Table 1

Technologies for minimizing laboratory blood loss in NICU environment

Laboratory method Range of blood volumes Analytes Advantages Disadvantages References
POC & whole-blood benchtop analyzers 25-100 Na, K, Hb/Hct, blood gases & pH, glucose, bilirubin & most others Small whole-blood samples; Expanding menu; Rapid analysis; Less preanalytical error in patient identification (POCs only) For some POCs: 1) connectivity to computer systems to patient’s medical record; and 2) oversight and regulations for CLIA non-waived testing (in the US) [17, 25]

In-line POC

0-24 Na, K, Hb/Hct, blood gases & pH Little to no blood loss Requires indwelling arterial catheter; Limited menu; Expensive; Connectivity to computer systems [13, 26]
Transcutaneous None SpO2, tcpO2, tcpCO2 & bilirubin Requires no blood sampling;Continuous for the gases Limited menu [18, 19]
Alternative body fluids (e.g., saliva, interstitial fluid) 10-100 Cortisol & some drugs Requires no blood sampling; Conserves blood Limited reference values;
Limited menu; Interstitial fluid requires indwelling capillary tube
Future technologies None Glucose, tissue Hb & tissue oxyhemoglobin saturation Utilize nanotechnologies, allow continuous monitoring; and/or require no blood sampling Not commercially available [22, 24]