The Accuracy of Noninvasive Hemoglobin Measurement by Multiwavelength Pulse Oximetry After Cardiac Surgery

Nguyen, Ba-Vinh; Vincent, Jean‐Louis; Nowak, Emmanuel; Coat, M.; Paleiron, Nicolas; Gouny, P; Ould-Ahmed, Mehdi; Guillouët, Maïté; Arvieux, Charles C.; Bueret, Gildas

doi:10.1097/sa.0b013e318254dbf1

Cited by 16 publications

(22 citation statements)

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“…This recently reviewed technique 1 has been used in studies involving volunteers and surgery, with varying conclusions about accuracy and precision. [2][3][4][5][6][7][8][9][10][11] However, little is known about how SpHb reacts to specific procedures performed during surgery, such as intravenous infusion of crystalloid and colloid fluid. There is some evidence that SpHb changes more than Hb during volume loading with Ringer's acetate 7 but no evaluation of the accuracy of SpHb during administration of colloid fluid has been performed.…”

Section: Introductionmentioning

confidence: 99%

Accuracy of noninvasive haemoglobin measurement by pulse oximetry depends on the type of infusion fluid

Bergek

Zdolsek²,

Hahn³

2013

European Journal of Anaesthesiology

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Section: Introductionmentioning

confidence: 99%

Accuracy of noninvasive haemoglobin measurement by pulse oximetry depends on the type of infusion fluid

Bergek

Zdolsek²,

Hahn³

2013

European Journal of Anaesthesiology

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“…Miller et al demonstrated limits of agreement of -3.24 to 3.77 g/dl in a similar patient population to our own, Gayat et al found limits of agreement of -3.3 to 6.9 g/dl in an emergency medicine population, Ruppel et al documented limits of agreement of -5.48 to 2.95 g/dl in an ICU population and Nguyen et al of at least -4.6 to 2.1 g/dl in a post cardiac surgery ICU population [5][6][7]9]. Other studies however, have reported smaller limits of agreement using the same sensor revision used in our study.…”

Section: Discussionmentioning

confidence: 79%

“…However, this paper did not include a formal analysis of the distribution of the points, which we now present from our dataset [1][2][3][4][5][6][7][8][9]. This is the first study, to our knowledge, which applies the trending analysis as proposed by Critchley et al [16] to hemoglobin measurement.…”

Section: Discussionmentioning

confidence: 90%

“…This corresponds with the vast majority of the data residing within 30% of the reference measure. [9]. Adapted for hemoglobin trending.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have compared the accuracy of individual values against intermittent laboratory or point of care [1][2][3][4][5][6][7][8][9]. While absolute values are important, the ability to reliably detect trends (e.g.…”

Section: Introductionmentioning

confidence: 99%

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Ability of the Masimo pulse CO-Oximeter to detect changes in hemoglobin

Colquhoun

Forkin

Durieux

et al. 2012

J Clin Monit Comput

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The decision to administer blood products is complex and multifactorial. Accurate assessment of the concentration of hemoglobin [Hgb] is a key component of this evaluation. Recently a noninvasive method of continuously measuring hemoglobin (SpHb) has become available with multi-wavelength Pulse CO-Oximetry. The accuracy of this device is well documented, but the trending ability of this monitor has not been previously described. Twenty patients undergoing major thoracic and lumbar spine surgery were recruited. All patients received radial arterial lines. On the contralateral index finger, a R1 25 sensor (Rev E) was applied and connected to a Radical-7 Pulse CO-Oximeter (both Masimo Corp, Irvine, CA). Blood samples were drawn intermittently at the anesthesia provider's discretion and were analyzed by the operating room satellite laboratory CO-Oximeter. The value of Hgb and SpHb at that time point was compared. Trend analysis was performed by the four quadrant plot technique, testing directionality of change, and Critchley's polar plot method testing both directionality and magnitude of the change in values. Eighty-eight samples recorded at times of sufficient signal quality were available for analysis. Four quadrant plot analysis revealed 94% of data within the quadrants associated with the correct direction change, and 90% of data points lay within the analysis bounds proposed by Critchley. Pulse CO-Oximetry offers an acceptable trend monitor in patients undergoing major spine surgery. Future work should explore the ability of this device to detect large changes in hemoglobin, as well as its applicability in additional surgical and non-surgical patient populations.

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Disturbed fluid responsiveness and lactate/pyruvate ratio as predictors for mortality of septic shock patients

Mohamed

Essam

2016

Egyptian Journal of Anaesthesia

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Objectives: Evaluation of fluid responsiveness of septic shock patients admitted to surgical ICU and the predictability of non-invasive monitoring and estimated lactate/pyruvate (L/P) ratio for survival of these patients. Patients and methods: The study included 58 septic shocked patients admitted and managed at surgical ICU. After non-invasive determination of baseline hemodynamic data and calculation of shock index (SI-0) and Pleth variability index (PVI-0), all patients received intravenous colloid infusion followed 15-min later by non-invasive re-evaluation for SI-15 and PVI-15. Blood samples were obtained for estimation of blood lactate and pyruvate levels at admission (BLL-0 and BPL-0) and 12-h after fluid resuscitation (BLL-12 and BPL-12) and L/P ratio was calculated. All patients were managed according to the Surviving Sepsis Campaign guidelines and followed up for ICU mortality rate (MR). Results: ICU stay MR was 20.7%. Survival showed negative significant correlation with PVI, L/P ratio and BLL, while it showed positive significant correlation with BPL. Receiver Operating Characteristic (ROC) curve analysis defined baseline and persistently low PVI, high BLL and L/P ratio as significant sensitive predictors for MR, while elevated BPL-12 as significant specific predictor for survival. Regression analysis defined persistently elevated L/P ratio as the highly significant specific predictor, while persistently disturbed SI and PVI could predict mortality as screening tests. Odds ratio for mortality at BLL-0 of >2 mmol/L was 0.0321 (95% CI: 0.0037-0.2755), while it was 4.1111 (95% CI: 1.0702-15.792) at BLL-0 >4 mmol/L. Conclusion: After fluid resuscitation and hemodynamic stability, persistently elevated BLL could predict mortality, while elevated BPL could predict survival of septic shock patients. Continuous non-invasive evaluation of fluid responsiveness judged by PVI and SI could provide sensitive

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The Accuracy of Noninvasive Hemoglobin Measurement by Multiwavelength Pulse Oximetry After Cardiac Surgery

Cited by 16 publications

References 0 publications

Accuracy of noninvasive haemoglobin measurement by pulse oximetry depends on the type of infusion fluid

Accuracy of noninvasive haemoglobin measurement by pulse oximetry depends on the type of infusion fluid

Ability of the Masimo pulse CO-Oximeter to detect changes in hemoglobin

Disturbed fluid responsiveness and lactate/pyruvate ratio as predictors for mortality of septic shock patients

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