Despotis G J, Alsoufiev A, Hogue C W, Zoys T N, Goodnough L T, Santoro S A, Kater K M, Barnes P, Lappas D G
Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO 63110, USA.
Crit Care Med. 1996 Jul;24(7):1163-7. doi: 10.1097/00003246-199607000-00016.
To compare point-of-care results obtained from an on-site hemocytometer with values provided by an institutional laboratory instrument.
A prospective laboratory evaluation.
The central laboratory and cardiac surgical intensive care unit of a university-affiliated tertiary care center.
Normal range comparison was performed using blood specimens routinely obtained from 48 hospitalized patients for complete blood count analysis. The second evaluation was performed on blood specimens routinely obtained (in the intensive care unit) after cardiac surgery involving extracorporeal circulation in a series of 187 consecutive patients.
Hemoglobin concentration, platelet count, mean corpuscular volume, mean platelet volume, and red and white blood cell counts were measured with both on-site (MD 16, Coulter Electronics, Hialeah, FL) and laboratory (STKS, Coulter Electronics) instruments. Hematocrit and red cell distribution width were calculated using measured variables. Blood specimens were obtained from two distinct patients series. To evaluate measurement values within the normal range, a series of 48 routinely obtained blood specimens for complete blood count analysis in our institutional laboratory were utilized for concurrent analysis with the on-site hemocytometer. To evaluate measurement values out of the normal range, a second comparison involved measurements performed on blood specimens obtained in the cardiac surgical intensive care unit for complete blood count analysis. Linear regression demonstrated good correlations between on-site and laboratory hemoglobin concentration (r2 = .97), hematocrit (r2 = .95), platelet count (r2 = .97), mean corpuscular volume (r2 = .91), red cell distribution width (r2 = .80), and red (r2 = .95) and white (r2 = .96) blood cell count results. A marginal correlation was observed between mean platelet volume values (r2 = .47). Bias analysis (mean +/- 2 SD) demonstrated similar measurements between on-site and laboratory hemoglobin concentration, hematocrit, platelet count, red blood cell count, white blood cell count, mean platelet volume, mean corpuscular volume, and red cell distribution width.
On-site hemoglobin concentration, hematocrit, white blood cell count, red blood cell count, red cell distribution width, and platelet count values compare well with those results obtained from the laboratory. The MD 16 hemocytometer (Coulter Electronics) provides on-site hematologic results that can provide an accurate and rapid quantitative assessment of platelets, and red and white blood cells. Rapid access to information obtained from this type of system may be clinically useful, especially in critically ill patients.
比较现场血细胞计数器得出的即时检测结果与机构实验室仪器提供的值。
前瞻性实验室评估。
一所大学附属三级医疗中心的中央实验室和心脏外科重症监护病房。
使用从48例住院患者常规采集的血标本进行全血细胞计数分析，以进行正常范围比较。第二次评估是对一系列187例连续接受体外循环心脏手术的患者（在重症监护病房）常规采集的血标本进行的。
使用现场仪器（MD 16，库尔特电子公司，海厄利亚，佛罗里达州）和实验室仪器（STKS，库尔特电子公司）测量血红蛋白浓度、血小板计数、平均红细胞体积、平均血小板体积以及红细胞和白细胞计数。通过测量变量计算血细胞比容和红细胞分布宽度。血标本来自两个不同的患者系列。为评估正常范围内的测量值，在我们机构实验室中，将一系列48份常规采集的用于全血细胞计数分析的血标本与现场血细胞计数器同时进行分析。为评估超出正常范围的测量值，第二次比较涉及对在心脏外科重症监护病房采集的用于全血细胞计数分析的血标本进行测量。线性回归显示现场和实验室的血红蛋白浓度（r2 = 0.97）、血细胞比容（r2 = 0.95）、血小板计数（r2 = 0.97）、平均红细胞体积（r2 = 0.91）、红细胞分布宽度（r2 = 0.80）以及红细胞（r2 = 0.95）和白细胞（r2 = 0.96）计数结果之间具有良好的相关性。平均血小板体积值之间观察到边缘相关性（r2 = 0.47）。偏倚分析（均值±2标准差）显示现场和实验室的血红蛋白浓度、血细胞比容、血小板计数、红细胞计数、白细胞计数、平均血小板体积、平均红细胞体积和红细胞分布宽度的测量结果相似。
现场血红蛋白浓度、血细胞比容、白细胞计数、红细胞计数、红细胞分布宽度和血小板计数的值与实验室获得的结果比较良好。MD 16血细胞计数器（库尔特电子公司）提供的现场血液学结果可对血小板以及红细胞和白细胞进行准确、快速的定量评估。快速获取从这类系统获得的信息可能在临床上有用，尤其是在危重症患者中。
