title: Reliability of the HemoCue® hemoglobinometer in critically ill patients: a prospective observational study.
abstract: BACKGROUND
  The aim of the study was to assess the reliability of hemoglobin measurements made with HemoCue®, compared with those made with the reference method in critically ill patients.
  
  
  METHODS
  A prospective observational study was conducted in three adult surgical intensive care units of a university hospital. One hundred and ninety-eight consecutive patients were included, and a total of 1166 hemoglobin concentrations were measured using arterial blood samples in the laboratory (HbLAB) and at bedside (HbHC.art) with a portable hemoglobinometer (HemoCue® Hb201+). Simultaneously, a capillary measurement (HbHC.cap) was performed at bedside using the same device.
  
  
  RESULTS
  The mean difference (bias) between HbHC.cap and HbLAB was 0.2 g/dL (95%CI, 0.1;0.3), and limits of agreement were -1.3 g/dL (95%CI, -1.4;-1.2) to 1.7 g/dL (95%CI, 1.6;1.9). The discrepancies between HbHC.cap and HbLAB were greater than 1 g/dL in 30.8% of cases. The bias between HbHC.art and HbLAB was -0.1 g/dL (95% CI, -0.2;0.2), and limits of agreement were slightly better at -1.1 g/dL (95% CI, -1.2;-1.0) and 1.0 g/dL (95% CI, 0.9;1.1). The HemoCue®'s accuracy was not affected by the hospital unit, the puncture site (finger or ear), norepinephrine administration or by hemoglobin levels below 10 g/dL or 8 g/dL.
  
  
  CONCLUSIONS
  Capillary HemoCue® is not sufficiently accurate to make a therapeutic decision such as whether a blood transfusion should be performed. The method's performance was moderately improved by the use of arterial blood.
authors.affiliation: Centre Hospitalier et Universitaire de Poitiers, Université de Poitiers et Inserm ERI23, France. o.mimoz@chu-poitiers.fr
authors.forename: O
authors.initials: O
authors.lastname: Mimoz
authors.forename: D
authors.initials: D
authors.lastname: Frasca
authors.forename: A
authors.initials: A
authors.lastname: Médard
authors.forename: L
authors.initials: L
authors.lastname: Soubiron
authors.forename: B
authors.initials: B
authors.lastname: Debaene
authors.forename: C
authors.initials: C
authors.lastname: Dahyot-Fizelier
mesh_terms: D000328:Adult; D000368:Aged; D003422:Critical Care / Q000379:methods*; D016638:Critical Illness / Q000628:therapy*; D004837:Epinephrine / Q000627:therapeutic use; D005260:Female; D006452:Hemoglobinometry / Q000295:instrumentation*; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D014662:Vasoconstrictor Agents / Q000627:therapeutic use
chemical_list: D006454:Hemoglobins; D014662:Vasoconstrictor Agents; D004837:Epinephrine