Reliability of HemoCue in patients with gastrointestinal bleeding

Abstract

Although we demonstrated a low bias between HemoCue and blood hemoglobin determination, large HemoCue vs. hemoglobin differences may still occur, and therefore therapeutic decisions based upon capillary HemoCue alone should be very cautious.

Evaluation of two methods to measure hemoglobin concentration among women with genetic hemoglobin disorders in Cambodia: A method-comparison study

“…There has been some investigation of the accuracy of HemoCue® to measure Hb in some clinical disease states, e.g. gastrointestinal bleeding [27] and as a screening tool for blood donations [28][29][30], however to our knowledge there has been no exploration of whether HemoCue® is as accurate as the gold standard hematology analyzer for measuring Hb in individuals with genetic Hb disorders.…”

Accuracy of Determining Hemoglobin Level Using Occlusion Spectroscopy in Patients with Severe Gastrointestinal Bleeding

“…In patients admitted to ICUs for gastrointestinal bleeding, Van de Louw et al reported a low mean difference (bias, 0.06 ± 0.87 g/dl) between hemoglobin level determined by a laboratory and that of capillary blood samples. 6 These authors found that 21% of the differences were greater than 1 g/dl. Rippmann et al observed a bias of 0.6 ± 0.6 g/dl between hemoglobin levels determined by a central laboratory and those from a HemoCue ® system for capillary blood.…”

“…Although most authors have defined inaccurate measurement as an absolute difference (i.e., >1 g/dl) and have excluded patients from their analysis in whom measurement of hemoglobin level by a device was technically unavailable, 13,17 the proportion of inaccurate measurements that we found appears to be consistent with previous studies. 6,13,14,18 For the occlusion spectroscopy-based method, the proportion of inaccurate measurements appears to be clinically unacceptable and is globally comparable to the oximetrybased method. 14,18 Despite significant correlations with the reference method for both SoHb and cHb, the BlandAltman method suggests that the bias, precision, and limits of agreement for SoHb cannot substitute for the reference method.…”

“…However, its accuracy in clinical trials remains controversial, notably in patients with severe hemorrhage. [5][6][7][8][9][10] Recently, a continuous and totally noninvasive technology to measure hemoglobin concentration, based on pulse cooximetry, has been proposed. This method discerns the distinctive light-absorption characteristics of the different hemoglobin species and applies proprietary algorithms to determine total hemoglobin levels.…”

“…Portable cooximeters have been developed to obtain rapid measurements of hemoglobin from a single drop of capillary blood (from a fingertip skin puncture), but this technique is somewhat invasive and its accuracy remains controversial. [5][6][7][8][9][10] A new technology, the Signal extraction technology (Masimo Corp., Irvine, CA), has been developed to improve the accuracy of oxygen saturation measured by pulse oximetry values, and was designed to noninvasively measure hemoglobin concentration using multiple wavelengths of light. 30,31 Although some studies have evaluated the accuracy of pulse cooximetry as acceptable to determine hemoglobin concentration, [32][33][34] several other studies, conducted under clinical conditions and particularly during severe hemorrhage, have found this method to have less than optimal accuracy.…”