A Comparison of Three Methods of Hemoglobin Monitoring in Patients Undergoing Spine Surgery

Abstract

Although HCue was consistently accurate, our data confirm that SpHb often correlated well with tHb values. Yet our study indicates that SpHb may not be as accurate as clinically necessary in some patients. Improved refinement of continuous, noninvasive technology, such as SpHb, could address important clinical requirements.

Improved non-invasive total haemoglobin measurements after in-vivo adjustment

“…For example, when the true haemoglobin is 9.0 g. , respectively, during complex spine surgery. Miller et al [8] also recently reported that 22% of SpHb values differed from tHb by > 2 g.dl…”

“…In addition, the number of blood samples and time needed to obtain Hb values can be reduced. Previous studies have demonstrated that SpHb was accurate when compared with laboratory haemoglobin measurements in relatively stable clinical situations [1][2][3] but not in critical situations when Hb data are frequently needed, such as after cardiac surgery [7] or when there is inadequate perfusion [8]. Therefore, whether or not SpHb is sufficiently accurate has been controversial in the peri-operative period.…”

“…Therefore, whether or not SpHb is sufficiently accurate has been controversial in the peri-operative period. It had been hoped that the sensors would be revised or another solution would be developed [4][5][6][7][8]. Our simple in-vivo adjustment method may help resolve some of the issues with sensors and further develop the efficacy of SpHb.…”

“…In-vivo adjustment could improve the limits of agreements to within 2 g.dl À1 in 98% of all measurements. Although how accurate SpHb needs to be is controversial [8], we believe that SpHb measurements after in-vivo adjustment are acceptable in clinical set- tings, based on mean absolute bias, the precision and the limits of agreements. However, most of the patients in our study had relatively adequate perfusion, and fewer than 10% of measurements were performed in patients with a haemoglobin concentration below Hb < 8 g.dl…”

Efficacy of Pulse Co-oximeter in Hemoglobin Estimation: A non invasive method

“…Gayat et al [17] estimated failure rate to be about 9% (although the investigators of this study did not adhere to the manufacturer directions or use in the conduct of the www.pacificejournals.com/apalm eISSN: 2349-6983; pISSN: 2394-6466 study). Miller [18] noticed reduced accuracy when the pulse oximeter indicated a low perfusion index. This finding is supported by Gayat et al [17] study where low blood pressure was associated with reduced accuracy.…”