J Clin Monit Comput - The relative trending accuracy of noninvasive continuous hemoglobin monitoring during hemodialysis in critically ill patients.

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Resumo

The pulse CO-Oximeter (Radical-7; Masimo Corp., Irvine, CA) is a multi-wavelength spectrophotometric method for noninvasive continuous monitoring of hemoglobin (SpHb). Because evaluating the relative change in blood volume (BV) is crucial to avoid hypovolemia and hypotension during hemodialysis, it would be of great clinical benefit if BV could be estimated by measurement of SpHb during hemodialysis. The capability of the pulse CO-Oximeter to monitor BV depends on the relative trending accuracy of SpHb. The purpose of the current study was to evaluate the relative trending accuracy of SpHb by the pulse CO-Oximeter using Crit-Line as a reference device. In 12 patients who received hemodialysis (total 22 sessions) in the intensive care unit, BV was determined from SpHb. Relative changes in blood volume determined from SpHb were calculated according to the equation: BV(SpHb)=[starting SpHb]/[current SpHb] - 1. The absolute values of SpHb and hematocrit measured by Crit-Line (CL-Hct) showed poor correlation. On the contrary, linear regression analysis showed good correlation between BV(SpHb) and the relative change in blood volume measured by Crit-Line [BV(CL-Hct)] (r=0.83; P=0.001). Bland-Altman analysis also revealed good agreement between BV(SpHb) and BV(CL-Hct) (bias, -0.77%; precision, 3.41%). Polar plot analysis revealed good relative trending accuracy of SpHb with an angular bias of 4.1? and radial limits of agreement of 24.4? (upper) and -16.2? (lower). The results of the current study indicate that SpHb measurement with the pulse CO-Oximeter has good relative trending accuracy.

Resumo Limpo

puls cooximet radic masimo corp irvin ca multiwavelength spectrophotometr method noninvas continu monitor hemoglobin sphb evalu relat chang blood volum bv crucial avoid hypovolemia hypotens hemodialysi great clinic benefit bv estim measur sphb hemodialysi capabl puls cooximet monitor bv depend relat trend accuraci sphb purpos current studi evalu relat trend accuraci sphb puls cooximet use critlin refer devic patient receiv hemodialysi total session intens care unit bv determin sphb relat chang blood volum determin sphb calcul accord equat bvsphbstart sphbcurrent sphb absolut valu sphb hematocrit measur critlin clhct show poor correl contrari linear regress analysi show good correl bvsphb relat chang blood volum measur critlin bvclhct r p blandaltman analysi also reveal good agreement bvsphb bvclhct bias precis polar plot analysi reveal good relat trend accuraci sphb angular bias radial limit agreement upper lower result current studi indic sphb measur puls cooximet good relat trend accuraci

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