Accuracy and trending ability of hemoglobin measurement by the Pulse CO-Oximeter during vascular surgery
Real time information of Hb concentration can guide a tailored patient blood management. The study investigates the accuracy, precision and trending ability of the Pulse CO-Oximeter (SpHb) and blood gas analyzer in measuring the Hb concentration, compared to hematological analysis, in surgery at high risk of hemorrhage. We performed an observational study, involving 48 patients undergoing abdominal aortic open surgery. The primary endpoints of the study were to compare the accuracy in measuring the Hb concentration using non-invasive method (Masimo rainbow SET® Radical 7 Pulse CO-Oximetry™) compared to the values provided by invasive conventional blood gas analyzer and hematological analysis. The secondary endpoint was to compare the differences between the baseline and the final value of the Hb after surgery (Δ-values), as well as the trending ability. Bias (precision) for the SpHb was 1.63 g/dL (± 0.05) with 95% limits of agreement between 0.85 and + 2.4 g/dL, while for the blood gas analyzer was 0.69 g/dL (± 0.04) with 95% limits of agreement between 0.07 and 1.3 g/dL. Δ-values values were not statistically different from the reference values of ΔHb obtained with the hematological analysis. Trending ability was good for both Pulse CO-Oximeter and blood gas analysis. Our results have shown that the SpHb is not precise enough to replace an invasive approach, but the trending ability of SpHb is accurate and may provide important information on the changes in hemoglobin concentration to guide blood management.
KeywordsBlood transfusion Hemoglobin Hemorrhage Point-of-care systems
Rosanna Carmela De Rosa has designed the study, collected data, contributed to the statistical analysis and to the draft of the manuscript. Giovanni Marco Romano has designed the study, collected data, contributed to the statistical analysis and to the draft of the manuscript. Roberta Abbate has designed the study, collected data, and contributed to the draft of the manuscript. Edoardo De Robertis has designed the study, contributed to the statistical analysis and to the draft of the manuscript. Antonio Corcione has contributed to writing and reviewing the manuscript.
Compliance with ethical standards
Conflicts of interest
Rosanna Carmela De Rosa and Edoardo De Robertis were speakers in Masimo sponsored symposia.
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