Baystate Medical Center, Springfield, MA, USA.
Nephrol Dial Transplant. 2010 Aug;25(8):2710-4. doi: 10.1093/ndt/gfq016. Epub 2010 Feb 22.
Haemoglobin variability may be associated with increased death. Frequent haemoglobin monitoring may allow earlier detection of trends in haemoglobin slopes, alerting staff to intercurrent events. The more frequent haemoglobin values may provide early evidence of response to erythropoietin (EPO) doses, and allow more appropriate anaemia management. Our objective is to assess whether frequent haemoglobin monitoring data (12x/month) using a computer algorithm (AMIE, Leeds, UK) will reduce haemoglobin variability compared with 1x/month monitoring.
We performed an observational case-control study of 44 unselected patients, comprising one dialysis facility measuring Crit-Line haemoglobin, lab haemoglobin, standard deviation of residuals as surrogate of haemoglobin variability and EPO dosing.
Haemoglobin variability and 'percent in target haemoglobin range' significantly improved with 12x/month haemoglobin results using a computer algorithm. There was also a non-significant trend toward for lower EPO doses.
Use of a computer algorithm to analyse 12x/month haemoglobin values provides early evidence of haemoglobin trends and allows more appropriate anaemia management, with decreased haemoglobin variability, lower EPO doses and more patients achieving target haemoglobin.
血红蛋白变异性可能与死亡率增加有关。频繁监测血红蛋白水平可能有助于更早地发现血红蛋白斜率的趋势，提醒医护人员注意并发事件。更频繁的血红蛋白值可能提供对促红细胞生成素（EPO）剂量反应的早期证据，并允许更合理的贫血管理。我们的目的是评估使用计算机算法（英国利兹的 AMIE）进行 12 次/月的频繁血红蛋白监测数据是否比 1 次/月的监测能降低血红蛋白变异性。
我们对 44 例未选择的患者进行了观察性病例对照研究，包括一个测量 Crit-Line 血红蛋白、实验室血红蛋白、残差标准差作为血红蛋白变异性替代指标和 EPO 剂量的透析中心。
使用计算机算法分析 12 次/月的血红蛋白值可显著降低血红蛋白变异性，提高“目标血红蛋白范围内的百分比”。EPO 剂量也呈降低的趋势，但无统计学意义。
使用计算机算法分析 12 次/月的血红蛋白值可提供血红蛋白趋势的早期证据，并允许更合理的贫血管理，降低血红蛋白变异性，减少 EPO 剂量，使更多患者达到目标血红蛋白水平。
