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Hemoglobin mass determination : exploring carboxyhemoglobin stability and analyzer interchangeability

(2025) DRUG TESTING AND ANALYSIS. 17(9). p.1721-1725
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Abstract
Carbon monoxide (CO) rebreathing is frequently used to determine hemoglobin mass (Hbmass) during hypoxic or heat training and high-altitude research. Accurate and reliable carboxyhemoglobin (HbCO) determination is crucial for reliable Hbmass measurements. The aim was therefore to explore the stability of HbCO and interchangeability of two Radiometer analyzers in the determination of Hbmass. Twelve subjects performed a CO rebreathing test. Five capillary blood samples were taken before and after the CO rebreathing test and either analyzed immediately on site (three capillary tubes, Day 1, ABL 90) or stored at room temperature and sent to another laboratory for analysis 4–8 days later (two capillary tubes, ABL 825). Intraclass correlation coefficient (ICC) and relative typical error (TE) were calculated to compare both measurements. A paired sample t test was performed to detect potential differences between Day 1 (ABL 90) and Days 4–8 (ABL 825). A trivial mean difference was observed between the two measurements for ΔHbCO (0.05%, p = 0.01, d = −0.12) and Hbmass (7.7 g, p = 0.01, d = 0.10). High reliability (ICC > 0.98) and low TE (< 0.91%) were found for ΔHbCO and Hbmass. Immediate analysis with the same analyzer remains recommended despite trivial differences between measurements. However, when logistical issues (analyzer breakdown, extreme, and/or remote locations) do not allow optimal procedures, delayed analysis, potentially with a different analyzer, might be used as a viable alternative.
Keywords
carbon monoxide rebreathing, HbCO, red blood cell count, reliability, CO-REBREATHING METHOD, CARBON-MONOXIDE, BLOOD

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MLA
Bouten, Janne, et al. “Hemoglobin Mass Determination : Exploring Carboxyhemoglobin Stability and Analyzer Interchangeability.” DRUG TESTING AND ANALYSIS, vol. 17, no. 9, 2025, pp. 1721–25, doi:10.1002/dta.3877.
APA
Bouten, J., Garcia, J., Carin, R., Nader, E., Pichon, A., Robach, P., … Brocherie, F. (2025). Hemoglobin mass determination : exploring carboxyhemoglobin stability and analyzer interchangeability. https://doi.org/10.1002/dta.3877
Chicago author-date
Bouten, Janne, Johan Garcia, Romain Carin, Elie Nader, Aurélien Pichon, Paul Robach, Philippe Connes, and Franck Brocherie. 2025. “Hemoglobin Mass Determination : Exploring Carboxyhemoglobin Stability and Analyzer Interchangeability.” DRUG TESTING AND ANALYSIS. https://doi.org/10.1002/dta.3877.
Chicago author-date (all authors)
Bouten, Janne, Johan Garcia, Romain Carin, Elie Nader, Aurélien Pichon, Paul Robach, Philippe Connes, and Franck Brocherie. 2025. “Hemoglobin Mass Determination : Exploring Carboxyhemoglobin Stability and Analyzer Interchangeability.” DRUG TESTING AND ANALYSIS. doi:10.1002/dta.3877.
Vancouver
1.
Bouten J, Garcia J, Carin R, Nader E, Pichon A, Robach P, et al. Hemoglobin mass determination : exploring carboxyhemoglobin stability and analyzer interchangeability. Vol. 17, DRUG TESTING AND ANALYSIS. 2025. p. 1721–5.
IEEE
[1]
J. Bouten et al., “Hemoglobin mass determination : exploring carboxyhemoglobin stability and analyzer interchangeability,” DRUG TESTING AND ANALYSIS, vol. 17, no. 9. pp. 1721–1725, 2025.
@misc{01JP7HV9Q1HZKTYHPTD2AEBBDY,
  abstract     = {{Carbon monoxide (CO) rebreathing is frequently used to determine hemoglobin mass (Hbmass) during hypoxic or heat training and high-altitude research. Accurate and reliable carboxyhemoglobin (HbCO) determination is crucial for reliable Hbmass measurements. The aim was therefore to explore the stability of HbCO and interchangeability of two Radiometer analyzers in the determination of Hbmass. Twelve subjects performed a CO rebreathing test. Five capillary blood samples were taken before and after the CO rebreathing test and either analyzed immediately on site (three capillary tubes, Day 1, ABL 90) or stored at room temperature and sent to another laboratory for analysis 4–8 days later (two capillary tubes, ABL 825). Intraclass correlation coefficient (ICC) and relative typical error (TE) were calculated to compare both measurements. A paired sample t test was performed to detect potential differences between Day 1 (ABL 90) and Days 4–8 (ABL 825). A trivial mean difference was observed between the two measurements for ΔHbCO (0.05%, p = 0.01, d = −0.12) and Hbmass (7.7 g, p = 0.01, d = 0.10). High reliability (ICC > 0.98) and low TE (< 0.91%) were found for ΔHbCO and Hbmass. Immediate analysis with the same analyzer remains recommended despite trivial differences between measurements. However, when logistical issues (analyzer breakdown, extreme, and/or remote locations) do not allow optimal procedures, delayed analysis, potentially with a different analyzer, might be used as a viable alternative.}},
  author       = {{Bouten, Janne and Garcia, Johan and Carin, Romain and Nader, Elie and Pichon, Aurélien and Robach, Paul and Connes, Philippe and Brocherie, Franck}},
  issn         = {{1942-7603}},
  keywords     = {{carbon monoxide rebreathing,HbCO,red blood cell count,reliability,CO-REBREATHING METHOD,CARBON-MONOXIDE,BLOOD}},
  language     = {{eng}},
  number       = {{9}},
  pages        = {{1721--1725}},
  series       = {{DRUG TESTING AND ANALYSIS}},
  title        = {{Hemoglobin mass determination : exploring carboxyhemoglobin stability and analyzer interchangeability}},
  url          = {{http://doi.org/10.1002/dta.3877}},
  volume       = {{17}},
  year         = {{2025}},
}

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