• Pediatric Infection and Vaccine
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• v.17 no.2
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• pp.101-107
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• 2010

Purpose : In evaluation of patients, laboratory results are crucial in determination of a treatment plan. Obtaining venous blood from infants and children is a difficult procedure. Substitution of a capillary blood sample for a venous blood sample has been suggested. However, there are few studies showing mutual correlation between C-reactive protein (CRP) results in capillary and venous blood. This study was designed to determine whether the result of the capillary sample is the same as the result of the venous blood sample. Methods : After informed consent, a pair of venous and fingertip capillary blood samples were simultaneously collected from 100 children. The LC-178CRPTM was used for analysis of capillary blood and the Hitachi 7180 automatic hematology analyzer was used for analysis of venous blood. We compared CRP of both venous and capillary blood samples. Results were analyzed by crosstabulation analysis, simple regression analysis and the Bland Altman Plot method. Results : A close correlation (90.63%) was observed between capillary and venous blood analyzed by crosstabulation analysis. CRP results were similar between the two groups and showed a high coefficient correlation ($\beta$=1.3434, $R^2$=0.9888, P<0.0001) when analyzed by a simple regression model. The average value in venous blood was also higher compared to capillary blood. According to Bland Altman Plot analysis, lab results were measured at a 95% confidence interval. Conclusion : CRP results from capillary blood showed close correlation with venous blood sampling. At present, venous blood sampling is the preferred method. However, due to difficulty in venous blood sampling, capillary sampling could be considered as an alternative technique for use with children.

• Journal of Biomedical Engineering Research
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• v.23 no.4
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• pp.323-327
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• 2002

Chronic diabetic patients need to sample capillary blood for monitoring and controlling the blood sugar level. Frequent sampling requires to minimize pain during skin puncture. The present study developed mechanisms to minimize pain with effective sampling procedure. which consisted of tapered spring, guiding tunnel, and 30G needle Penetration depth was limited to within 2mm for pain reduction as well as for safety. Simple no-reuse mechanism also prevented the cross-patient and secondary infection possibility. Clinical experiments demonstrated the best convenience and safety with minimal pain in the diabetes, normal, and nursing students groups. Sing1e blood sampling was enough for successful blood sugar test by portable analyzer. The present sing1e use auto-lancet should be of great convenience in frequent capillary blood sampling for the diabetes.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.10 no.9
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• pp.2451-2459
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• 2009

The present study aimed to evaluate the accuracy of the blood glucose test with almost painless vacuum assisted auto-lancing technique. The blood glucose concentration measurements in the capillary blood sampled from the alternative (forearm) site were compared with the standard venous or finger sampling techniques. Capillary blood was sampled from both the left index finger and the forearm, followed by the venous blood sampling in 531 patients who visited the C University Hospital. Blood sugar test was performed for each blood samples for comparative analysis. Mean blood glucose concentration measured on the forearm was closer to the venous glucose level than that of the finger, but the difference was approximately 10 mg/dL small enough to ignore from the clinical point of view. The correlation coefficients of the measured blood glucose levels between finger and vein and between forearm and vein were 0.94 and 0.92, respectively (p<0.001). The blood glucose measurement on the forearm also well correlated with the finger, showing a correlation coefficient of 0.94, and both data were very much close to each other. Therefore, the blood sugar test on the alternative capillary blood sampling site such as forearm was accurate enough for clinical practice. The vacuum assisted auto-lancing technique on the alternative site would be of particular interest for the disease management of the chronic diabetes, since it induces almost no pain when sampling blood from the capillaries.

• Clinical and Experimental Pediatrics
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• v.45 no.4
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• pp.449-453
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• 2002

Purpose : Arterial blood gas analysis is frequently performed in neonatal intensive care unit (NICU) to evaluate ventilation and the metabolic state of critically ill infants. In occasions when umbilical arterial catheterization is not available, frequent arterial puncture is mandatory. This requires some technical skill and may occasionally have side effects. So we studied the validity of capillary blood gas analysis which can be performed conveniently compared with arterial blood. Methods : Twenty-four neonates admitted to NICU during April to Aug. 2001 were studied. They were more than two weeks old without indwelling arterial catheters. Thirty-six times, simultaneous arterial, and capillary blood gases were drawn by puncture and the pH, $pCO_2$ and $pO_2$ of each sample was measured. Blood pressure and body temperature was checked before sampling to rule out impaired peripheral circulation. Capillary blood was collected from warmed heels. Results : There was a strong correlation between capillary and arterial pH(r=0.91, P<0.05). The absolute value of the difference between arterial and capillary pH was less than 0.05. Also capillary $pCO_2$ showed correlation with arterial $pCO_2$(r=0.77, P<0.05). Despite a statistically significant correlation between capillary and arterial $pO_2$(r=0.68, P<0.05), the absolute value of the difference was more than 10 mmHg in 92% of cases. Conclusion : Capillary blood gases accurately reflected arterial pH and $pCO_2$ and showed a relative correlation with $pO_2$. Capillary blood gas analysis can be a useful alternative to arterial blood when continuation of the umbilical arterial catheter is no longer available.

