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A PROSPECTIVE COMPARATIVE STUDY OF ESTIMATION OF HEMOGLOBIN USING PORTABLE HEMOGLOBINOMETER HEMOCUE AND AUTOMATED HEMATOLOGY ANALYZER IN BLOOD DONORS.��BY CHE MELISA BINTI AHMAD ZAIDI

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Introduction & Aim

  1. Blood transfusion is one of the famous modern healthcare which have been used to save million of lives.
  2. There is several reasons blood donation cannot be done and one of them is low hemoglobin (Hb) level of blood donors.
  3. Hb estimation of blood donors is the only laboratory test performed prior to blood donation.
  4. In India minimum acceptable Hb value for blood donation is 12.5 g/dl for both male and female blood donors.
  5. Hb screening of blood donors is very essential.
  6. This also ensures that the patient who received packed red cell transfusion has optimum Hb dose.
  7. The aim of this study is to compare capillary and venous Hb values measured by the HemoCue with venous Hb value measured by a fully automated hematology analyzer and to evaluate accuracy and reliability of HemoCue Hb 301 in measuring Hb estimation value in blood donors who were accepted for blood donation in their blood bank.

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Materials and Methods

  • This prospective study was conducted on 330 blood donors.
  • GMERS Medical College and General Hospital, Sola, Ahmedabad, Gujarat, from 1st March 2021 to 31st May 2021 over a period of three months.
  • All blood donors in this study underwent a routine blood donor screening method including Hb estimation by trained blood bank staff prior to blood donation.

Inclusion Criteria

  • Whole blood donors who came to blood bank during the time period of study and were declared medically fit to donate blood.

Exclusion Criteria

  • Whole blood donors declared medically not fit to donate blood by a qualified medical officer.

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Procedure

  1. Hb of each donor was measured by HemoCue Hb 301 using finger prick capillary blood sample.
  2. The first drop was wiped off by dry cotton swab.
  3. A drop of blood was then drawn into a micro cuvette by capillary action.
  4. The blood filled micro cuvette was placed in a given slot of the HemoCue Hb 301 photometer.
  5. After a few seconds (≤ 10 seconds), the hemoglobin reading appeared on the screen of the HemoCue Hb 301 device.
  6. Slot of the micro cuvette was closed in between measurements.
  7. Later donor was moved to the blood donation area and then two milliliters venous sample was collected from each donor before blood donation.
  8. Samples collected in EDTA tube and was mixed well by 8–10 times gentle inversion.
  9. Hemoglobin was estimated in the venous sample using HemoCue Hb 301 immediately and in automated hematology analyzer (Horiba pentra XLR).
  10. Venous hemoglobin estimation was performed using the same HemoCue Hb 301 device which was used for the finger prick capillary sample hemoglobin estimation.
  11. Since the volume of the capillary blood was small, it was not possible to measure hemoglobin from it in the automated hematology analyzer.
  12. The hemoglobin value measured by the automated hematology analyzer was taken as reference value.

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Results

Age group and gender wise distribution of blood donors (total 330) is shown in table 1.

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Hemoglobin estimation value measured by automated hematology analyzer was taken as a reference value. According to the reference value, two groups of blood donors were formed. One group of blood donors had hemoglobin value ≥ 12.5gm/dl and other group of blood donors had hemoglobin value < 12.5gm/dl. (Table 2)

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  • They estimated hemoglobin value using capillary and venous sample by HemoCue Hb301 and automated hematology analyzer.
  • Mean hemoglobin value, mean hemoglobin difference, correlation coefficient and P value were obtained by statistical analysis and paired comparison as shown in table 3.

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Discussion

  1. Hb value of finger prick (capillary) samples in blood donors using a HemoCue Hb 301 were slightly higher.
  2. This may be because of the composition of a drop of blood obtained from the capillaries by finger prick technique is not the same as blood obtained from a vessel by venipuncture.
  3. The finger prick sample is dependent on skin thickness, temperature of the skin, depth of penetration of the lancet and potential milking of the finger by the phlebotomist.
  4. Attention for training and periodic competency assessments of staff performing finger prick hemoglobin assessments.
  5. Venous sampling provides a more reliable assessment of hemoglobin as it reflects the blood coursing through the veins, heart and arteries.
  6. Each collection technique and testing method has its own variations and limitations.

