Non-Invasive Haemoglobin Estimation in Patients with Thalassaemia Major
Journal Title: Sultan Qaboos University Medical Journal - Year 2014, Vol 14, Issue 4
Abstract
Objectives: Tis study aimed to validate pulse CO-oximetry-based haemoglobin (Hb) estimation in children and adults with thalassaemia major (TM) and to determine the impact of different baseline variables on the accuracy of the estimation. Methods: Tis observational study was conducted over a fve-week period from March to April 2012. A total of 108 patients with TM attending the daycare thalassaemia centre of a tertiary care hospital in Muscat, Oman, were enrolled. Spot (Sp) Hb measurements were estimated using a Pronto-7® pulse CO-oximetry device (Masimo Corp., Irvine, California, USA). Tese were compared to venous samples of Hb using the CELL-DYN Sapphire Hematology Analyzer (Abbott Diagnostics, Abbott Park, Illinois, USA) to determine the reference (Ref) Hb levels. A multivariable linear regression model was used to assess the impact of baseline variables such as age, gender, weight, height, Ref Hb and blood pressure on the Hb estimations. Results: Of the 108 enrolled patients, there were 54 males and 54 females with a mean age of 21.6 years (standard deviation [SD] = 7.3 years; range: 2.5–38 years). Te mean Ref Hb and Sp Hb were 9.4 g/dL (SD = 0.9 g/dL; range: 7.5–12.3 g/dL) and 11.1 g/dL (SD = 1.2 g/dL; range: 7.5–14.7 g/dL), respectively. Te coefcient of determination (R2) was 21% with a mean difference of 1.7 g/dL (SD = 1.1 g/dL; range: −0.9–4.3 g/dL). In the multivariable model, the Ref Hb level (P = 0.001) was the only statistically signifcant predictor. Conclusion: Te Pronto-7® pulse CO-oximetry device was found to overestimate Hb levels in patients with TM and therefore cannot be recommended. Further larger studies are needed to confrm these results.
Authors and Affiliations
Murtadha K. Al Khabori| Departments of Haematology, Sultan Qaboos University Hospital, Arwa Z. Al-Riyami| Departments of Haematology, Sultan Qaboos University Hospital, Khalil Al-Farsi| Departments of Haematology, Sultan Qaboos University Hospital, Mohammed Al-Huneini| Departments of Haematology, Sultan Qaboos University Hospital, Abdulhakeem Al-Hashim| Departments of Medicine, Sultan Qaboos University Hospital, Nasser Al-Kemyani| Departments of Anaesthesia & Intensive Care, Sultan Qaboos University Hospital, Issa Al-Qarshoubi| Departments of Medicine, Sultan Qaboos University Hospital, Hammad Khan| Department of Haematology, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman, Khalfan Al-Amrani| Departments of Emergency Medicine, Sultan Qaboos University Hospital, Shahina Daar| Department of Haematology, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman
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