Blood draw site and analytic device influence hemoglobin measurements

Anemia is a continuing global public health concern and a priority for international action. The prevalence of anemia is estimated from the hemoglobin (Hb) levels within target populations, yet the procedures for measuring Hb are not standardized and different approaches may result in discrepancies....

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Main Authors: David W. Killilea, Frans A. Kuypers, Sandra K. Larkin, Kathleen Schultz
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2022-01-01
Series:PLoS ONE
Online Access:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9710840/?tool=EBI
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author David W. Killilea
Frans A. Kuypers
Sandra K. Larkin
Kathleen Schultz
author_facet David W. Killilea
Frans A. Kuypers
Sandra K. Larkin
Kathleen Schultz
author_sort David W. Killilea
collection DOAJ
description Anemia is a continuing global public health concern and a priority for international action. The prevalence of anemia is estimated from the hemoglobin (Hb) levels within target populations, yet the procedures for measuring Hb are not standardized and different approaches may result in discrepancies. Several analytical variables have been proposed to influence Hb measurements, but it is difficult to understand the impact on specific variables from large population or field studies. Therefore, we designed a highly controlled protocol that minimized most technical parameters to specifically investigate the impact of blood draw site and analytic device on Hb measurements. A diverse cohort of sixty healthy adults each provided a sequential capillary and venous blood sample that were measured for Hb using an automated hematology analyzer (ADVIA-2120) and two point-of-care devices (HemoCue 201+ and HemoCue 301). Comparing blood draw sites, the mean Hb content was 0.32–0.47 g/dL (2–4%) higher in capillary compared to venous blood from the same donors. Comparing different Hb measuring instruments, the mean Hb content was 0.19–0.46 g/dL (1–4%) higher measured with HemoCue devices compared to ADVIA-2120 in both capillary and venous blood from the same donors. The maximum variance in measurement was also higher with HemoCue devices using blood from venous (5–6% CV) and capillary (21–25% CV) sites compared to ADVIA-2120 (0.6–2% CV). Other variables including blood collection tube manufacturer did not affect mean Hb content. These results demonstrate that even when most technical variables are minimized, the blood draw site and the analytical device can have a small but statistically significant effect on the mean and dispersion of Hb measurements. Even in this study, the few participants identified as mildly anemic using venous blood measured by ADVIA-2120 would not have been classified as anemic using their capillary blood samples or point-of-care analyzers. Thus, caution is warranted when comparing Hb values between studies having differences in blood draw site and Hb measuring device. Future anemia testing should maintain consistency in these analytical variables.
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spelling doaj.art-82edc419760944c18717dfc0a25a8acb2022-12-22T02:59:03ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-011711Blood draw site and analytic device influence hemoglobin measurementsDavid W. KillileaFrans A. KuypersSandra K. LarkinKathleen SchultzAnemia is a continuing global public health concern and a priority for international action. The prevalence of anemia is estimated from the hemoglobin (Hb) levels within target populations, yet the procedures for measuring Hb are not standardized and different approaches may result in discrepancies. Several analytical variables have been proposed to influence Hb measurements, but it is difficult to understand the impact on specific variables from large population or field studies. Therefore, we designed a highly controlled protocol that minimized most technical parameters to specifically investigate the impact of blood draw site and analytic device on Hb measurements. A diverse cohort of sixty healthy adults each provided a sequential capillary and venous blood sample that were measured for Hb using an automated hematology analyzer (ADVIA-2120) and two point-of-care devices (HemoCue 201+ and HemoCue 301). Comparing blood draw sites, the mean Hb content was 0.32–0.47 g/dL (2–4%) higher in capillary compared to venous blood from the same donors. Comparing different Hb measuring instruments, the mean Hb content was 0.19–0.46 g/dL (1–4%) higher measured with HemoCue devices compared to ADVIA-2120 in both capillary and venous blood from the same donors. The maximum variance in measurement was also higher with HemoCue devices using blood from venous (5–6% CV) and capillary (21–25% CV) sites compared to ADVIA-2120 (0.6–2% CV). Other variables including blood collection tube manufacturer did not affect mean Hb content. These results demonstrate that even when most technical variables are minimized, the blood draw site and the analytical device can have a small but statistically significant effect on the mean and dispersion of Hb measurements. Even in this study, the few participants identified as mildly anemic using venous blood measured by ADVIA-2120 would not have been classified as anemic using their capillary blood samples or point-of-care analyzers. Thus, caution is warranted when comparing Hb values between studies having differences in blood draw site and Hb measuring device. Future anemia testing should maintain consistency in these analytical variables.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9710840/?tool=EBI
spellingShingle David W. Killilea
Frans A. Kuypers
Sandra K. Larkin
Kathleen Schultz
Blood draw site and analytic device influence hemoglobin measurements
PLoS ONE
title Blood draw site and analytic device influence hemoglobin measurements
title_full Blood draw site and analytic device influence hemoglobin measurements
title_fullStr Blood draw site and analytic device influence hemoglobin measurements
title_full_unstemmed Blood draw site and analytic device influence hemoglobin measurements
title_short Blood draw site and analytic device influence hemoglobin measurements
title_sort blood draw site and analytic device influence hemoglobin measurements
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9710840/?tool=EBI
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