Point of care estimation of haemoglobin in neonates

Abstract

Objective: To evaluate whether measurement of haemoglobin concentration in neonates using point of care testing agrees with laboratory measurement.

Design: 127 paired blood samples taken from babies on a neonatal intensive care unit for full blood count and blood gas analysis by point of care testing were reviewed according to current practice. A comparison was made between the laboratory and blood gas analyser haemoglobin measurements to assess limits of agreement and look for any systematic difference.

Setting: Neonatal Unit, Jessop Wing, Royal Hallamshire Hospital, Sheffield, UK

Patients: Babies staying on the neonatal unit, who currently have contemporaneous blood samples taken for full blood count and blood gas analysis by point of care testing.

Intervention: Results from blood samples were reviewed.

Main outcome measure: Comparison between laboratory and point of care testing haemoglobin concentrations.

Results: The mean laboratory haemoglobin concentration was 155 g/l (range 30–226 g/l); the mean point of care testing haemoglobin concentration was 157 g/l (range 30–228 g/l). The mean (SD) difference between paired samples was 2 (11) g/l; 95% CI −4.0 to 0.1 g/l; and limits of agreement −23 to 19 g/l.

Conclusions: The blood gas analyser on the neonatal unit at Royal Hallamshire Hospital, Sheffield, gives a useful estimation of haemoglobin concentration compared with laboratory measurement, with smaller sample volume. Although this does not replace a full blood count, it is a useful adjunct to neonatal care monitoring.