Noninvasive hemoglobin monitoring in clinical trials: a systematic review and meta-analysis

Zortéa, Tailyne; Wizbicki, Daniele Paola da Silva; Madeira, Kristian; Ambrosio, Pedro Gabriel; Souza, Rafaela Okchstein Borges de; Durães, Edson Souza Machado

doi:10.1016/j.bjane.2020.06.001

Cited by 3 publications

(4 citation statements)

References 20 publications

(53 reference statements)

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“…Other studies have reported smaller differences 999 . In two meta-analyses, the overall difference between laboratory and noninvasive measured Hb-concentrations were not statistically significant 1000,1001 . Noninvasive Hb-monitoring devices are not intended to replace laboratory-measured Hb concentrations.…”

Section: Discussionmentioning

confidence: 89%

“…999 In two meta-analyses, the overall difference between laboratory and noninvasive measured Hb-concentrations were not statistically significant. 1000,1001 Noninvasive Hb-monitoring devices are not intended to replace laboratory-measured Hb concentrations. The value of the noninvasive method is for trend analysis and to monitor changes in Hb concentrations in addition to laboratorymeasured Hb concentrations during the intervals between individual invasive blood sampling and Hb measurements.…”

Section: Evidence Summarymentioning

confidence: 99%

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Management of severe peri-operative bleeding: Guidelines from the European Society of Anaesthesiology and Intensive Care

Kietaibl

Ahmed

Afshari

et al. 2023

European Journal of Anaesthesiology

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BACKGROUND Management of peri-operative bleeding is complex and involves multiple assessment tools and strategies to ensure optimal patient care with the goal of reducing morbidity and mortality. These updated guidelines from the European Society of Anaesthesiology and Intensive Care (ESAIC) aim to provide an evidence-based set of recommendations for healthcare professionals to help ensure improved clinical management. DESIGN A systematic literature search from 2015 to 2021 of several electronic databases was performed without language restrictions. Grading of Recommendations, Assessment, Development and Evaluation (GRADE) was used to assess the methodological quality of the included studies and to formulate recommendations. A Delphi methodology was used to prepare a clinical practice guideline. RESULTS These searches identified 137 999 articles. All articles were assessed, and the existing 2017 guidelines were revised to incorporate new evidence. Sixteen recommendations derived from the systematic literature search, and four clinical guidances retained from previous ESAIC guidelines were formulated. Using the Delphi process on 253 sentences of guidance, strong consensus (>90% agreement) was achieved in 97% and consensus (75 to 90% agreement) in 3%. DISCUSSION Peri-operative bleeding management encompasses the patient's journey from the pre-operative state through the postoperative period. Along this journey, many features of the patient's pre-operative coagulation status, underlying comorbidities, general health and the procedures that they are undergoing need to be taken into account. Due to the many important aspects in peri-operative nontrauma bleeding management, guidance as to how best approach and treat each individual patient are key. Understanding which therapeutic approaches are most valuable at each timepoint can only enhance patient care, ensuring the best outcomes by reducing blood loss and, therefore, overall morbidity and mortality. CONCLUSION All healthcare professionals involved in the management of patients at risk for surgical bleeding should be aware of the current therapeutic options and approaches that are available to them. These guidelines aim to provide specific guidance for bleeding management in a variety of clinical situations.

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Section: Discussionmentioning

confidence: 89%

Section: Evidence Summarymentioning

confidence: 99%

Management of severe peri-operative bleeding: Guidelines from the European Society of Anaesthesiology and Intensive Care

Kietaibl

Ahmed

Afshari

et al. 2023

European Journal of Anaesthesiology

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“…Pulse oximeters have been developed with up to 14 different wavelengths. Their clinical application, however, remains to be determined [25].…”

Section: Monitoring Standardsmentioning

confidence: 99%

Patient monitoring in the nonoperating room anesthesia (NORA) setting: current advances in technology

Routman

Boggs

2021

Current Opinion in Anaesthesiology

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Purpose of reviewNonoperating room anesthesia (NORA) procedures continue to increase in type and complexity as procedural medicine makes technical advances. Patients presenting for NORA procedures are also older and sicker than ever. Commensurate with the requirements of procedural medicine, anesthetic monitoring must meet the American Society of Anesthesiologists standards for basic monitoring. Recent findingsThere have been improvements in the required monitors that are used for intraoperative patient care. Some of these changes have been with new technologies and others have occurred with software refinements. In addition, specialized monitoring devises have also been introduced into NORA locations (depth of hypnosis, respiratory monitoring, point-of care ultrasound). These additions to the monitoring tools available to the anesthesiologist working in the NORA-environment push the boundaries of procedures which may be accomplished in this setting. SummaryNORA procedures constitute a growing percentage of total administered anesthetics. There is no difference in the monitoring standard between that of an anesthetic administered in an operating room and a NORA location. Anesthesiologists in the NORA setting must have the same compendium of monitors available as do their colleagues working in the operating suite.

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“…Noninvasive spectroscopic Hb measuring devices (noninvasive Hb [NHb]) are a bedside tool to estimate Hb instantaneously with a sensor attached to one of the limbs. Recently, the clinical utility of NHb devices among adult and pediatric populations has been summarized by a systematic review and meta-analysis, excluding neonates and infants [7]. Evaluation of the diagnostic accuracy of NHb devices for neonatal Hb measurement is the primary objective of this systematic review and meta-analysis.…”

Section: Introductionmentioning

confidence: 99%

Agreement between Noninvasive Hemoglobin and Laboratory Hemoglobin Measurements in Neonates: A Systematic Review and Meta-Analysis

2022

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Background and Objective: The noninvasive hemoglobin (NHb) devices are recently evaluated as an alternative to laboratory hemoglobin (LHb) in neonates. This systematic review explores the diagnostic accuracy of NHb devices for neonatal hemoglobin measurement. Methods: Literature related to the comparison of NHb device with LHb in neonates was searched from Medline, PubMed Central, PubMed, Web of Science, Google Scholar, and Scopus databases after PROSPERO registration. The quality of included publications was assessed by QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies). The pooled correlation coefficient and bias (precision) in Bland-Altman difference plots were used for summary statistics using MetaXL 5.0 software. Results: A total of 1,477 paired NHb-LHb observations were analyzed from 1,047 neonates in 10 studies. Massimo radical-pulse co-oximetry (8 studies) and Mediscan-2000 (2 studies) were used for NHb estimation. The pooled correlation coefficient between NHb and LHb was r = 0.94 (95% CI: 0.83–0.98, p < 0.001), and the pooled bias (precision) was −0.013 (1.4) gm/dL between NHb and LHb measurements in Bland-Altman analysis. NHb device had better precision in stable neonates (0.91gm/dL) over sick neonates (1.66 gm/dL). Conclusions: Hemoglobin measurement by NHb is excellently correlated with LHb measurement with a minimal average difference. It may be used as a screening tool for hemoglobin measurement in neonates to avoid frequent phlebotomy.

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Noninvasive hemoglobin monitoring in clinical trials: a systematic review and meta-analysis

Cited by 3 publications

References 20 publications

Management of severe peri-operative bleeding: Guidelines from the European Society of Anaesthesiology and Intensive Care

Management of severe peri-operative bleeding: Guidelines from the European Society of Anaesthesiology and Intensive Care

Patient monitoring in the nonoperating room anesthesia (NORA) setting: current advances in technology

Agreement between Noninvasive Hemoglobin and Laboratory Hemoglobin Measurements in Neonates: A Systematic Review and Meta-Analysis

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