利用 HemoCue 在剖宫产期间估算血液血红蛋白浓度：采样部位的影响。

Estimation of blood haemoglobin concentration using the HemoCue during caesarean section: the effect of sampling site.

机构信息

Magill Department of Anaesthesia, Intensive Care and Pain Management, Chelsea and Westminster Hospital, London, UK.

出版信息

Int J Obstet Anesth. 2010 Jan;19(1):67-70. doi: 10.1016/j.ijoa.2009.05.010. Epub 2009 Nov 27.

DOI:10.1016/j.ijoa.2009.05.010

PMID:19945277

Abstract

BACKGROUND

Haemoglobin concentration measured using the HemoCue is accurate for capillary and venous/arterial blood, provided the recommended sampling method is strictly observed. Analysis of blood, particularly of capillary samples, using the HemoCue is useful during caesarean section. The toe might be preferred to the thumb since it is numb during neuraxial anaesthesia, but whether sampling at either site is accurate in this situation, given the cardiovascular effects of anaesthesia and pregnancy, is not known. We aimed to compare haemoglobin values measured in venous and capillary samples (toe and thumb) during caesarean section under neuraxial anaesthesia.

METHOD

Fifty healthy women having caesarean section under spinal or combined spinal-epidural anaesthesia were included. At the end of surgery, the great toe and thumb (non-i.v. fluid side) were lanced as recommended for a HemoCue reading. A venous blood sample (non-i.v. fluid side) was also taken and sent for formal laboratory measurement and tested with the HemoCue. Bland-Altman analysis was applied to the haemoglobin values.

RESULTS

Bias (mean difference) and precision +/- 2 SD were respectively 0.2 +/-1.6 for laboratory vs. toe, 0.1 +/-1.8 for laboratory vs. thumb, and 0.2 +/-1.6 laboratory vs. venous.

CONCLUSION

Our results suggest that in terms of accuracy, the two sites are equally suitable for use during caesarean section under neuraxial anaesthesia.

摘要

背景

使用 HemoCue 测量的血红蛋白浓度对于毛细血管和静脉/动脉血液是准确的，前提是严格遵守推荐的采样方法。在剖宫产期间，使用 HemoCue 分析血液，特别是毛细血管样本，是有用的。由于神经阻滞麻醉和妊娠会影响心血管，在这种情况下，与拇指相比，脚趾可能是首选，因为它在神经阻滞麻醉期间是麻木的，但由于麻醉和妊娠的心血管效应，尚不清楚在这两种情况下，在这两个部位采样是否准确。我们的目的是比较在椎管内麻醉下剖宫产时静脉和毛细血管（脚趾和拇指）样本中测量的血红蛋白值。