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Comparison between a laser lancing device and lancet for capillary blood sampling, capillary blood hemoglobin measurement, and blood typing.

Author(s): Kim J, Yoon SY, Lim CS, Yoon J

Publication: Transfusion, 2021, Vol. 61, Page 2918-2924

PubMed ID: 34268735 PubMed Review Paper? No

Purpose of Paper

Conclusion of Paper

Studies

1. Study Purpose

   This study compared capillary hemoglobin levels and blood typing results between case-matched finger-prick capillary blood specimens obtained using a lancet or a laser lancing device. The authors compared capillary hemoglobin levels in specimens obtained using each device to venous hemoglobin levels in a subset of patients. Capillary blood was obtained from 91 healthy volunteers and 100 outpatients (diagnosis not specified) by finger prick sampling from the second or third finger using a lancet on one finger and a laser lancing device on the same finger on the opposite hand. The first drop of blood was wiped away and collection order was random with 96 patients undergoing sampling with laser lancet device first. Venous EDTA blood was also collected from 103 participants. Capillary hemoglobin levels were measured using a HemoCue Hb 301 point of care machine. Venous hemoglobin levels were measured using DxH 900. ABO compatibility and Rh blood type were assessed by the slide method which involved mixing a drop of blood with reagent antisera and evaluating visible agglutination after 2 min.

   Summary of Findings:

   Of the 191 patients in the study, 47 and 50 had hemoglobin levels below the threshold for donor deferral (12.5 g/dL) when collected by laser lancing device and lancet, respectively. Capillary hemoglobin levels were very strongly correlated between specimens obtained with the two different lancing methods (r=0.927, P<0.001), and mean levels, while higher with the lancing device were not significantly different between the two lancing methods (13.42±2.14 for laser lancing device and 13.33 ±2.18 for lancet, P=0.113). While capillary hemoglobin levels were higher than venous hemoglobin levels (13.42±2.14 versus 12.72±2.29, P<0.1 for laser lancing and 13.33 ±2.18 versus 12.72±2.29, P=0.02 for lancet), capillary and venous hemoglobin levels were very strongly correlated when capillary specimens were obtained with the laser lancing device or lancet (r=0.963 and r=0.964, respectively P<0.001). The sensitivity and specificity of low capillary hemoglobin (<12.5 g/dL) for detecting low venous hemoglobin was 80% and 98.53%, respectively, when a laser lancing device was used and 85.71% and 97.06%, respectively, when a lancet was used. Importantly there was 100% agreement in ABO and Rh groups between capillary specimens collected using a lancet and a laser lancing device. The skin puncture pain scores were significantly lower when collection was with a laser lancing device than a lancet (P<0.001).

   Biospecimens

   • Bodily Fluid - Blood

   Preservative Types

   • None (Fresh)

   Diagnoses:

   • Not specified
   • Normal

   Platform:

   Analyte	Technology Platform
   Glycoprotein	Immunoassay
   Protein	Hematology/ auto analyzer

   Pre-analytical Factors:

   Classification	Pre-analytical Factor	Value(s)
   Biospecimen Acquisition	Method of fluid acquisition	Lancet Laser lancing device
   Biospecimen Acquisition	Anatomical location of blood draw	Vein Capillary

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