Department of Pediatrics and Adolescent Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japan.
Pediatr Res. 2023 Mar;93(4):1036-1040. doi: 10.1038/s41390-022-02204-7. Epub 2022 Jul 29.
Iron deficiency anemia in children affects psychomotor development. We compared the accuracy and trend of a non-invasive transcutaneous spectrophotometric estimation of arterial hemoglobin (Hb) concentration (SpHb) by rainbow pulse CO-oximetry technology to the invasive blood Hb concentration measured by an automated clinical analyzer (Hb-Lab).
We measured the SpHb and Hb-Lab in 109 patients aged 1-5 years. Regression analysis was used to evaluate differences between the two methods. The bias, accuracy, precision, and limits of agreement of SpHb compared with Hb-Lab were calculated using the Bland-Altman method.
Of the 109 enrolled subjects, 102 pairs of the SpHb and Hb-Lab datasets were collected. The average value of measured Hb was 12.9 ± 1.03 (standard deviation [SD]) g/dL for Hb-Lab. A significant correlation was observed between SpHb and Hb-Lab measurements (SpHb = 7.002 + 0.4722 Hb-Lab, correlation coefficient r = 0.548, 95% confidence interval = 0.329-0.615). Bland-Altman analysis showed good visual agreement, with a mean bias between SpHb and Hb-Lab of 0.188 ± 0.919 g/dL (mean ± SD).
We concluded that non-invasive Hb measurement is useful for Hb estimation in children and provides new insights as a screening tool for anemia.
Our results indicated a good correlation between non-invasive transcutaneous spectrophotometric estimation of arterial hemoglobin (Hb) concentration using a finger probe sensor by rainbow pulse CO-oximetry technology and invasive blood Hb concentration. Although previous studies have indicated that in patients with a worse condition, the bias between the two methods was large, this study, which was conducted on children with stable disease, showed a relatively small bias. Further studies using this non-invasive device might help to understand the current status of anemia in Japan and promote iron intake and nutritional management in children.
儿童缺铁性贫血会影响精神运动发育。我们比较了非侵入性经皮动脉血红蛋白（Hb）浓度分光光度测定（SpHb）和自动临床分析仪（Hb-Lab）测量的侵入性血液 Hb 浓度的准确性和趋势。
我们测量了 109 名 1-5 岁患者的 SpHb 和 Hb-Lab。使用回归分析评估两种方法之间的差异。使用 Bland-Altman 法计算 SpHb 与 Hb-Lab 比较的偏差、准确性、精密度和一致性界限。
在纳入的 109 名受试者中，收集了 102 对 SpHb 和 Hb-Lab 数据集。Hb-Lab 测量的平均 Hb 值为 12.9±1.03（标准差[SD]）g/dL。SpHb 与 Hb-Lab 测量值之间存在显著相关性（SpHb=7.002+0.4722 Hb-Lab，相关系数 r=0.548，95%置信区间=0.329-0.615）。Bland-Altman 分析显示良好的视觉一致性，SpHb 与 Hb-Lab 之间的平均偏差为 0.188±0.919 g/dL（均值±SD）。
我们得出结论，非侵入性 Hb 测量可用于儿童的 Hb 估计，作为贫血的筛查工具提供了新的见解。
我们的结果表明，使用手指探针传感器的彩虹脉冲 CO-oximetry 技术进行的非侵入性经皮动脉血红蛋白（Hb）浓度分光光度测定与侵入性血液 Hb 浓度之间存在良好的相关性。虽然之前的研究表明在病情较重的患者中，两种方法之间的偏差较大，但这项在病情稳定的儿童中进行的研究显示偏差相对较小。进一步使用这种非侵入性设备的研究可能有助于了解日本目前的贫血状况，并促进儿童的铁摄入和营养管理。
