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

Abstract

Our study demonstrates poor correlation between hemoglobin measured noninvasively by multiwavelength pulse oximetry and a laboratory hematology analyzer. The difference was greater when the pulse oximetry perfusion index was low, as may occur in shock, hypothermia, or vasoconstriction patients. The multiwavelength pulse oximetry is not sufficiently accurate for clinical use in a cardiovascular intensive care unit.

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

“…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.…”

“…Several studies measuring SpHb in healthy volunteers exposed to haemodilution [1], surgical patients [2] and patients in the intensive care unit [3] have demonstrated acceptable values compared with laboratory total haemoglobin concentrations (tHb). However, there have also been differences in SpHb and tHb values measured in patients undergoing volume loading [4], major urologic surgery [5] and caesarean section [6], and after cardiac surgery [7]. Thus, whether or not SpHb is sufficiently accurate for clinical use remains controversial and a correction method or a newer developed sensor has been desired.…”

The Accuracy and Reliability of Non-Invasive Haemoglobin Measurements in the Emergency Room: a Small Prospective Observational Quality Control Study from a Swiss University Hospital ED

“…The accuracy and reliability of the portable Pronto-7 Pulse COOximeter was reported in numerous studies conducted in the operating room [10][11][12][13][14][15][16][17][18][19][20][21] and in the intensive care unit [4,5,[22][23][24][25] with predominantly satisfactory performance. In a study done in bleeding trauma patients the agreement was moderate [bias (LOA) of -0.6 (-3.0; +1.9)] g/dl [26], where the limit of agreement is defined as the mean difference + twice the standard deviation of the differences [27].…”

Current Use of Noninvasive Hemoglobin Monitoring in Anesthesia

“…About 58 % of their data pairs had a difference [1 g/dL, and [32 % had a difference [2 g/dL [30]. Another report on 41 cardiac ICU patients showed a poor correlation and wide LOA between SpHb (Radical-7) and tHb [31]. Additionally, 40 % of the patients received norepinephrine.…”