| Performance of the RAD-57 pulse CO-oximeter compared with standard laboratory carboxyhemoglobin measurement. | |
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MedLine Citation:
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PMID: 20605259 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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STUDY OBJECTIVE: We assess agreement between carboxyhemoglobin levels measured by the Rad-57 signal extraction pulse CO-oximeter (RAD), a Food and Drug Administration-approved device for noninvasive bedside measurement, and standard laboratory arterial or venous measurement in a sample of emergency department (ED) patients with suspected carbon monoxide poisoning. METHODS: The study was a cross-sectional cohort design using a convenience sample of adult and pediatric ED patients in a Level I trauma, burn, and hyperbaric oxygen referral center. Measurement of RAD carboxyhemoglobin was performed simultaneously with blood sampling for laboratory determination of carboxyhemoglobin level. The difference between the measures for each patient was calculated as laboratory carboxyhemoglobin minus carboxyhemoglobin from the carbon monoxide oximeter. The limits of agreement from a Bland-Altman analysis are calculated as the mean of the differences between methods ±1.96 SDs above and below the mean. RESULTS: Median laboratory percentage carboxyhemoglobin level was 2.3% (interquartile range 1 to 8.5; range 0% to 38%). The mean difference between laboratory carboxyhemoglobin values and RAD values was 1.4% carboxyhemoglobin (95% confidence interval [CI] 0.2% to 2.6%). The limits of agreement of differences of measurement made with the 2 devices were -11.6% and 14.4% carboxyhemoglobin. This range exceeded the value of ±5% carboxyhemoglobin defined a priori as clinically acceptable. RAD correctly identified 11 of 23 patients with laboratory values greater than 15% carboxyhemoglobin (sensitivity 48%; 95% CI 27% to 69%). There was one case of a laboratory carboxyhemoglobin level less than 15%, in which the RAD device gave a result greater than 15% (specificity of RAD 96/97=99%; 95% CI 94% to 100%). CONCLUSION: In the range of carboxyhemoglobin values measured in this sample, the level of agreement observed suggests RAD measurement may not be used interchangeably with standard laboratory measurement. |
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Authors:
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Michael Touger; Adrienne Birnbaum; Jessica Wang; Katherine Chou; Darion Pearson; Polly Bijur |
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Publication Detail:
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Type: Comment; Comparative Study; Journal Article Date: 2010-06-03 |
Journal Detail:
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Title: Annals of emergency medicine Volume: 56 ISSN: 1097-6760 ISO Abbreviation: Ann Emerg Med Publication Date: 2010 Oct |
Date Detail:
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Created Date: 2010-09-27 Completed Date: 2010-10-19 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8002646 Medline TA: Ann Emerg Med Country: United States |
Other Details:
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Languages: eng Pagination: 382-8 Citation Subset: AIM; IM |
Copyright Information:
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Copyright © 2010 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved. |
Affiliation:
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Department of Emergency Medicine, Albert Einstein College of Medicine, Bronx, NY, USA. michael.touger@nbhn.net |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Carbon Monoxide Poisoning / blood, diagnosis Carboxyhemoglobin / analysis* Cross-Sectional Studies Emergency Service, Hospital Female Humans Male Middle Aged Oximetry / instrumentation*, standards Point-of-Care Systems / standards Sensitivity and Specificity Young Adult |
| Chemical | |
Reg. No./Substance:
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9061-29-4/Carboxyhemoglobin |
| Comments/Corrections | |
Comment On:
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Ann Emerg Med. 2010 Oct;56(4):389-91
[PMID:
20646785
]
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Comment In:
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Ann Emerg Med. 2010 Oct;56(4):442-4; author reply 444-5
[PMID:
20868919
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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