Accuracy of Noninvasive Multiwave Pulse Oximetry Compared With Carboxyhemoglobin From Blood Gas Analysis in Unselected Emergency Department Patients

Roth, Dominik von; Herkner, Harald; Schreiber, Wolfgang; Hubmann, Nina; Gamper, Gunnar; Laggner, Anton N.; Havel, Christof

doi:10.1016/j.annemergmed.2010.12.024

Cited by 65 publications

(66 citation statements)

References 19 publications

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“…Specifically, the S pCO under-estimated COHb in all cases, with 2 S pCO values falling into the range that would not have supported a diagnosis of CO poisoning (2% and 4%). Moreover, the precision of the Rad-57 appears to decrease as the COHb increases, 12,17,19 despite the manufacturer's assertion that the accuracy is Ϯ 3% up to a COHb of 40%. 8 -10 While several studies have found that the Rad-57 is likely to systematically overestimate the COHb, as compared to blood levels, 17,19,[23][24][25] Weaver found repeated underestimation by the device.…”

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confidence: 97%

“…Roth et al used a receiver operating curve characteristic to define a cutoff value of Ͻ 6.6% to screen for CO poisoning. 19 Evidently, appropriate clinical levels have yet to be defined.…”

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confidence: 99%

“…16 Other studies indicate that the Rad-57 is less accurate and precise when used in clinical practice. [17][18][19] In a prospective study by Touger et al, performed in the ED of a level 1 trauma and burn center, the authors enrolled 120 patients with suspected CO toxicity, 17 measuring S pCO by the Rad-57 while COHb levels were simultaneously drawn. The accuracy of the Rad-57 was 1.4% in this study, but the limits of agreement were Ϫ11.6 to 14.4% with a precision of 6.6%.…”

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confidence: 99%

“…19 Of 16,108 patients screened in the ED with a portable CO-oximeter, only 1,578 patients had a blood gas drawn during their routine clinical care within 60 min of the screening, and 17 were ultimately diagnosed with CO poisoning. They found a bias of 2.32% and precision of 4.01%.…”

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confidence: 99%

“…[11][12][13]15,17,19,25 The most powerful use of a noninvasive COHb monitor would be to rapidly, accurately, and precisely determine if patients have occult CO toxicity: a simple screening test that reliably determines whether verification of CO toxicity with a blood test is warranted. The performance of the Rad-57 in this pragmatic study by Weaver and colleagues raises doubts about the device's ability to reliably serve that purpose.…”

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confidence: 99%

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Noninvasive Carbon Monoxide Detection: Insufficient Evidence for Broad Clinical Use

Wilcox

Richards

2013

Respir Care

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mentioning

confidence: 97%

“…Roth et al used a receiver operating curve characteristic to define a cutoff value of Ͻ 6.6% to screen for CO poisoning. 19 Evidently, appropriate clinical levels have yet to be defined.…”

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Noninvasive Carbon Monoxide Detection: Insufficient Evidence for Broad Clinical Use

Wilcox

Richards

2013

Respir Care

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Development of a Raman microspectrophotometric method to quantitate carboxyhemoglobin in blood

Melbourn

Brettell

Maldonado

et al. 2020

J Raman Spectroscopy

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Carboxyhemoglobin (COHb) quantitation is a routine toxicological analysis performed in cases of suspected acute carbon monoxide poisoning. Current methods available for COHb quantitation include spectrophotometric methods and gas chromatographic methods, both of which have advantages and disadvantages. The goal of the present study was to develop a Raman microspectrophotometric COHb quantitation method and assess its precision and accuracy. A strong linear correlation (average R2 = 0.98) was found to exist between COHb concentration and the ratio of the Raman intensities at approximately 1,552 and 1,580 cm−1. The limits of detection and quantitation were found to be 4.4% and 13.2% COHb, respectively. Intraday and interday studies of three calibrators indicated high precision, with the coefficient of variation ranging from 0.85% to 3.4%. The accuracy of this method was evaluated through the quantitation of blind samples, first using the proposed Raman microspectrophotometric method and then by a published UV–visible spectrophotometric method. For the proposed Raman method, 87.5% of the samples were quantitated with less than 20% error. The average variances of the two methods were found to be statistically different using a two‐sample F test, with the Raman microspectrophotometric method having a lower average variance. This study demonstrates that Raman microspectrophotometry may be used to quantitate the COHb concentration of blood samples. Furthermore, this method is comparable with established spectrophotometric methods while eliminating the need for time‐consuming sample preparation and limiting the use of consumables and the generation of waste.

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Dermale und inhalative Intoxikationen

Sagoschen¹

2013

Med Klin Intensivmed Notfmed

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Patients with dermal and inhalation poisoning are uncommon in intensive care treatment. We describe the diagnostics and specific toxicological treatment of patients with hydrofluoric acid burns. For inhalation poisoning, we focus on smoke inhalation, especially the management of cyanide and carbon monoxide poisoning. Special attention is given to the use of hyperbaric oxygenation for the treatment of carbon monoxide poisoning.

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Accuracy of Noninvasive Multiwave Pulse Oximetry Compared With Carboxyhemoglobin From Blood Gas Analysis in Unselected Emergency Department Patients

Cited by 65 publications

References 19 publications

Noninvasive Carbon Monoxide Detection: Insufficient Evidence for Broad Clinical Use

Noninvasive Carbon Monoxide Detection: Insufficient Evidence for Broad Clinical Use

Development of a Raman microspectrophotometric method to quantitate carboxyhemoglobin in blood

Dermale und inhalative Intoxikationen

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