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Hemoglobin Testing at the Point of Care

Since the level of blood oxygenation can be an essential element of patient assessment, measurement of hemoglobin levels in the clinical setting is often desirable. In keeping with the recent trend to incorporate sophisticated technology into easily used point-of-care devices, recent products from several manufacturers offer prompt assessment of hemoglobin values.

HemoCue, Inc., Lake Forest, Calif., says that its HemoCue Hemoglobin Test Systems provide quick, simple and reliable quantitative hemoglobin results with the same performance as a large hematology analyzer. The companys test system options consist of either the B-Hemoglobin Photometer or the more recent Hb 201+ Analyzer and disposable microcuvettes.

The Hb 201+ has an internal electronic self-test. Every time the analyzer is turned on, it will automatically verify the performance of the optronic unit. The test is performed every second hour if the analyzer is on. This new function means that a control cuvette is no longer necessary, although one is still available as an accessory.

The unbreakable, plastic microcuvette collects the exact amount of arterial or venous blood necessary (10 l). The cuvette cavity contains reagents deposited on its inner walls and the blood sample is drawn into the cavity by capillary action and spontaneously mixed with the reagents. The microcuvette is placed into the portable analyzer. The hemoglobin value appears on the display screen in less than a minute. Hb 201 microcuvettes cannot be used in the B-Hemoglobin system and vice versa.

The dual wavelength test procedure corrects for lipemia, leukocytosis and other sources of turbidity. Capillary, venous or arterial blood samples can be used, so transfusion decisions, EPO dosing and anemia screenings can be performed immediately and at the point of care. Both systems are CLIA waived and the B-Hemoglobin photometer is available with data management capabilities.

GDS Technology, a divis ion of Stanbio Laboratory, Boerne, Texas, produces the STATSite MHgb, based on the azidemethemoglobin method and able to use either finger stick or venous whole blood samples. The company says that this CLIA-waived device is the first palm-sized, battery-operated, dedicated hemoglobin test system designed for use in physician offices, public health clinics, blood centers and emergency rooms.

The system consists of a reflectance meter and proprietary hemoglobin test cards that measures hemoglobin on a single drop of blood in seconds. Each package of reagent test cards includes a lot-specific quality control key. The system automatically pre-checks the test card when it is inserted into the meter. As soon as the drop of blood is added to the card, the sample is detected and the Hgb result is displayed on the LCD screen in either g/dL or mmol/L.

The STAT-Site MHgb specifications include a linear range of 6 to 21 g/dL, within-run precision CVs of 3.5 percent to 4.9 percent and total precision CVs of 2.9 percent to 4.2 percent. These results were based on whole blood samples from infants, children and adult patients.

ITC, Edison, N.J., manufactures the Hgb Pro Professional Hemoglobin Testing System, consisting of a compact, battery-operated meter and single-use test strips, used in measuring total hemoglobin, from capillary or venous whole blood. The system is portable, easy to use and provides a test result in 30 seconds or less. Testing entails placing a drop of venous or arterial blood on a test strip, which is then inserted in the test device. The Hgb Pro is self-calibrating. It includes data storage for the most recent 250 tests. Liquid quality controls are available and the company recommends that quality-control testing should be performed upon receipt of new lot of test strips and once every three months thereafter.

In the countertop category, Bio-Rad Laboratories, Hercules, Calif., produces the D-10 Hemoglobin Testing System to pr ovide comprehensive hemoglobin testing in a compact footprint.

This fully automated system combines diabetes monitoring and -thalassemia testing on a single platform with selectable programs for fast HbA1c or HbA2/F/A1c reporting. The company says that the D-10 offers simple and efficient operation for clinics, physician offices or clinical laboratories. Device features include whole-blood primary tube sampling, which eliminates off-line sample preparation, touch-screen operation and automatic sample bar code reading, which increase ease-of-use.

As with devices to determine sedimentation rate, hematocrit and prothrombin time, prompt, easily used hemoglobin measurement systems now provide a virtual hematology laboratory at the point of care.

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