Co-oximetry reporting
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Fellow Point of Care folks,
I am running into some issues validating my blood gas analyzers for co-oximetry. My total hemoglobin is showing a significant bias that is not reflected in the reference ranges (compared to the main lab). What are my options here? (bias:
sometimes 1.5-2.0 g/dL)
1. Perform my own reference range study and report out a different reference for hemoglobin?
2. Only report out the % Co-ox. (anyone doing this?)
#2 seems like the way I would like to go, and not report total hemoglobin… most physicians only want to see CoHb and MetHb.
Thank you,
Brad
Brad C Simmons, MLS(ASCP)CM
Point of Care Coordinator
Straub Medical Center
888 South King Street
Honolulu, Hawaii 96813
(808) 522-3509
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What is your blood gas method? We see a bias with our RapidPoint 500 instruments so we had to do a correlation coefficient adjustment.
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While not reporting tHb may seem like a good option because most physicians are not looking for that value, I would be hesitant to drop it. I have found that ensuring that tHb is part of your blood gas/critical care profile is very beneficial for catching preanalytical errors on the part of the end users. Errors such as undermixing or hemodilution reveal themselves in the tHb value, and often prove difficult to catch by looking at other tests.
And yes, as someone else mentioned, most ABG analyzers will offer a coefficient adjustment to more closely match the values with your main lab analyzer.
Lastly - is your ABG analyzer a calculated or measured tHb? You will typically not get good correlation with a calculated tHb in a critical care population when comparing to main lab (or other measured tHb) method.
I had to use fresh blood samples for some of my Hgb GEM validations
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