Impact of Oxygenation Status on the Noninvasive Measurement of Hemoglobin

Gomaa, Dina; Rodriquez, Dario; Petro, Michael; Blakeman, Thomas; Branson, Richard D.

doi:10.7205/milmed-d-16-00137

Cited by 5 publications

(5 citation statements)

References 14 publications

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“…The oxygen saturation percentage (%) was measured with the Masimo Radical-7 and was reported in the results. A recent report by Gomaa et al reported that oxygen saturation affects the SpHb accuracy [16].…”

Section: Hemoglobin Perfusion Index and Pleth Variability Index Measu...mentioning

confidence: 98%

Can Non-Invasive Spectrophotometric Hemoglobin Replace Laboratory Hemoglobin Concentrations for Preoperative Anemia Screening? A Diagnostic Test Accuracy Study

Alwabari,

Alhamad,

Alsahaf

et al. 2023

JCM

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Preoperative assessment of hemoglobin concentration in blood is important to diagnose anemia. The primary aim of this prospective diagnostic test accuracy study was to monitor non-invasive spectrophotometric hemoglobin (SpHb, g/dL) concentrations among adults prior to elective surgery and to investigate the correlation and agreement of SpHb with laboratory hemoglobin (Hb, g/dl). A secondary aim was to identify the anemia cut-off values for SpHb based on the World Health Organization (WHO) definitions for anemia. This study included 151 consecutive patients (age ≥ 18 year) presenting for preoperative evaluation prior to scheduled elective general or orthopedic surgery. Results identified the mean ± SD of SpHb at 11.43 ± 2.01 g/dL, which underestimated the mean laboratory Hb (12.64 ± 2.29 g/dL, p < 0.001). A bias mean difference (SpHb–Hb) of −1.21 g/dL, with a SD of 1.76, was reported. This bias (SpHb–Hb) was inversely correlated with the mean Hb concentrations. A positive correlation existed between SpHb and Hb, with a good degree of reliability and a significant Intra Class Correlation (ICC). SpHb diagnosed anemia in 32.3% and 60.3% of males and females, respectively. The SpHb cut-off values to identify anemia were 11.3 and 10.2 g/dL for males and females, respectively, with a sensitivity of 83.3% for males and only 62.9% for females. The specificity for males and females were 81% and 91.3%, respectively. SpHb sensitivity allows for anemia diagnosis among males, but not females. However, the specificity allows SpHb to rule out anemia for both.

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Section: Hemoglobin Perfusion Index and Pleth Variability Index Measu...mentioning

confidence: 98%

Can Non-Invasive Spectrophotometric Hemoglobin Replace Laboratory Hemoglobin Concentrations for Preoperative Anemia Screening? A Diagnostic Test Accuracy Study

Alwabari,

Alhamad,

Alsahaf

et al. 2023

JCM

View full text Add to dashboard Cite

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“…It was reported that changes in oxygenation status may have an impact on the on accuracy of non-invasive measurement of Hb. The study by Gomma et al showed that changes in oxygenation in normal volunteers are associated with short-term SpHb signal loss but have no impact on the measured Hb [ 21 ]. We did not observe any major oxygenation drops in our patients that could have an impact on the feasibility of the accuracy of SpHb.…”

Section: Discussionmentioning

confidence: 99%

“…Comparisons between Hb determined with test devices were performed using Bland–Altman analysis and concordance correlation coefficient (CCC). We measured the limits of agreement (LOA) between the test devices, as it was shown that LOA is the most reliable indicator of accuracy in the clinical setting [ 21 ]. The 95% LOA was calculated as the mean of the two values, minus and plus 1.96 standard deviations.…”

Section: Methodsmentioning

confidence: 99%

Hemoglobin Determination Using Pulse Co-Oximetry and Reduced-Volume Blood Gas Analysis in the Critically Ill: A Prospective Cohort Study

