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Errors of measurement for blood volume parameters: a meta-analysis

¹Department of Physiology, Australian Institute of Sport, Belconnen, Australian Capital Territory, Australia; ²Health Science/Sport and Recreation, Auckland University of Technology, Auckland, New Zealand; and ³Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia

Submitted 2 May 2005 ; accepted in final form 21 June 2005

The volume of red blood cells (V_RBC) is used routinely in the diagnostic workup of polycythemia, in assessing the efficacy of erythropoietin administration, and to study factors affecting oxygen transport. However, errors of various methods of measurement of V_RBC and related parameters are not well characterized. We meta-analyzed 346 estimates of error of measurement of V_RBC for techniques based on Evans blue (V_RBC,Evans), ⁵¹chromium-labeled red blood cells (V_RBC,51Cr), and carbon monoxide (CO) rebreathing (V_RBC,CO), as well as hemoglobin mass with the carbon-monoxide method (M_Hb,CO), in athletes and active and inactive subjects undergoing various experimental and control treatments lasting minutes to months. Subject characteristics and experimental treatments had little effect on error of measurement, but measures with the smallest error showed some increase in error with increasing time between trials. Adjusted to 1 day between trials and expressed as coefficients of variation, mean errors for M_Hb,CO (2.2%; 90% confidence interval 1.4–3.5%) and V_RBC,51Cr (2.8%; 2.4–3.2%) were much less than those for V_RBC,Evans (6.7%; 4.9–9.4%) and V_RBC,CO (6.7%; 3.4–14%). Most of the error of V_RBC,Evans was due to error in measurement of volume of plasma via Evans blue dye (6.0%; 4.5–7.8%), which is the basis of V_RBC,Evans. Most of the error in V_RBC,CO was due to estimates from laboratories with a relatively large error in M_Hb,CO, the basis of V_RBC,CO. V_RBC,51Cr and M_Hb,CO are the best measures for research on blood-related changes in oxygen transport. With care, V_RBC,Evans is suitable for clinical applications of blood-volume measurement.

reliability; hemoglobin mass; volume of red blood cells; Evans blue dye; carbon monoxide

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