Questions & Answers

Discoverying CoRA: Advanced Measurement Technology in Combined ESR and CBC Testing

Explore all questions and answers from the workshop. If you need any further questions or additional information, feel free to contact us. 

How and when does the Yumizen H550E (H500E) measure temperature for ESR analysis? 

The temperature is measured inside the instrument during each analysis. It is recorded in the raw data for the calculation of the ESR result. This is a specific correction calculation, different from that used for sedimentation rate. 

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Can we measure ESR and DIFF at the same time? 

Not exactly at the same time, because to perform ESR + DIFF, you need two different samples. The advantage is that ESR measurement, done independently of the blood count, ensures it doesn’t interfere with the device’s other functions. 

  • ESR = 1 test = 1 sample (180µL) 

  • DIFF = 1 test = 1 sample (20µL)

Reminder: It is possible to update a Yumizen H550 (H500) V3 to V4, but without the ESR version. 

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Can we upgrade Yumizen H550 (H500) to Yumizen H550E (H500E)? 

No, this is not possible for several reasons, mainly legal and registration reasons. 

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How does old blood affect the results? For example, blood older than 4 hours.

On average, ESR decreases with blood age, quickly in the first few hours and more slowly after. There is no significant decrease up to 8 hours. After 24 hours, an average decrease of 12% is observed. 

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Does the Yumizen H550E (H500E) show any value or curve about Rheo D or just a flag? 

There is a flag on the main screen report and a value in the Expert mode screen. There is no Rheo-D curve. It is a time measurement that triggers the “poikilocytosis” symptom above 0.5 seconds.  

NB: In the Expert mode screen, you also have an ESR result with 0.1 millimeters precision. This precision is relevant for very low ESR. 

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Are there any examples of patient reports on the analyzer?

Yes, you can find this print screen in a Yumizen H550E (H500E) user manual. 

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How many CBC+DIF+ESR tests can be run per hour?

  • CBC-DIFF is 1 test (dedicated sample). 

  • ESR is 1 test (dedicated sample). 

Each test takes 60 seconds. So, if you have to run samples with CBC-DIFF + ESR for all, in 1 hour, you can analyze 60 tests (30 CBC-DIFF tests + 30 ESR tests). 

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What is the measurement technology difference between ALIFAX and HORIBA, which is also based on the aggregation phase? 

The main difference is that ALIFAX does not use a diluent, meaning the blank measurement is done on an empty tube. This means the ESR value depends on the luminosity. The luminosity of LEDs is not stable; it changes with age and temperature. Therefore, it’s not a direct luminosity measurement but a transformation to Beer-Lambert optical density by the blank measurement, which is done with the diluent in our instrument. This makes the measurement more accurate. 

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Which sample conditions interfere with the analysis? Any limitations detected yet? 

There are no significant limitations yet, except for very high ESR values. The dynamics of raw measurements decrease with high ESR, meaning we are not precise at high values. However, up to 120 mm, which is already pathological, performances are validated and accurate. Very high values above 120 are rare and remain pathological, so this would not impact the diagnosis. 

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Lipemia interferences?  

We tested the interference of lipidemia, bilirubin, and hemolysis. The first two do not generate significant interference. For hemolysis, it is more nuanced because it depends on the level of hemolysis. 

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What are the reference ranges? 

This may depend on the country or the clinician, but here is an example of a widely used recommendation (source): 

  • Male <50 years old: ≤15 mm/hr 

  • Female <50 years old: ≤20 mm/hr 

  • Male >50 years old: ≤20 mm/hr 

  • Female >50 years old: ≤30 mm/hr 

  • Child: ≤10 mm/hr

Here is what is indicated in our user manual: 

Parameter
(Conventional Units)
0 - 30 days1 - 6 months6 months - 2 years2 - 6 years
ESR0 - 20 - 200 - 200 - 20
Parameter
(Conventional Units)
6 -12 years12 -15 years15 -18 years18 - 21 years
FemaleMale
ESR0 - 20 - 200 - 200 - 200 - 15

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What are the differences between Mindray BC-700 series (CBC-DIFF + ESR analyzer series)?

Unfortunately, we have not yet been able to evaluate their technology. I cannot make a judgment based on their publications. 

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