Comparison between continuous noninvasive hemoglobin monitoring and venous blood hemoglobin monitoring in children with kidney disease / 北京大学学报(医学版)

ABSTRACT

Objective:To assess the correlation and consistency between continuous noninvasive hemo globin detection and venous blood hemoglobin detection in children with kidney disease,and try to analyze the affecting factors.Try to provide a reference for the monitoring of hemoglobin in children with kid ney disease by continuous noninvasive hemoglobin detection technique.Methods:Eighty-five inpatient children with kidney disease,50 boys (58.8％) and 35 girls (41.2％),aged from 3 years old to 18 years old (9.35 ± 4.29) were included finally.Noninvasive hemoglobin monitoring by spectrophotometry (SpHb) was stably read by PRONTO-7,selecting the ring finger of the non handedness as the detection site.And then the venous blood hemoglobin of the same patient was collected in 5 minutes as the true hemoglobin (tHb) by Beckman coulter DXH-800.The data of SpHb and tHb were compared and analyzed using SPSS 17.0 and MedCalc.Results:Correlation analysis showed data of SpHb and tHb were with significant correlation,the correlation coefficient between SpHb and tHb was 0.85 (P ＜ 0.05).BlandAltman plot points suggested that the mean of differences between SpHb and tHb was-1.3 g/dL.The 95％ CI of agreement of SpHb-tHb was-4.2-1.5 g/dL,suggesting that the average measurement re sult of SpHb was lower than that of tHb.The mean of differences as percent between SpHb and tHb was -9.8％,95％ CI of agreement was (-35.9％,16.2％) exceeding the acceptable range of true value ± 6％.The consistent rate of non-invasive hemoglobin detection and venous blood hemoglobin detection was 31.8％,the 95％ CI of consistent rate was (21.7％,41.9％).The chi square test of the fourfold table showed that the diagnosis of anemia with SpHb was of high sensitivity,but the specificity was low,the false positive rate was high,and the difference was statistically significant (P =0.000).Conclusion:There was a significant correlation between SpHb and tHb in the children with kidney disease.Noninvasive hemoglobin measurement can be used for monitoring of changes of hemoglobin in children with kidney diseases.But the consistency between SpHb and tHb needs to be improved.Noninvasive hemoglobin measurement could not replace the venous hemoglobin measurement.It could not be used for the diagnosis of anemia,and the accuracy of hemoglobin concentration measurement in children with kidney disease should be further explored.