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 NICU for full blood count and blood gas analysis by Point of Care Testing (POCT) 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 POCT.

Interventions:Results from blood samples were reviewed.

Main outcome measures:Comparison made between laboratory and POCT haemoglobin concentrations.

Results:The mean laboratory haemoglobin concentration was 15.5g/dL (range 3.0-22.6g/dL); the mean POCT haemoglobin concentration was 15.7g/dL (range 3.0-22.8g/dL). The mean difference between paired samples was 0.2g/dL, with a standard deviation of 1.1g/dL. 95% confidence intervals were -0.4 to 0.01g/dL; the limits of agreement were -2.3 to 1.9g/dL.

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