Comparison of total haemoglobin mass measured with the optimized carbon monoxide rebreathing method across different Radiometer™ ABL-80 and OSM-3 hemoximeters

A new Radiometer™ hemoximeter (ABL-80) has recently become available to measure carboxyhaemoglobin concentration for the optimized CO-rebreathing method (oCOR-method). Within the English Institute of Sport (EIS), hemoximeters are used in three different laboratories; therefore, precision and agreement of total haemoglobin mass (tHbmass) determination across sites is essential, and comparison to the previous model OSM-3 is desirable. Six male and one female (age 30  ±  6 years, body mass 78.1  ±  10.6 kg) undertook the oCOR-method. Venous blood (∼2 ml) was sampled immediately before and at 7 min during the oCOR-method; with seven replicates from each time point simultaneously analysed on five different Radiometer™ hemoximeters [OSM-3(1), OSM-3(2), ABL-80(1), ABL-80(2) and ABL-80(3)]. There were no differences (p > 0.05) between Δ%HbCO or mean tHbmass analysed with five different hemoximeters (OSM-3(1): 886  ±  167 g; OSM-3(2): 896  ±  160 g: ABL-80(1): 904  ±  157 g; ABL-80(2): 906  ±  163 g: ABL-80(3): 906  ±  162 g). However, the Bland–Altman plot revealed that there was closer agreement between ABL-80 machines for tHbmass than for the OSM-3. The variance (i.e. % error) across replicate samples decreased as the number of samples increased, with the error derived from the 'worse-case' scenario (single samples) being 1.2 to 1.6 fold greater in the OSM-3 than the ABL-80. Although there were no differences in the average tHbmass measured with five different hemoximeters, the new ABL-80 were in better agreement with each other compared to the old OSM-3. Previously, five replicates were required to achieve a low error using the OSM-3; however, three replicates are sufficient with the ABL-80 model to produce an error of ≤ 1% in tHbmass. (note)