) measurement was performed at bedside using the HemoCue. The HemoCue’s accuracy was not affected by the hospital unit, puncture site (finger or ear), norepinephrine administration, or Hb levels below 80 g/L. However, the capillary HemoCue was not sufficiently accurate to make a therapeutic decision. The method’s performance was moderately improved by the use of arterial blood.25 To conclude, one limitation of this review is that some of the cited publications lack a suitable statistical method when comparing these devices. General Considerations There are several reasons supporting the use of POCT devices, including those for Hb assessment, in clinical and laboratory practice.26 First, saving time is critical in several areas of health care, where a very rapid Hb measurement might be required to make immediate therapeutic decisions. This might happen in any health care context where the clinical laboratory is too far, making turnaround time incompatible with a fast triage (e.g., in decentralized health care facilities with no support of a clinical laboratory unit within a network or those organized according to a huband-spoke model), or in hospital units where the fastest possible turnaround time from shipping a sample for Hb assessment to the core laboratory might still be insufficient (e.g., critical hemorrhages in the operating room, intensive care patients). The availability of POCT for Hb assessment Downloaded from jla.sagepub.com by guest on November 22, 2012 6 Journal of Laboratory Automation XX(X) Table 2. Summary of Some Features of Reviewed Studies Study Automatic Hematology Analyzer 7 HemoCue Model Compared Rechner et al. Paddle8 Gomez-Simon et al.11 Morris et al.9 Coulter Max-M Coulter STKS Technicon H3 analyzer Abbott Cell-Dyn 3500 — — — B-Hemoglobin Van de Louw et al.10 Cell counter Pentra 120 Retic ABX B-Hemoglobin van Kampen and Zijlstra2 Coulter Max-M Gupta et al.12 Frasca et al.20 Seguin et al.21 Marino et al.22 Sysmex XE 2100 Sysmex XE 2100 Sysmex XT 2000i Beckman Coulter LH 750 Hb 301 B-Hemoglobin Hb 301 Hb 201+ Nkrumah et al.23 Ziemann et al.24 Mimoz et al.25 Lippi et al.26 ADVIA 120 Sysmex KX21N Sysmex SE 9000 Sysmex XE 2100 Hb 201+ B-Hemoglobin Donor Hb Checker Hb 201+ — Accuracy and Reproducibility + + + – + + + – + + + + – +/− +/− + + +/− – + Type of Sample Arterial Capillary, venous, arterial Venous Capillary, venous Capillary, venous Capillary, venous Venous Arterial Arterial Capillary, venous, arterial Capillary Venous Capillary Capillary, arterial The long dashes represent that the study does not provide the HemoCue model. is also valuable due to the low amount of blood required by these devices in patients requiring critical venous access, especially neonates and those undergoing chemotherapy. The use of POCT devices also represents the best option in the unfortunate circumstance of natural disasters, where there is a compelling need to convey laboratory technologies that can be easily transported, installed, and appropriately used outside the traditional laboratory environment.27 Sports medicine is another ideal context for POCT, where rapid test results might guide the application of specific training regimens28 and, even more important, might support antidoping testing when carried out with rigorous preanalytical and analytical requirements.29,30 There is, for example, a wide experience on blood results of athletes in comparison with those shown by blood donors based on the HemoCue, which was proposed for evaluating possible differences between physically active and nonactive healthy subjects.31 In all these situations, POCT devices such as the HemoCue might yield accurate Hb results within seconds, with a small amount of sample required and thereby less discomfort for the athletes. Authors’ Recommendations for Better Accuracy HemoCue devices have been subject to varying opinions as to their value. Thus, for all the above-mentioned findings, some recommendations should be taken into account: 1. Economic, clinical, and regulatory issues should be clearly addressed before suggesting its implementation in all testing (i.e., both clinical and laboratory) settings. Health technology assessment, usually performed in clinical circumstances for complex and expensive drug treatments or for imaging diagnostics techniques, should also be applied to portable analyzers, which are widely used and have a heavy impact on health care quality. 