Miles Lachlan F, Wood Erica M
Department of Critical Care, Melbourne Medical School, The University of Melbourne, Melbourne, VIC, Australia; Department of Anaesthesia, Austin Health, Heidelberg, VIC, Australia.
Transfusion Research Unit, Department of Public Health and Preventative Medicine, Monash University, Melbourne, VIC, Australia; Department of Clinical Haematology, Monash Health, Clayton, VIC, Australia.
Br J Anaesth. 2025 Feb;134(2):274-276. doi: 10.1016/j.bja.2024.12.002. Epub 2025 Jan 14.
Accurate and timely diagnostic information is a vital adjunct to clinical assessment to inform therapeutic decision-making, including decisions to transfuse, or not transfuse, blood components. A prospective cohort study of diagnostic point-of-care (POC) haemoglobin measurements on arterial or central venous samples from adults undergoing major noncardiac surgery compared three widely used devices, HemoCue®, i-STAT™, and the Rad-67™ pulse CO-Oxymeter® finger sensor device, against standard laboratory haemoglobin measurements, but importantly not against a blood gas analyser. The study focused on haemoglobin results below 100 g L to establish the utility of these devices to guide red cell transfusion decisions. None of the limits of agreement between POC device and laboratory results were within the allowable difference of plus or minus 4 g L, and no device consistently over- or underestimated laboratory haemoglobin results in the same direction. However, results from the HemoCue® had the lowest likelihood to lead to inappropriate red cell transfusion. Clinicians should be aware of the patient, sample, and device factors that can influence the accuracy of POC haemoglobin testing results.
准确及时的诊断信息是临床评估的重要辅助手段，有助于指导治疗决策，包括决定是否输注血液成分。一项前瞻性队列研究对接受非心脏大手术的成年人动脉或中心静脉样本进行即时检验（POC）血红蛋白测量，比较了三种广泛使用的设备——HemoCue®、i-STAT™和Rad-67™脉搏碳氧血红蛋白仪手指传感器设备——与标准实验室血红蛋白测量结果，但重要的是未与血气分析仪进行比较。该研究聚焦于血红蛋白结果低于100 g/L的情况，以确定这些设备在指导红细胞输注决策方面的效用。POC设备与实验室结果之间的一致性界限均不在允许的±4 g/L差异范围内，且没有一种设备始终在同一方向上高估或低估实验室血红蛋白结果。然而，HemoCue®的结果导致不适当红细胞输注的可能性最低。临床医生应了解可能影响POC血红蛋白检测结果准确性的患者、样本和设备因素。