• Journal of Biomedical Engineering Research
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• v.25 no.6
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• pp.557-563
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• 2004

A new vacuum assisted auto-lancing technique is proposed to minimize pain. Specially designed lancing device was introduced, which applied -100mmHg right after skin puncture on the forearm. Sampled blood volumes were measured in 58 normal females. Mean volume of 464 samples was approximately 2.6$\muL$ and the frequency of more than 0.5$\muL$ was 86%. Thus the success rate of blood sugar test should also be the same when using modern glucose meters capable of testing with only 0.3~0.5$\muL$ of capillary blood. When pain scores were quantitatively evaluated by the visual pain measure, only 23% pain of the traditional finger sampling was experienced, demonstrating that capillary blood sampling was performed on the forearm with almost no pain. The present technique reduced pain to a great degree, though resampling might be unavoidable due to 14% of test failure rate estimated for modern glucose meters. However, minimized pain makes the present technique of great convenience for diabetic patients who need blood sampling a few times a day.

• The Journal of Korean Academic Society of Nursing Education
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• v.12 no.2
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• pp.265-271
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• 2006

Purpose: To analyze the newly developed vacuum assisted auto-lancing technique applied to the forearm for the purpose of obtaining an adequate blood sample for glucose test with minimal pain. Methods: Visual and facial pain measures were introduced to compare lancing pain between the forearm and fingertip in 58 normal females. Sampled blood volumes were accurately measured by computer scanning technique. Results: Visual pain measure demonstrated significant pain reduction effect of the forearm sampling compared with the traditional fingertip sampling, which was also consistent with facial pain measure results. Blood volume more than $0.5{\mu}L$, enough for blood glucose testing with modern glucometers, was collected in 399(86%) of 464 forearm samples. Conclusions: Capillary blood sampling could be performed with minimal pain on the forearm by the newly developed vacuum assisted auto-lancing technique. With some resampling when necessary, the forearm sampling seemed very useful, considering almost no pain felt by the patients.

• Journal of Biomedical Engineering Research
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• v.32 no.1
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• pp.25-31
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• 2011

Blood glucose information is important for self regulation in daily life, but the frequency of self test remains to be only 17%(9 tests/month) in Korea, mainly due to pain during blood sampling. The present study tried to validate the clinical efficacy of the forearm as an alternative sampling site with minimized pain. Capillary blood was sampled both on the index finger($G_F$) and the forearm($G_A$), immediately followed by glucose measurements in 531 subjects, 25 who visited the Health Enhancement Center of C University Hospital, then venous blood($G_V$) was sampled for glucose test. The blood glucose concentration measured on the forearm was closer to the venous glucose than on the finger. The mean difference between $G_V$and $G_F$ was only 10 mg/dL well within the internationally accepted error limit. Error grid analyses of $G_F-G_V$, $G_A-G_V$ and $G_A-G_F$ revealed that the number of data points in regions A and B took 100%, 99.8%, and 97.9%, respectively. These results demonstrate the forearm blood glucose test is not only accurate but also clinically valid. Therefore, the forearm blood glucose test can be a useful way of self managing the chronic diabetes with minimized sampling pain.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.4
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• pp.1751-1758
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• 2012

Capillary blood sampling on the forearm reduces pain caused by skin puncture. The present study compared the blood glucose test results performed at different sampling sites of the forearm, finger, and vein to evaluate clinical validity of this alternative site blood sampling technique. Subjects numbered 555 including 61 diabetic patients participated to measure the glucose concentration on the finger ($G_F$) and the forearm ($G_A$) with a portable glucometer under overnight fasting state. Then, the venous glucose concentration ($G_V$) was measured in 514 subjects in less than 1 hour. The test results were analyzed by simple linear regression, intraclass correlation, and Passing-Bablok regression techniques. $G_A$ was highly correlated with $G_F$ or $G_V$ showing the correlation coefficients (r) of approximately 0.97 (P<0.0001) in the normal group. The patient group also resulted similarly high correlation with only slightly lower r value. The mean differences in glucose concentration were less than ${\pm}10mg/dL$ regardless of the sampling sites. Intraclass correlation coefficients were slightly smaller than r but very much similar in value in both groups. The 95% confidence intervals of the slope as well as the intercept in the Passing-Bablok regression analysis were < ${\pm}20%$ and < ${\pm}20mg/dL$, respectively, which were within the clinically acceptable ranges. These three statistical techniques introduced in the present study well demonstrated the consistency of $G_A$ with $G_F$ and $G_V$. Therefore, the forearm blood glucose test could be considered as clinically valid under fasting condition.

• Neonatal Medicine
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• v.17 no.2
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• pp.239-244
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• 2010

Purpose: To evaluate two different heel lancet device in terms of pain response and success of the procedure in the preterm infants undergoing heel puncture. Methods: 100 preterm infants undergoing capillary blood gas analysis or capillary bilirubin monitoring underwent heel puncture, were randomly allocated to blood sampling from the heel with either a conventional manual lancet or an automatic incision device. Primary outcome measures included the Premature Infants Pain Profile (PIPP) score, total duration of procedure, number of heel puncture and number of bruise. The pain response was evaluated using PIPP score and the effectiveness was evaluated using three criteria: total duration of blood sampling, number of puncture, bruising of the heel or ankle. Statistical analysis was performed using the SPSS ver. 13.0 program. Difference between the groups were analysed with t test (continuous variables) and the Chi square test or Fisher test (categorical variables). Results: The mean PIPP score was 4.91 for the automatic lancet group compared with 5.84 for the conventional manual lancet group (P=0.0255).The number of pain scores above 7 during blood collection did not differ between two groups (P=0.2167). The procedure took less time to perform in the automatic lancet group (mean, 30.69 seconds) than in the conventional lancet group (mean, 48.92 seconds) (P<0.0001). Conclusion: This study demonstrated that the automatic lancet device causes less pain and a shorter procedure time than the conventional manual lancet in preterm infants undergoing heel puncture. On the basis of these results the automatic lancet device is very useful method for blood collection in preterm infants by heel puncture.