2. The users of the device should be adequately trained as with any medical device about test requirements, performance, limitations, and potential interferences. 3. Test results on venous and arterial sampling are more accurate than those obtained on capillary blood and should therefore be preferred whenever possible (Table 2). 4. Rigorous quality assessment with either internal quality controls and external quality assessment or even proficiency testing should be established for verifying and continuously monitoring the quality of results. 5.Responsibility of assessment, quality of data, quality control schemes, and training of personnel should be reserved to laboratory professionals, who are experienced and trained specifically for these purposes. Downloaded from jla.sagepub.com by guest on November 22, 2012 7 Sanchis-Gomar et al. Preliminary data attest that the HemoCue might be associated with favorable economic revenues. Moreover, HemoCue devices allow quicker switch-over with good quality and accuracy, and less time and resources are spent on management. Thus, the HemoCue remains useful as a clinical guide in the acute setting. More important, these devices are leading a revolution in urban and tertiary-care hospitals. It is, however, noteworthy that these testing devices should not replace formal laboratory venous sampling, which still remains the gold standard. Declaration of Conflicting Interests The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. Funding The authors received no financial support for the research, authorship, and/or publication of this article. References 1. Vanzetti, G. An Azide-Methemoglobin Method for Hemoglobin Determination in Blood. J. Lab. Clin. Med. 1966, 67(1), 116–126. 2.van Kampen, E. J.; Zijlstra, W. G. Spectrophotometry of Hemoglobin and Hemoglobin Derivatives. Adv. Clin. Chem. 1983, 23, 199–257. 3.Kruske, S. G.; Ruben, A. R.; Brewster, D. R. An Iron Treatment Trial in an Aboriginal Community: Improving NonAdherence. J. Paediatr. Child Health 1999, 35(2), 153–158. 4. Mills, A. F.; Meadows, N. Screening for Anaemia: Evaluation of a Haemoglobinometer. Arch. Dis. Child. 1989, 64(10), 1468–1471. 5.Nguyen, H. T. High Humidity Affects HemoCue Cuvette Function and HemoCue Haemoglobin Estimation in Tropical Australia. J. Paediatr. Child Health 2002, 38(4), 427–428. 6.Lardi, A. M.; Hirst, C.; Mortimer, A. J.; McCollum, C. N. Evaluation of the HemoCue for Measuring Intra-operative Haemoglobin Concentrations: A Comparison with the Coulter Max-M. Anaesthesia 1998, 53(4), 349–352. 7. Rechner, I. J.; Twigg, A.; Davies, A. F.; Imong, S. Evaluation of the HemoCue Compared with the Coulter STKS for Measurement of Neonatal Haemoglobin. Arch. Dis. Child Fetal Neonatal Ed. 2002, 86(3), F188–F189. 8. Paddle, J. J. Evaluation of the Haemoglobin Colour Scale and Comparison with the HemoCue Haemoglobin Assay. Bull. World Health Organ. 2002, 80(10), 813–816. 9.Morris, L. D.; Osei-Bimpong, A.; McKeown, D.; Roper, D.; Lewis, S. M. Evaluation of the Utility of the HemoCue 301 Haemoglobinometer for Blood Donor Screening. Vox Sang. 2007, 93(1), 64–69. 10.Van de Louw, A.; Lasserre, N.; Drouhin, F.; Thierry, S.; Lecuyer, L.; Caen, D.; Tenaillon, A. Reliability of HemoCue in Patients with Gastrointestinal Bleeding. Intensive Care Med. 2007, 33(2), 355–358. 11.Gomez-Simon, A.; Navarro-Nunez, L.; Perez-Ceballos, E.; Lozano, M. L.; Candela, M. J.; Cascales, A.; Martinez, C.; Corral, J.; Vicente, V.; Rivera, J. Evaluation of Four Rapid Methods for Hemoglobin Screening of Whole Blood Donors in Mobile Collection Settings. Transfus. Apher. Sci. 2007, 36(3), 235–242. 12. Gupta, A.; Wrench, I. J.; Feast, M. J.; Alderson, J. D. Use of the HemoCue Near Patient Testing Device to Measure the Concentration of Haemoglobin in Suction Fluid at Elective Caesarean Section. Anaesthesia 2008, 63(5), 531–534. 