2022

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Hospital-acquired anemia is common in patients hospitalized in the intensive care unit (ICU). A major source of iatrogenic blood loss in the ICU is the withdrawal of blood for laboratory testing. The aim of our study was to analyze the feasibility and accuracy of non-invasive spot-check pulse co-oximetry (SpHb), and a reduced-volume blood gas analysis (ABG Hb) for the determination of Hb concentration in critically ill patients. Comparisons between Hb determined with test devices and the gold standard—complete blood count (CBC)—were performed using Bland–Altman analysis and concordance correlation coefficient (CCC). The limits of agreement between SpHb and CBC Hb were –2.0 [95%CI −2.3–(−1.7)] to 3.6 (95%CI 3.3–3.9) g/dL. The limits of agreement between ABG Hb and CBC Hb were −0.6 [95%CI −0.7–(−0.4)] to 2.0 (95%CI 1.9–2.2) g/dL. Spearman’s coefficient and CCC between ABG Hb and CBC Hb were 0.96 (95%CI 0.95–0.97, p <0.001) and 0.91 (95% CI 0.88–0.92), respectively. Non-invasive spot-check Hb co-oximetry is not sufficiently accurate for the monitoring of hemoglobin concentration in critically ill patients. Reduced volume arterial blood gas analysis has acceptable accuracy and could replace complete blood count for the monitoring of Hb concentration in critically ill patients, leading to a significant reduction in blood volume lost for anemia diagnostics.

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“…SpHb and venous lab Hb sample values were recorded at the same time during the outpatient visit. Oxygen saturation percentages (%) were also monitored, as they are reported to affect SpHb accuracy, according to Gomma et al [25].…”

Section: Measurement Time and Sitementioning

confidence: 99%

Comparing Non-Invasive Spectrophotometry to Hematology Analysis for Hemoglobin Measurements in Sickle Cell Disease Patients

Yassen,

Omer,

Alsahaf

et al. 2023

JCM

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Patients with sickle cell disease (SCD) require repeated blood sampling for hemoglobin (Hb) concentration measurements. The primary aim of this study was to compare non-invasive spectrophotometric hemoglobin (SpHb, g/dL) measurements to those taken via an automated hematology analyzer (Hb, g/dL) in patients with SCD visiting outpatient clinics and to investigate the correlations and agreements between both measurement techniques. Secondarily, we aimed to identify the SpHb cut-off concentration for the diagnosis of anemia and to monitor the effects of the pleth variability index (PVI, %) and perfusion index (PI) on SpHb measurements. The results gained from the examination of one hundred and fifty-eight patients indicated that the SpHb measurements overestimated the lab Hb concentrations, with a mean (SpHb-Hb) bias of 0.82 g/dL (SD 1.29). The SpHb measurements were positively correlated with the Hb measurements (Kendall’s tau correlation (τ), n = 158, τ = 0.68, p < 0.001), with an intra-class correlation (ICC) of 0.67 and a 95% CI from 0.57 to 0.74 (p = 0.000). The SpHb cut-off concentration to diagnose anemia was 11.4 and 11.7 g/dL for males and females, respectively. SpHb sensitivity was low for males and females at 64.4% and 57.1%; however, the specificity was higher at 90.9% and 75%, with positive predictive values (PPVs) of 95.6 and 85.7, respectively. No correlation existed between SpHb measurements and the PVI (%) in contrast with a moderate correlation with the PI (r = 0.049, p = 0.54, and r = 0.36, p < 0.001, respectively). The mean PI was low at 2.52 ± 1.7. In conclusion, the SpHb measurements were consistently higher than the lab Hb concentrations, with a positive correlation. The sensitivity and precision of the SpHb measurements were lower than expected. However, the SpHb specificity and its positive predictive values (PPVs) indicated that it is less likely for a patient with a positive SpHb test result for anemia to be non-anemic. These results will allow SpHb measurement to play a role in excluding the presence of anemia. In light of the low PI values determined, the SpHb measurements were challenging to take and, thus, require further technological improvements.

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Impact of Oxygenation Status on the Noninvasive Measurement of Hemoglobin

Abstract: Changes in oxygenation in normal volunteers are associated with short-term SpHgb signal loss (<10 minutes), but no impact on the measured SpHgb.

Cited by 5 publications

References 14 publications

Can Non-Invasive Spectrophotometric Hemoglobin Replace Laboratory Hemoglobin Concentrations for Preoperative Anemia Screening? A Diagnostic Test Accuracy Study

Can Non-Invasive Spectrophotometric Hemoglobin Replace Laboratory Hemoglobin Concentrations for Preoperative Anemia Screening? A Diagnostic Test Accuracy Study

Hemoglobin Determination Using Pulse Co-Oximetry and Reduced-Volume Blood Gas Analysis in the Critically Ill: A Prospective Cohort Study

Comparing Non-Invasive Spectrophotometry to Hematology Analysis for Hemoglobin Measurements in Sickle Cell Disease Patients

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