Gómez-Simón A, Plaza E M, Torregrosa J M, Ferrer-Marín F, Sánchez-Guiu I, Vicente V, Lozano M L, Rivera J
Centro Regional de Hemodonación, Servicio de Hematología y Oncología Médica, IMIB, Universidad de Murcia, Murcia, Spain.
Vox Sang. 2014 Nov;107(4):343-50. doi: 10.1111/vox.12165. Epub 2014 Jun 11.
Inaccuracy of fingerstick haemoglobin compromises donor's health and losses blood donations. We evaluated the benefit of double haemoglobin screening with HemoCue.
Blood donors underwent fingerstick screening by HemoCue and were driven for donation if capillary haemoglobin was within the regulatory range. Those failing were drawn venous blood and donated if their venous haemoglobin determined with HemoCue was acceptable.
Of 276 605 donor clinic visits, 10 011 (3·6%) were assessed by two-step haemoglobin screening using HemoCue, because of low (n = 9444) or high (n = 567) capillary haemoglobin. Among these, 2561 (25·6%) were deemed eligible [recovered donations]. The recovery rate was 23·8% and 55·0% among donors presenting with low and high capillary haemoglobin, respectively. In both categories of attempted donations, capillary and venous haemoglobin with HemoCue correlated significantly in recovered donors (R(2) ≈ 0·5-0·7) but not in deferred visits (R(2) < 0·15). Venous haemoglobin with HemoCue and by haematological analyzer significantly correlated in all donations attempts (R(2) ≈ 0·7). Donors presenting with low capillary haemoglobin showed small bias between capillary and venous haemoglobin by HemoCue (-2·4 ± 6·2 g/l), fingerstick haemoglobin and venous haemoglobin with counter (1·3 ± 7·3 g/l), and venous haemoglobin with HemoCue and counter (3·7 ± 3·9 g/l). This bias was slightly greater in donors with high capillary haemoglobin (-7·5 ± 7·8, 13·7 ± 7·5, and 6·2 ± 7·5, respectively). Double haemoglobin screening by HemoCue reached an accuracy of 87·3% for qualifying donors presenting with low fingerstick haemoglobin.
Double haemoglobin measurement with HemoCue [fingerstick and venous blood if required] is feasible and allows a significant recovery of blood donations.
指尖血红蛋白检测不准确会损害献血者健康并导致献血流失。我们评估了使用HemoCue进行双重血红蛋白筛查的益处。
献血者接受HemoCue指尖筛查,若毛细血管血红蛋白在规定范围内则前往献血。不合格者抽取静脉血,若其用HemoCue测定的静脉血红蛋白可接受则进行献血。
在276605次献血者门诊就诊中,10011例(3.6%)因毛细血管血红蛋白低(n = 9444)或高(n = 567)接受了使用HemoCue的两步血红蛋白筛查。其中,2561例(25.6%)被判定合格[挽回的献血量]。毛细血管血红蛋白低和高的献血者中挽回率分别为23.8%和55.0%。在两类尝试献血者中,合格献血者的毛细血管血红蛋白和静脉血红蛋白与HemoCue显著相关(R²≈0.5 - 0.7),但在被推迟就诊者中不相关(R²<0.15)。在所有献血尝试中,HemoCue测定的静脉血红蛋白与血液分析仪测定的静脉血红蛋白显著相关(R²≈0.7)。毛细血管血红蛋白低的献血者中,HemoCue测定的毛细血管血红蛋白与静脉血红蛋白之间偏差较小(-2.4±6.2g/l),指尖血红蛋白与计数器测定的静脉血红蛋白之间偏差较小(1.3±7.3g/l),HemoCue测定的静脉血红蛋白与计数器测定的静脉血红蛋白之间偏差较小(3.7±3.9g/l)。毛细血管血红蛋白高的献血者偏差略大(分别为-7.5±7.8、13.7±7.5和6.2±7.5)。对于指尖血红蛋白低的合格献血者,使用HemoCue进行双重血红蛋白筛查的准确率达到87.3%。
使用HemoCue进行双重血红蛋白测量[必要时测量指尖血和静脉血]是可行的,且能显著挽回献血量。