Oceans (Mar 2022)

Evaluation of the HemoCue<sup>®</sup> WBC System as a Point of Care Diagnostic Tool for White Blood Cell Quantification in Pinnipeds

  • Abby M. McClain,
  • Emily R. Whitmer,
  • Carlos Rios,
  • Eric D. Jensen,
  • Nicole I. Stacy,
  • Shawn P. Johnson

DOI
https://doi.org/10.3390/oceans3010007
Journal volume & issue
Vol. 3, no. 1
pp. 72 – 83

Abstract

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Point of care (POC) hematology testing can be valuable in triage and field settings. We assessed the accuracy between the HemoCue® WBC system and two comparative analyzers, as well as the precision of the HemoCue® WBC system in five different pinniped species: Zalophus californianus, Arctocephalus townsendi, Callorhinus urcinus, Phoca vitulina, and Mirounga angustirostris for white blood cell (WBC) quantification. In Zalophus (n = 164; 106 from U.S. Navy Marine Mammal Program (Navy); 58 from The Marine Mammal Center (TMMC)), the HemoCue® was compared to two hematology analyzers, Sysmex Xe-5000 and Vet ABC Plus. In Phoca (n = 50; TMMC), Callorhinus (n = 29; TMMC), Arctocephalus (n = 17; TMMC), and Mirounga (n = 67; TMMC), the HemoCue® was compared to Vet ABC Plus only. Bland–Altman and Passing–Bablok agreement of HemoCue® with Sysmex Xe-5000 and Vet ABC Plus analyzers were good for Zalophus, Arctocephalus, Phoca, and Mirounga but marginal with Callorhinus; bias = 0.56 × 109/L (Zalophus; Navy), −2.13 × 109/L (Zalophus; TMMC), −1.59 × 109/L (Arctocephalus), −2.48 × 109/L 0.917 (Phoca), −0.01 × 109/L (Mirounga), and −6.05 × 109/L (Callorhinus). The coefficient of variation from triplicate runs of samples were within acceptable limits for all species (2.50% ± 1.63 (Zalophus; TMMC), 3.09% ± 2.14 (Arctocephalus), 2.47% ± 1.35 (Callorhinus), 2.88% ± 1.75 (Phoca), and 3.44% ± 2.53 (Mirounga)), respectively. The presence of nucleated red blood cells (nRBC; 1–37 nRBC/100 WBC) did not significantly interfere with WBC counts in Zalophus, Callorhinus, and Phoca at the population level, but their presence should be evaluated at the individual level. The HemoCue® provides an accurate method for WBC quantification with WBC counts up to 30 × 109/L (upper limit of linearity of the analyzer) in Zalophus, Arctocephalus, Phoca, and Mirounga, but is less accurate in Callorhinus, and showed good precision in all species.

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