J Clin Monit Comput - Validation of continuous and noninvasive hemoglobin monitoring by pulse CO-oximetry in Japanese surgical patients.

Tópicos

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Resumo

We evaluated the accuracy of noninvasive and continuous total hemoglobin (SpHb) monitoring with the Radical-7(?) Pulse CO-Oximeter in Japanese surgical patients before and after an in vivo adjustment of the first SpHb value to match the first reference value from a satellite laboratory CO-Oximeter. Twenty patients undergoing surgical procedures with general anesthesia were monitored with Pulse CO-Oximetry for SpHb. Laboratory CO-Oximeter values (tHb) were compared to SpHb at the time of the blood draws. Bias, precision, limits of agreement and correlation coefficient of SpHb compared to tHb were calculated before and after SpHb values were adjusted by subtracting the difference between the first SpHb and tHb value from all subsequent SpHb values. Trending of SpHb to tHb and the effect of perfusion index (PI) on the agreement of SpHb to tHb were also analyzed. Ninety-two tHb values were compared to the SpHb. Bias ? 1SD was 0.2 ? 1.5 g/dL before in vivo adjustment and -0.7 ? 1.0 g/dL after in vivo adjustment. Bland-Altman analysis showed limits of agreement of -2.8 to 3.1 g/dL before in vivo adjustment and -2.8 to 1.4 g/dL after in vivo adjustment. The correlation coefficient was 0.76 prior to in vivo adjustment and 0.87 after in vivo adjustment. In patients with adequate perfusion (PI =1.4) the correlation coefficient was 0.89. In vivo adjustment of SpHb significantly improved the accuracy in our cohort of Japanese surgical patients. The strongest correlation between SpHb and tHb values was observed in patients with adequate peripheral perfusion suggesting that low perfusion may affect the accuracy of SpHb monitoring.

Resumo Limpo

evalu accuraci noninvas continu total hemoglobin sphb monitor radic puls cooximet japanes surgic patient vivo adjust first sphb valu match first refer valu satellit laboratori cooximet twenti patient undergo surgic procedur general anesthesia monitor puls cooximetri sphb laboratori cooximet valu thb compar sphb time blood draw bias precis limit agreement correl coeffici sphb compar thb calcul sphb valu adjust subtract differ first sphb thb valu subsequ sphb valu trend sphb thb effect perfus index pi agreement sphb thb also analyz ninetytwo thb valu compar sphb bias sd gdl vivo adjust gdl vivo adjust blandaltman analysi show limit agreement gdl vivo adjust gdl vivo adjust correl coeffici prior vivo adjust vivo adjust patient adequ perfus pi correl coeffici vivo adjust sphb signific improv accuraci cohort japanes surgic patient strongest correl sphb thb valu observ patient adequ peripher perfus suggest low perfus may affect accuraci sphb monitor

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