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Hydroxocobalamin and cyanocobalamin interference on co-oximetry based hemoglobin measurements

Prasad V A Pamidi1, Marlene DeAbreu, Donghak Kim

  • 1Instrumentation Laboratory, Lexington, MA 02421, USA. PPamidi@ilww.com

Clinica Chimica Acta; International Journal of Clinical Chemistry
|December 2, 2008
PubMed

Insights

Hydroxocobalamin and cyanocobalamin interfere with co-oximeter hemoglobin measurements. Some analyzers, like the GEM Premier 4000, show minimal impact and can detect this cobalamin interference.

Area of Science:

  • Clinical Chemistry
  • Analytical Chemistry
  • Biochemistry

Background:

  • Hydroxocobalamin (OHCbl) and cyanocobalamin (CNCbl) are vitamin B-12 analogs with a strong red color.
  • OHCbl is an antidote for cyanide poisoning.
  • Cobalamins can interfere with spectrophotometric hemoglobin assays on co-oximeters.

Purpose of the Study:

  • To compare the impact of OHCbl and CNCbl on hemoglobin measurements across different co-oximetry systems.
  • To evaluate the accuracy of hemoglobin measurements in the presence of cobalamins.
  • To assess the ability of co-oximeters to detect and flag cobalamin interference.

Main Methods:

  • Blood samples were spiked with varying concentrations of OHCbl or CNCbl (0-2 g/l).
  • Measurements were performed on GEM Premier 4000, IL 682 CO-Oximeter, Radiometer ABL 735, and Siemens Rapidpoint 405 analyzers.
  • Interference was evaluated by comparing spiked samples to control samples.

Main Results:

  • Spectral and blood measurements confirmed that OHCbl and CNCbl affect hemoglobin measurement accuracy.
  • Interference originates from measurement algorithm errors, not cobalamin-induced hemoglobin changes.
  • Both OHCbl and CNCbl demonstrated similar interference effects.

Conclusions:

  • GEM Premier 4000 and Siemens Rapidpoint 405 showed minimal interference at OHCbl concentrations around 0.5 g/l.
  • Cyanocobalamin interference effects were comparable to hydroxocobalamin.
  • The GEM Premier 4000's error detection system successfully flagged cobalamin interference.
Abstract

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