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Comparison of capillary hemoglobin values and venous hemoglobin values in various studies seen in Table 4.

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  • Present study findings show capillary HB value is higher than venous Hb value is also similar as various studies done by different authors.
  • The hemoglobin value obtained by automated hematology analyzer was considered as gold standard.
  • Donor acceptance criteria for hemoglobin value is ≥ 12.5gm/dl as per Indian Drugs and Cosmetic Act, 1940 amendment from time to time.

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Conclusion

  1. The method used for hemoglobin screening of blood donors should be accurate, reliable and affording.
  2. The main purpose of screening hemoglobin test is to prevent development or worsening of anemia in blood donors.
  3. Finger prick capillary hemoglobin value measured by HemoCue Hb 301 is slightly higher than automated hematology analyzer.
  4. Although hemoglobin measured by automated hematology analyzer is gold standard but it is not easy to transport, requires electricity and venous blood sample.
  5. While HemoCue Hb 301 is portable, easy to transport, battery operated instrument, finger prick capillary blood sample required and easy to use with minimum staff training.
  6. HemoCue Hb 301 accuracy, efficacy, utility, time taken, cost effectiveness and acceptable false rate in estimation of hemoglobin.
  7. It was concluded that HemoCue Hb 301 is an appropriate and reliable screening method for pre-donation hemoglobin estimation for blood donors.

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PUSAT DARAH NEGARA

A PROSPECTIVE COMPARATIVE STUDY OF ESTIMATION OF HEMOGLOBIN USING PORTABLE HEMOGLOBINOMETER COMPOLAB TM AND AUTOMATED HEMATOLOGY MINDRAY BC-6200 ANALYZER IN BLOOD DONORS.

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Introduction:

  • To determine the accuracy of finger prick hemoglobin assessment in apheresis blood donors, the performance of a portable hemoglobin meter CompoLab TM was prospectively compared with that of an automated hematology Mindray BC-6200 analyzer.

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Material and Method:

  • 100 apheresis blood donor’s capillary finger prick was measured by CompoLab TM and venous sample hemoglobin measured by automated hematology Mindray BC-6200 analyzer.

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Results

  • Age group and gender wise distribution of apheresis blood donors (total 100) is shown in table 1.

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Table 1: Age group and gender wise distribution of apheresis blood donors

Age group

Male

Female

Total

18-30

8(100%)

0(0%)

8(8%)

31-40

26(92.86%)

2(7.14%)

28(28%)

41-50

27(93.10%)

2(6.90%)

29(29%)

51-60

27(93.10%)

2(6.90%)

29(29%)

61-70

5 (83.33%)

1 (16.67%)

6(6%)

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93(93%)

7(7%)

100(100%)

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  • It was estimated hemoglobin value from capillary and venous sample by CompoLab TM and automated hematology Mindray BC-6200 analyzer. Mean hemoglobin value, mean hemoglobin difference, correlation coefficient and P value were obtained by statistical analysis and paired comparison as shown in table 2.

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Table 2: Paired comparison of capillary and venous sample hemoglobin determination by CompoLab TM and automated hematology Mindray BC-6200 analyzer :

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Total No

Hb gm/dL

(mean ± SD)

Mean Difference

(Hb gm/dl)

Correction coefficient (r)

P value

Automated hematology Mindray analyzer hemoglobin

Capillary CompoLab TM hemoglobin

100

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100

15.07 ± 0.88

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14.65 ± 0.94

0.42

0.68

<0.001

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Discussion

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  1. Retrain staff every two years for assessment competency to make sure they can perform as the way of Standard of Procedure(SOP).
  2. Quality Control have to be done everyday to make sure the range of CompoLab TM in normal value.
  3. Advise donors to take Iron Supplement and consume iron-rich foods.

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Conclusion

  1. Comparing the outcome of PDN and journal, pattern of results is slightly different which is we found that Hb value of finger prick (capillary) samples in blood donors using a CompoLab TM were slightly lower.
  2. This result may be effected by the type of machine which is The International Journal used HemoCue Hb 301 while PDN used CompoLab TM.
  3. However, the mean difference between CompoLab TM and automated hematology Mindray BC-6200 analyzer in PDN is only 0.42.
  4. Although the CompoLab TM is slightly lower than automated hematology Mindray BC-6200 analyzer value, it is still safe to be use for pre screening blood donation in PDN.

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