Abstract
Background: The authors report the relevance of using a point of care test (Helge®) for free hemoglobin determination and concordance of the values the with Cobas® 8000 and spectrophotometer methods. Results: The within-run of the point of care test was <3%. Good correlations among the three methods were observed and an acceptable concordance for hemolysis index values from 50 mg/dl. An excellent agreement between the Cobas 8000 and the spectrophotometer was found. Conclusion: Automated methods represent methods of choice for free hemoglobin determination. An advantage of the Helge system is that it can be applied to samples experiencing a delay in evaluation due to the long distance between the collection site and the central laboratory. Another advantage is its use at the bedside, in the monitoring of extracorporeal membrane oxygenation patients.
Papers of special note have been highlighted as: • of interest
References
- 1. . Determination of hemolysis cut-offs for biochemical and immunochemical analytes according to their value. Clin. Chem. Lab. Med. 58, 1232–1241 (2020). • The authors highlight allowable hemolysis index thresholds for several biochemistry parameters, in particular according to their concentration, leading to optimization in resampling to time saving in patient care.
- 2. . Hemolysis and plasma free hemoglobin during extracorporeal membrane oxygenation support: from clinical implications to laboratory details. ASAIO J. 66, 239–246 (2020). • The authors describe in detail the main pathophysiologic aspects in the extracorporeal membrane oxygenation setting and demonstrate the importance of determining free hemoglobin in this context.
- 3. . A method for determination of hemoglobin in plasma by near-ultraviolet spectrophotometry. Scand. J. Clin. Lab. Invest. 59, 66–70 (1959).
- 4. Plasma free hemoglobin is an independent predictor of mortality among patients on extracorporeal membrane oxygenation support. PLOS ONE 10, e0124034 (2015). • Princeps publication to determine the cutoff in the context of extracorporeal membrane oxygenation at 50 mg/dl. This manuscript is considered as reference and this threshold of 50 mg/dl is most often used.
- 5. . Measuring agreement in method comparison studies. Stat. Methods Med. Res. 8, 135–160 (1999).
- 6. . The meaning of kappa: probabilistic concepts of reliability and validity revisited. J. Clin. Epidemiol. 49, 775–782 (1996).
- 7. . Using the hemolysis index of Abbott's Alinity c for the measurement of plasma free hemoglobin in ECMO patients. Clin. Biochem. 100, 67–70 (2022).
- 8. Can the Roche hemolysis index be used for automated determination of cell-free hemoglobin? A comparison to photometric assays. Clin. Biochem. 46, 1298–1301 (2013).
- 9. . Point-of-care hemolysis detection in blood gas specimens directly at the emergency department. Scand. J. Clin. Lab. Invest. 79, 283–287 (2019).
- 10. NICE. Helge for detecting haemolysis (2020). www.nice.org.uk/guidance/mib225
- 11. Multicenter evaluation of the hemolysis index in automated clinical chemistry systems. Clin. Chem. Lab. Med. 47, 934–939 (2009).
- 12. Automated and cost-efficient early detection of hemolysis in patients with extracorporeal life support: use of the hemolysis-index of routine clinical chemistry platforms. J. Crit. Care 51, 29–33 (2019).
- 13. Is there a risk of misinterpretation of potassium concentration from undetectable hemolysis using a POCT blood gas analyzer in the emergency department? Medicina (Kaunas) 59, 66 (2022). • The authors have no conflict of interest with the company and their study demonstrates that POCT can be used routinely.
