Performance of the RAD-57 Pulse Co-Oximeter Compared With Standard Laboratory Carboxyhemoglobin Measurement

Touger, Michael; Birnbaum, Adrienne; Wang, Jessica; Chou, Katherine; Pearson, Darion; Bijur, Polly E.

doi:10.1016/j.annemergmed.2010.03.041

Cited by 71 publications

(57 citation statements)

References 7 publications

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“…Non-invasive and continuous measurement of COHb can be provided by pulse CO-oximeter but this device is shown to produce large error in the estimated value of 14%. 2 Meanwhile, fast and non-invasive measurement of arterial blood OxyHb saturation (SO 2 ) can be provided by pulse oximetry, but its high accuracy is limited to SO 2 greater than 70%. Techniques that are able to provide fast and accurate measurement of percent saturation of oxygen and CO in blood are of signi¯cant value, especially to individuals who are occupationally exposed to incomplete combustion of organic materials such as that of coal-¯red power plant operators and¯re¯ghters.…”

Section: Introductionmentioning

confidence: 99%

The application of extended modified Lambert Beer model for measurement of blood carboxyhemoglobin and oxyhemoglobin saturation

Huong

Ngu

2014

J. Innov. Opt. Health Sci.

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This work presents the use of extended Modi¯ed Lambert Beer (MLB) model for accurate and continuous monitoring of percent blood carboxyhemoglobin (COHb) (SCO) and oxyhemoglobin (OxyHb) saturation (SO 2 ) via a¯tting procedure. This quanti¯cation technique is based on the absorption characteristics of hemoglobin derivatives in the wavelength range of 520-600 nm to give the best estimates of the required parameters. A comparison of the performance of the developed model and MLB law is made using attenuation data from Monte Carlo simulations for a two-layered skin model. The results revealed a lower mean absolute error of 0:4% in the values estimated by the developed model as compared to 10% that is given by the MLB law. This study showed that the discussed approach is able to provide consistent and accurate measurement of blood SO 2 and SCO across di®erent skin pigmentations suggesting that it may potentially be used as an alternative means for clinical diagnosis of carbon monoxide (CO) poisoning.

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Section: Introductionmentioning

confidence: 99%

The application of extended modified Lambert Beer model for measurement of blood carboxyhemoglobin and oxyhemoglobin saturation

Huong

Ngu

2014

J. Innov. Opt. Health Sci.

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“…These results contrast sharply with Touger et al, who found few false positives but several false negatives. 17 Although Weaver did not report on the rate of screening false negatives, a concerning finding in this study is the nature of these false negatives. Even when the device detected a case of occult CO toxicity, the S pCO reading was 13% while the COHb was 19%.…”

mentioning

confidence: 75%

“…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.…”

mentioning

confidence: 97%

“…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%.…”

mentioning

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%

See 2 more Smart Citations

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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Performance of the RAD-57 Pulse Co-Oximeter Compared With Standard Laboratory Carboxyhemoglobin Measurement

Cited by 71 publications

References 7 publications

The application of extended modified Lambert Beer model for measurement of blood carboxyhemoglobin and oxyhemoglobin saturation

The application of extended modified Lambert Beer model for measurement of blood carboxyhemoglobin and oxyhemoglobin saturation

Noninvasive Carbon Monoxide Detection: Insufficient Evidence for Broad Clinical Use

Development of a Raman microspectrophotometric method to quantitate carboxyhemoglobin in blood

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