13.Mendrone, A., Jr.; Sabino, E. C.; Sampaio, L.; Neto, C. A.; Schreiber, G. B.; Chamone Dde, A.; Dorlhiac-Llacer, P. E. Anemia Screening in Potential Female Blood Donors: Comparison of Two Different Quantitative Methods. Transfusion 2009, 49(4), 662–668. 14. Gomez-Escolar Viejo, L.; Sala, G. S.; Azorin, J. M.; Laudemia, R.; Sanchez, J.; Regadera, M. P. Reliability of Hemoglobin Measurement by HemoCue in Patients with Gastrointestinal Bleeding. Gastroenterol. Hepatol. 2009, 32(5), 334–338. 15. Richards, N. A.; Boyce, H.; Yentis, S. M. Estimation of Blood Haemoglobin Concentration Using the HemoCue during Caesarean Section: The Effect of Sampling Site. Int. J. Obstet. Anesth. 2010, 19(1), 67–70. 16.Bahadur, S.; Jain, S.; Jain, M. Estimation of Hemoglobin in Blood Donors: A Comparative Study Using HemoCue and Cell Counter. Transfus. Apher. Sci. 2010, 43(2), 155–157. 17.Lamhaut, L.; Apriotesei, R.; Combes, X.; Lejay, M.; Carli, P.; Vivien, B. Comparison of the Accuracy of Noninvasive Hemoglobin Monitoring by Spectrophotometry (SpHb) and HemoCue® with Automated Laboratory Hemoglobin Measurement. Anesthesiology 2011, 115(3), 548–554. 18.Miller, R. D.; Ward, T. A.; Shiboski, S. C.; Cohen, N. H. A Comparison of Three Methods of Hemoglobin Monitoring in Patients Undergoing Spine Surgery. Anesth. Analg. 2011, 112(4), 858–863. 19.Spielmann, N.; Mauch, J.; Madjdpour, C.; Schmugge, M.; Weiss, M.; Haas, T. Accuracy and Precision of Hemoglobin Point-of-Care Testing during Major Pediatric Surgery. Int. J. Lab. Hematol. 2012, 34(1), 86–90. 20.Frasca, D.; Dahyot-Fizelier, C.; Catherine, K.; Levrat, Q.; Debaene, B.; Mimoz, O. Accuracy of a Continuous Noninvasive Hemoglobin Monitor in Intensive Care Unit Patients. Crit. Care Med. 2011, 39(10), 2277–2282. 21. Seguin, P.; Kleiber, A.; Chanavaz, C.; Morcet, J.; Malledant, Y. Determination of Capillary Hemoglobin Levels Using the HemoCue System in Intensive Care Patients. J. Crit. Care 2011, 26(4), 423–427. 22. Marino, Z.; Carrion, J. A.; Bedini, J. L.; Crespo, G.; Martinez, S. M.; Sanchez-Tapias, J. M.; Forns, X.; Navasa, M. A. Evaluation of a Portable Hemoglobinometer (HemoCue) to Control Anemia in Hepatitis C Liver Transplant Recipients Undergoing Antiviral Therapy. Eur. J. Gastroenterol. Hepatol. 2011, 23(10), 942–947. Downloaded from jla.sagepub.com by guest on November 22, 2012 8 Journal of Laboratory Automation XX(X) 23. Nkrumah, B.; Nguah, S. B.; Sarpong, N.; Dekker, D.; Idriss, A.; May, J.; Adu-Sarkodie, Y. Hemoglobin Estimation by the HemoCue® Portable Hemoglobin Photometer in a Resource Poor Setting. BMC Clin. Pathol. 2011, 11, 5. 24. Ziemann, M.; Lizardo, B.; Geusendam, G.; Schlenke, P. Reliability of Capillary Hemoglobin Screening under Routine Conditions. Transfusion 2011, 51(12), 2714–2719. 25.Mimoz, O.; Frasca, D.; Medard, A.; Soubiron, L.; Debaene, B.; Dahyot-Fizelier, C. Reliability of the HemoCue® Hemoglobinometer in Critically Ill Patients: A Prospective Observational Study. Minerva Anestesiol. 2011, 77(10), 979–985. 26. Lippi, G.; Plebani, M.; Favaloro, E. J.; Trenti, T. Laboratory Testing in Pharmacies. Clin. Chem. Lab. Med. 2010, 48(7), 943–953. 27.Lippi, G.; Favaloro, E. J.; Plebani, M. Laboratory Medicine and Natural Disasters: Are We Ready for the Challenge? Clin. Chem. Lab. Med. 2010, 48(5), 573–575. 28.Wells, H. J.; Higgins, G. L., III; Baumann, M. R. Implementing an Electronic Point-of-Care Medical Record at an Organized Athletic Event: Challenges, Pitfalls, and Lessons Learned. Clin. J. Sport Med. 2010, 20(5), 377–378. 29. Banfi, G.; Drago, L.; Lippi, G. Analytical Variability in Athletes Haematological Testing. Int. J. Sports Med. 2010, 31(3), 218. 30.Banfi, G.; Lombardi, G.; Colombini, A.; Lippi, G. A World Apart: Inaccuracies of Laboratory Methodologies in Antidoping Testing. Clin. Chim. Acta 2010, 411(15–16), 1003–1008. 31. Johansson, P. I.; Ullum, H.; Jensen, K.; Secher, N. H. A Retrospective Cohort Study of Blood Hemoglobin Levels in Blood Donors and Competitive Rowers. Scand. J. Med. Sci. Sports 2009, 19(1), 92–95. Downloaded from jla.sagepub.com by guest on November 22, 2012
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