HemoCue® Plasma/Low Hb System

HemoCue Academy, April 2013

CONFIDENTIAL
Hemoglobin WBC/DIFF 1
FOR INTERNAL USE ONLY
Products
 HemoCue® Plasma/Low Hb

Features
 2 wavelengths, 570 and 880 nm
 Measurement range:0.00-3.00 g/dL
 Mesuring time 15-60 seconds

Segments
 Blood banks and Hospitals
 For low concentrations of hemoglobin in plasma,
serum and irrigated solutions

2
 Definition hemolysis and how the
Plasma/Low Hb system works
• Hemolysis -The destruction of red blood cells, with subsequent release of
Hb into surrounding fluid (plasma).
• Hemolysis may occur in vivo or in vitro (inside or outside the body).
 Plasma/Low Hb uses the same reagent as Hb 201 microcuvettes
 Measures both Hb from intact red cells and free Hb
if both are present in a sample
 If free Hb is to be determined, the sample needs to be
centrifuged prior to analysis to get rid of any
intact red cells

3
HemoCue® Plasma/Low Hb System
- For determination of low hemoglobin levels in plasma,
serum, aqueous solutions or stored banked erythrocytes.

• Hemolysis assessment of stored blood

• Quality control during Intra-Operative
Blood Salvage
• Hemolysis assessment of Laboratory
Samples
• Calculation of blood loss during
surgical procedures

4
 HemoCue® Plasma/Low Hb System
-Unique Quality Control of Blood Products

Degree of hemolysis is an essential indicator of the

quality and integrity of blood products. HemoCue’s
innovation has set the standard — making it possible
to easily and accurately estimate hemolysis directly
at the point of care.

• Replace subjective visual judgment

• Precise factory calibration against ICSH
• Blood-based liquid controls available
• For plasma, serum aqueous solutions or stored
erythrocyte suspensions
• Simple to use, providing results within 1 minute
• Portability enables testing anywhere
• Brief training with virtually no maintenance

5
Hemolysis Assessment of Stored Blood

 For determination of hemolysis

(free hemoglobin) in blood products.
 The amount of free hemoglobin in the
supernatant phase of stored erythrocyte
preparations is an important indicator of
product integrity and quality.
 Filtration, incorrect storage and vigorous
handling are typical situations that can
cause hemolysis which may compromise
quality, making blood products less useful
as well as potentially harmful.

6
Quality Control of Blood Products

There is a strong international trend towards a more regulated

control of the quality of blood products. See hemolysis levels
allowed for blood products below:

• European Directive 2004/33/EC:

Free Hb < 0.8%
• American AABB:
Free Hb < 1.0%

7
Quality Control of Blood Products
-Hemolysis Calculation

% Hemolysis = Plasma/Low Hb x (1-EVF) x 100

Total Hb

Example: Plasma/Low Hb: 0.48 g/dL

EVF: 0.61
Total Hb: 18.9 g/dL

Hemolysis = 0.48 x 0.39 x 100 = 1.0%

18.9

EVF = Erythrocyte Volume Fraction, or Hematocrit

8
Quality Control of Blood Products
-Sampling

9
 Other Plasma Hemoglobin Methods

• >20 different assays in use today. Many are cumbersome and time-consuming and/or
are affected by interferences (elevated levels of bilirubin or lipids)
• These methods are mainly intended for in-vivo hemolysis, and are not optimized for
quality control of erythrocyte preparations or for irrigating solutions. This may result
in the need for specimen dilutions and analysis multiple times.
• Many laboratories have opted not to perform plasma hemoglobin analysis because of
the time and expense associated with the procedures currently available.

HemoCue Plasma/Low Hb delivers lab quality results within minutes of sampling.

The system is easy to use and does not require cumbersome dilution steps or exact
timing when adding different reagents.
Plasma Hemoglobin Measurement Techniques for the In Vitro Evaluation of Blood Damage Caused by Medical Devices.
Artif Organs. 1997;21:1255-1267

10
 Visual Methods
- Subjective, Inaccurate and Misleading

Visual inspection, although used, is a very inaccurate method.

Factors such as viewer experience, tube type and diameter, and the presence of
other interfering factors, limit the usefulness of visual inspection as a mean to
estimate the degree of hemolysis.

HemoCue Plasma/Low Hb takes the guesswork out of hemolysis assessment.

It delivers lab quality results almost as quick as making a visual assessment.
In short, it provides a far superior basis for critical decision.

Visual assessment of hemolysis in red blood cell units and segments can be deceptive. Transfusion 2004;44:984-989

11
 Why HemoCue® Plasma/Low?

• Simple to use, providing results within one minute

• Replace subjective visual judgment
• Precise factory calibration against ICSH
• Plasma, serum, aqueous solutions or
stored erythrocyte suspensions may be used
• Portability enables testing anywhere
• Brief training with virtually no
maintenance

12
 HemoCue® Plasma/Low Hb System
• Standardization of Plasma Hemoglobin
Testing for Quality Control of Blood Bags

HemoCue Academy, April 2013

CONFIDENTIAL
Hemoglobin WBC/DIFF 13
FOR INTERNAL USE ONLY
Products
1. Gently mix the blood in the tubing
with the blood in the bag;

• This requires “stripping” the tube

by rolling the blood from the tube
back into the bag
• Mix and let the blood return into
the tube using stripping pliers
• Repeat the above procedure 3
times
2. Prepare 3 segments with ~ 3ml
of blood from the blood bag
tubing using a heat sealer cutter:

• One segment for measuring

Plasma Low Hb
• One segment for measuring
total Hb
• One segment for storage as a
backup once the bag is shipped
3. Label each tube segment to correspond with the bag ID number

4. Empty one of the tube segments (for Plasma Low Hb determination) into
a Microtainer® Tube and label it with the corresponding bag ID number.
5. Centrifuge the Microtainer® Tube at 2000 g’s for 10 minutes
6. Place a drop of sample taken from the supernatant-phase onto a
hydrophopic (plastic) sheet and fill one HemoCue® Plasma/Low Hb
Microcuvette.

Supernatant-phase
7. Analyze the filled microcuvette with the HemoCue® Plasma/Low Hb
Photometer.
8. Use the second tube segment to determine the total hemoglobin
concentration with the HemoCue® Hb 201+ system
Plasma Low Standardization

9. Use the below formula to determine the level of plasma

hemoglobin in the blood bag (% hemolysis):

% of Hemolysis = Plasma Low Hb value x (1-EVF) x 100

Total Hb value

EVF (Erythrocyte Volume Fraction) = % Hct/100

% Hct (Hematocrit) can be determined in the lab or calculated by
multiplying the total Hb value with 2.941

10. Compare results in accordance with the international standards

determined by the blood bank.
 Because when it comes to
caring for people, we refuse
to compromise.

HemoCue Academy, April 2013

CONFIDENTIAL
Hemoglobin WBC/DIFF 22
FOR INTERNAL USE ONLY
Competitors