Validity of non-invasive point-of-care hemoglobin estimation in healthy and sick children-a method comparison study.
This study was conducted at a tertiary care center in northern India to evaluate the validity of non-invasive transcutaneous hemoglobin estimation in healthy and sick children in comparison to hemoglobin estimation by traditional lab method. A method comparison study was conducted including 150 subjects. Enrolled patients included 80 neonates with average age of 3.9 ± 2.1 days, and 70 children with average age of 5.8 ± 2 years. Each population (newborn and children) comprised of almost equal numbers of healthy and critically ill patients with shock. Hemoglobin (Hb) was estimated on enrolment by transcutaneous spectrophotometry (SpHb) and traditional automated lab analyzer (Hb-Lab). Difference between Hb levels by the two methods (called bias) was measured and analyzed using Bland-Altman method. Out of 148 data pairs analyzed, bias between SpHb and Hb-Lab was -1.52 ± 1.91 g/dl (mean ± SD). SpHb showed excellent positive correlation with Hb-Lab (r = 0.94 (p < 0.001)) and good visual agreement on Bland-Altman plots. Bias was higher in sick subjects with shock as compared to healthy ones in both neonatal and pediatric population (-2.31 ± 2.21 g/dl versus -0.77 ± 1.2 g/dl, respectively).


CONCLUSIONS
SpHb showed good accuracy and correlated well with lab estimated Hb levels in healthy children. However, in children with impaired peripheral perfusion, its diagnostic accuracy was inadequate to justify routine use for quantification of severity of anemia and making transfusion decisions solely on non-invasive estimation of hemoglobin.


BACKGROUND
Non-invasive hemoglobin estimation is a relatively new and novel method which has given mixed results regarding its potential efficacy in adults. There is limited data regarding usefulness and accuracy of non-invasive Hb estimation by SpHb in sick neonates and children.


BACKGROUND
Non-invasive Hb estimation by SpHb monitor is reasonably accurate in healthy neonates and children. It can be used in critically ill children and neonates, but in conjunction with lab confirmation of Hb values.
Department of Paediatrics, LLRM Medical College, Meerut, Uttar, Pradesh, 250002, India. dradityabhatt@gmail.com.
Aditya
A
Bhat
Department of Paediatrics, LLRM Medical College, Meerut, Uttar, Pradesh, 250002, India. au.llrm@gmail.com.
Amit
A
Upadhyay
Department of Paediatrics, LLRM Medical College, Meerut, Uttar, Pradesh, 250002, India. kinjalvijay@yahoo.com.
Vijay
V
Jaiswal
Department of Paediatrics, Government Medical College, Chandigarh, India. drdeepak.chawla@gmail.com.
Deepak
D
Chawla
Department of Paediatrics, LLRM Medical College, Meerut, Uttar, Pradesh, 250002, India. drsingh.dharamveer98@gmail.com.
Dharamveer
D
Singh
Department of Paediatrics, LLRM Medical College, Meerut, Uttar, Pradesh, 250002, India. drmith2010@gmail.com.
Mithilesh
M
Kumar
Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India. cpyadav123@gmail.com.
C P
CP
Yadav
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D016638:Critical Illness; D005260:Female; D006452:Hemoglobinometry / Q000379:methods*; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007362:Intensive Care Units; D008297:Male; D010092:Oximetry / Q000379:methods*; D019095:Point-of-Care Systems; D011446:Prospective Studies; D015203:Reproducibility of Results
D006454:Hemoglobins
Anemia; Non-invasive hemoglobin; Point-of-care hemoglobin; Shock; SpHb