title: Accuracy and precision of hemoglobin point-of-care testing during major pediatric surgery.
abstract: BACKGROUND
  The aim of the study was to compare accuracy and reproducibility of four point-of-care testing (POCT) devices (GEM® Premier 3000, ABL 800 flex, GEM® OPL™, HemoCue® B-Hemoglobin) for hemoglobin (Hb) analyzes as compared with the reference laboratory method (Sysmex XE 2100) in children undergoing major surgery.
  
  
  METHODS
  Pediatric patients undergoing craniofacial, spine, hip, or cancer surgery were included. Blood samples for Hb testing were taken at several intraoperative time points and generally withdrawn from the arterial catheter, if accessible.
  
  
  RESULTS
  A total of 256 blood samples were taken intraoperatively from 71 pediatric patients. All POCT devices showed very small bias (maximum -0.46 g/dL) to reference method as well as very good reproducibility (maximum coefficient of variation of 0.99%). However, in two cases (HemoCue), potential clinical relevant differences were observed beyond a range of 2 g/dL.
  
  
  CONCLUSIONS
  All POCT devices tested and operated by trained staff for hemoglobinometry showed reliable test results. They all allow for simple, fast, and precise bedside determination of hemoglobin concentration in the intraoperative setting.
authors.affiliation: Department of Anaesthesia, University Children's Hospital Zurich, Zurich, Switzerland.
authors.forename: N
authors.initials: N
authors.lastname: Spielmann
authors.forename: J
authors.initials: J
authors.lastname: Mauch
authors.forename: C
authors.initials: C
authors.lastname: Madjdpour
authors.forename: M
authors.initials: M
authors.lastname: Schmugge
authors.forename: M
authors.initials: M
authors.lastname: Weiss
authors.forename: T
authors.initials: T
authors.lastname: Haas
mesh_terms: D002648:Child; D002675:Child, Preschool; D006452:Hemoglobinometry / Q000295:instrumentation* / Q000379:methods; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D007223:Infant; D059035:Perioperative Period; D019095:Point-of-Care Systems; D015203:Reproducibility of Results
chemical_list: D006454:Hemoglobins