Continuous monitoring of haemoglobin concentration after in-vivo adjustment in patients undergoing surgery with blood loss

Abstract

SummaryNon-invasive monitoring of haemoglobin concentration provides real-time measurement of haemoglobin concentration (SpHb) using multi-wavelength pulse co-oximetry. We hypothesised that in-vivo adjustment using the mean of three haemoglobinometer (HemoCue â ) measurements from an arterial blood sample at the first SpHb measurement (HCueART) would increase the accuracy of the monitor. The study included 41 adults for a total of 173 measurements of haemoglobin concentration. In-vivo adjusted SpHb was automatically calculated by the following formula: in-vivo adjusted SpHb = unadjusted SpHb À (SpHb À HCueART). The accuracy of in-vivo adjusted SpHb was compared with SpHb retrospectively adjusted using the same formula, except for haemoglobin level which was assessed at the central laboratory and then compared with all other available invasive methods of haemoglobin measurement (co-oximetry, HbSAT; arterial HemoCue, HCueART; capillary HemoCue, HCueCAP). Compared with laboratory measurement of haemoglobin concentration, bias (precision) for unadjusted SpHb, in-vivo adjusted SpHb, retrospectively adjusted SpHb, HbSAT, HCueART and HCueCAP were À0

Assessment of haemoglobin measurement by several methods – blood gas analyser, capillary and venous HemoCue®, non‐invasive spectrophotometry and laboratory assay – in term and preterm infants

“…However, the accuracy of Hcue ven was found to be close to that of Hb(gas); the agreement of results of the Hcue cap method with those of the reference method were distinctly worse. Previous studies among adult patients in the ICU and in the operating theatre have reported differences in the accuracy of HemoCue method that depended on the source of blood samples . To our knowledge, comparison studies of Hcue cap and Hcue ven in neonates have not been conducted.…”

Red blood cell transfusion in perioperative pediatric anesthesia: a survey of current practice in Germany

“…This is a frequent situation in pediatric anesthesia, because arterial lines or central venous catheters are less common in pediatric patients than in adult patients. The accuracy of capillary Hemocue is not equivalent to venous Hemocue or blood gas analysis, but superior to noninvasive Hb measurement methods . To summarize, noninvasive and blood‐sparing bed‐side Hb measurement methods are rarely applied in German pediatric anesthesia.…”

“…The accuracy of capillary Hemocue is not equivalent to venous Hemocue or blood gas analysis, but superior to noninvasive Hb measurement methods. 35,36 To summarize, noninvasive and blood-sparing bed-side Hb measurement methods are rarely applied in German pediatric anesthesia.…”

The Accuracy and Reliability of Non-Invasive Haemoglobin Measurements in the Emergency Room: a Small Prospective Observational Quality Control Study from a Swiss University Hospital ED

“…The accuracy and reliability of the portable Pronto-7 Pulse COOximeter was reported in numerous studies conducted in the operating room [10][11][12][13][14][15][16][17][18][19][20][21] and in the intensive care unit [4,5,[22][23][24][25] with predominantly satisfactory performance. In a study done in bleeding trauma patients the agreement was moderate [bias (LOA) of -0.6 (-3.0; +1.9)] g/dl [26], where the limit of agreement is defined as the mean difference + twice the standard deviation of the differences [27].…”