Morisi Niccolò, Ferrarini Marco, Veronesi Laura, Manzini Giovanni, Giovanella Silvia, Alfano Gaetano, Stipo Lucia, Olmeda Fabio, Ligabue Giulia, Virzì Grazia Maria, Di Pinto Valentina, Rovati Luigi, Donati Gabriele
Surgical, Medical, Dental and Morphological Sciences Department (CHIMOMO), University of Modena and Reggio Emilia, 41124 Modena, Italy.
Nephrology, Dialysis and Renal Transplant Unit, Azienda Ospedaliero Universitaria di Modena, 41124 Modena, Italy.
J Clin Med. 2025 Jul 24;14(15):5242. doi: 10.3390/jcm14155242.
Continuous monitoring of hemoglobin (HB) and hematocrit (HCT) during hemodialysis could improve fluid management and patient safety. The Fresenius 5008 dialysis machine includes an ultrasound-based sensor that estimates HB and HCT values, though its accuracy compared to standard laboratory measurements remains unclear. This exploratory observational study assessed the agreement between sensor-derived and laboratory-derived HB and HCT values in 20 patients at the start of hemodiafiltration. A total of 177 paired blood samples were collected. Sensor values significantly underestimated laboratory HB (9.61 vs. 11.31 g/dL) and HCT (27% vs. 34%) ( < 8 × 10). Correlations were strong for both parameters (HB: r = 0.788; HCT: r = 0.876). Regression analyses revealed consistent proportional bias. Applying a fixed correction of +1.69 g/dL for HB and +7.55% for HCT eliminated the statistical differences and reduced intercepts in regression models. Bland-Altman plots confirmed improved agreement post-correction. Albumin levels correlated modestly with error magnitude. HB and HCT values from the Fresenius 5008 sensor are strongly correlated with laboratory data but are systematically underestimated at treatment start, likely due to hemodilution. Applying fixed correction factors improves accuracy and supports the sensor's use for real-time monitoring.
血液透析期间持续监测血红蛋白（HB）和血细胞比容（HCT）可改善液体管理并提高患者安全性。费森尤斯5008型透析机配备了一个基于超声的传感器，用于估算HB和HCT值，但其与标准实验室测量值相比的准确性尚不清楚。这项探索性观察性研究评估了20例患者在血液透析滤过开始时传感器得出的HB和HCT值与实验室得出的HB和HCT值之间的一致性。共采集了177对血样。传感器得出的值显著低估了实验室的HB（9.61对11.31 g/dL）和HCT（27%对34%）（<8×10）。两个参数的相关性都很强（HB：r = 0.788；HCT：r = 0.876）。回归分析显示存在一致的比例偏差。对HB应用+1.69 g/dL的固定校正值，对HCT应用+7.55%的固定校正值，消除了统计差异并减少了回归模型中的截距。布兰德-奥特曼图证实校正后一致性得到改善。白蛋白水平与误差幅度呈适度相关。费森尤斯5008型传感器得出的HB和HCT值与实验室数据高度相关，但在治疗开始时被系统性低估，可能是由于血液稀释。应用固定校正因子可提高准确性，并支持该传感器用于实时监测。
