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. 2006 Dec;374(1-2):75-80.
doi: 10.1016/j.cca.2006.05.042. Epub 2006 Jun 6.

The measurement of accurate fetal hemoglobin and related oxygen saturation by the hemoximeter

Shyang-Yun Pamela K Shiao  1 , Ching-Nan Ou, Hector Pierantoni
Affiliations

The measurement of accurate fetal hemoglobin and related oxygen saturation by the hemoximeter

Shyang-Yun Pamela K Shiao et al. Clin Chim Acta. 2006 Dec.

Abstract

Background: The purposes of this study were to examine the accuracy of fetal hemoglobin (HbF) as quickly measured by the hemoximeter, verified by the high-performance liquid chromatography method, and to examine related oxygen saturation (SO(2)) measurements in neonates.

Methods: Thirty-nine neonates with gestational ages ranging from 25 to 38 weeks were investigated (n=280 blood samples). Twenty younger premature neonates had blood transfusions (n=188 blood samples, 72 before and 116 after transfusions), and 19 older neonates did not.

Results: The bias of the hemoximeter was 23% (+/-9.1) against the HPLC; 25% (+/-7.9) before, and 19% (+/-8.6) after blood transfusions (all P<0.001), for HbF measurements. A regression line (HbFt by the HPLC=8.46+0.7 x HbF by the hemoximeter) has been provided for the prediction. Oxyhemoglobin dissociation curves with the status of (before and after) blood transfusions were presented. In relation to oxygen tension values of 50-75 mm Hg, in addition to the right-shifted oxyhemoglobin dissociation curves, pulse oximeter ranged from 95 to 98% before the transfusions, but decreased to 94 to 96% after the blood transfusions.

Conclusions: Accurate HbF and related oxygen saturation measurements need to be determined, especially for premature neonates, to minimize the risk of oxygen toxicity.

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Figures

Fig. 1
Fig. 1
Scatter plots of HbF measured by OSM3 hemoximeter (X-axis) and HbF (%) measured by HPLC (Y-axis) with a regression line (n = 280 blood samples).
Fig. 2
Fig. 2
Fitted Sigmoid curves for arterial HbO2, SaO2, and SpO2 before (n =72 blood samples) and after (n=116 blood samples) blood transfusions of HbA (solid markings = before transfusions, hollow markings = after transfusion); X-axis: arterial blood gas PO2 (mm Hg); Y-axis: arterial oxygen saturation measurements (%). Note: HbO2 = oxyhemoglobin, SO2 = arterial oxygen saturation, SpO2 = oxygen saturation by pulse oximetry, PaO2 = arterial oxygen tension.
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