Non‐invasive monitoring of haemoglobin concentration in paediatric surgical patients using near‐infrared spectroscopy*

Abstract

SummaryWe evaluated the near-infrared spectroscopy based tissue haemoglobin index for continuous non-invasive monitoring of haemoglobin concentration during paediatric surgery. Blood samples from 40 children (from birth to 16 years old) were analysed oximetrically. From the first blood sample the tissue haemoglobin index ⁄ haemoglobin concentration coefficient was calculated for further tissue haemoglobin index-derived haemoglobin concentrations in each patient. Comparison of corresponding values revealed a bias and precision of -0.02 and 5.41 g.l )1 , respectively.Sensitivity and specificity of tissue haemoglobin index were 73.1% and 70.0%, respectively, for predicting falling haemoglobin concentration values. Currently, the tissue haemoglobin index is not suitable for monitoring haemoglobin concentration in children undergoing surgery.

Measurement of Transcutaneous Hemoglobin Concentration by Noninvasive White-Light Spectroscopy in Infants

“…Conventional near-infrared spectroscopy can measure only relative changes of the parameter in the specific individual and therefore cannot be used for quantitative measure- ments. 20,21 To our knowledge, it has not been possible thus far to achieve this goal by the above-cited methods.…”

“…The last decade has seen several attempts with either near-infrared spectroscopy 15 or other spectroscopic methods [16][17][18][19][20] to measure the total hemoglobin in the skin quantitatively and to use the results as a measure of skin circulation. Conventional near-infrared spectroscopy can measure only relative changes of the parameter in the specific individual and therefore cannot be used for quantitative measure- ments.…”

Prediction of Plasma Hemoglobin Concentration by Near-Infrared Spectroscopy

“…Arterial carbon dioxide tension is another important variable that affects the result of our equation, and also a potential confounding factor, which made Dullenkopf et al (11) fail to prove the relationship of rSO 2 and Hb. We believe that an anesthesiologist can manage the arterial carbon dioxide tension within 5 mmHg, which affects Hb level ± 1.6 gm/dL (5 × 0.338 from equation A).…”

Near infrared spectroscopy: A diagnostic tool to evaluate effects of radiotherapy in the mandible?

“…But our study was not the only one to find poor results with NIRS. Dullenkopf et al [14] evaluated the NIRS based tissue haemoglobin index for continuous non-invasive monitoring of haemoglobin concentration during paediatric surgery, and they stated that their results support the need for caution, and that NIRS is a promising research tool, but not yet ready for routine clinical application for everything, as also stated Nicklin et al [52]. Kim and Liu [39] showed that there could be a significant error in the determination of haemoglobin derivative concentrations using NIRS when the values of haemoglobin extinction coefficients have variations or uncertainties.…”