Soner YILMAZ, Ulaş YAKUT, Mustafa GÜNEY, RIZA AYTAÇ ÇETİNKAYA, Türker TÜRKER, Sebahattin YILMAZ, İSMAİL YAŞAR AVCI

Gezici Kan Toplama Ekibinde Kullanılmak Üzere İki Farklı Hemoglobin Tarama Yönteminin Değerlendirilmesi

AMAÇ: Çalışmanın amacı, hasta başı hemoglobin konsantrasyonu ölçümü yapan iki cihazı laboratuvar ölçümleriyle kıyaslayarak mobil kan toplama şartlarında doğruluklarının tespit edilmesidir. Bu iki cihaz, pulse co-oksimetre olan Pronto-7® (Masimo Corp., Irvine,CA) ve spektrofotometrik yöntem kullanan HemoCue® Hb 201dir. YÖNTEM: Yüz elli iki kişiden kan örnekleri toplandı. Örnekler total hemoglobin ölçümü için üç farklı yöntemle çalışıldı: invaziv olmayan co-oksimetre cihazı Pronto-7, parmak ucundan alınan kanla çalışan spektrofotometrik cihaz HemoCue ve venöz kan örnekleriyle çalışan otomatik hematoloji analizatörü (referans cihaz). BULGULAR: Hemoglobin seviyelerinin aritmetik ortalaması venöz örneklere (Hb değerlerinin aritmetik ortalaması 14,6 mg/dl) göre parmak ucundan alınan örneklerde (Hb değerlerinin aritmetik ortalaması 15,1 mg/dl) hafifçe yüksek, pulse co-oksimetrede (Hb değerinin aritmetik ortalaması 14,1 mg/dl) ise hafifçe düşüktür. HemoCue ve Pronto-7nin duyarlılığı sırasıyla %97,7, %81,6, özgüllüğü ise sırasıyla %31,2, %43,7di. Hemo Cue ve Pronto-7nin pozitif prediktif değerleri yüksek (sırasıyla; %92,3 ve %92,5) fakat her ikisinin de negatif prediktif değerleri düşüktü (sırasıyla; %62,5 ve %21,8). Kan bağışçılarının HemoCue cihazı ile %88,4ü, Pronto 7 ile ise %78,2si (119/152) doğru olarak sınıflandırıldı. SONUÇ: Otomatik laboratuvar hemoglobin ölçümleri referans alındığında Pronto-7, HemoCueya göre daha düşük değerlerde ve daha az doğrulukta hemoglobin değerleri vermektedir.

Evaluation of Two Different Methods for Hemoglobin Screening of Blood Donors to Use in Mobile Blood Collection Team

AIM: The aim of the study is to compared two point-of care hemoglobin concentration measuring devices with laboratory measurements to determine their accuracy in mobile blood collection conditions. This two devices were the Pronto-7 (Masimo Corp., Irvine,CA) pulse co-oximeter and HemoCue Hb 201+ uses spectrophotometric method. METHODS: Blood samples were collected from 152 individuals. The samples were tested for total hemoglobin measurement by three different methods: noninvaziv pulse co-oximeter device Pronto-7, finger-stick blood sample on an automated spectrophotometric device HemoCue and venous samples on an automated hemotology analyzer (reference device) RESULTS: According to the venous samples (mean Hb value is 14.6 g/dl), the mean hemoglobin levels were detected slightly higher in the fingerstick samples (mean Hb value is 15.1 g/dl) and slightly lower in the pulse co-oximetry (mean Hb value is 14.1 g/dl). The sensivity of HemoCue, Pronto-7 was 97.7%, 81.6% and their specifity was 31.2% and %43.7, respectively. The positive predictive values (PPV) of HemoCue and Pronto-7 were high (92.3% and 92.5%, respectively) but both of their negative predictive values (NPV) were low (62.5% and 21.8%, respectively). Of blood donors, 88.4% (138/152) percent were correctly classified with HemoCue and 78.2% were with Pronto-7. COCLUSION: Taking automated laboratory hemoglobin measurement as a reference, Pronto-7 gave lower readings for Hb value and was less accurate than the Hemo-Cue system.

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