Department of Anesthesiology, Loma Linda University, Loma Linda, California, USA.
Anesth Analg. 2010 Dec;111(6):1424-6. doi: 10.1213/ANE.0b013e3181fc74b9. Epub 2010 Nov 3.
Total hemoglobin (tHb) is one the most frequently ordered laboratory measurements. Pulse CO-Oximetry™ (Masimo Corp., Irvine, CA) is a multi-wavelength spectrophotometric method for noninvasive and continuous hemoglobin monitoring (SpHb). In this study, we evaluated the accuracy of SpHb compared with laboratory CO-Oximeter measurement of tHb from arterial blood samples in 20 healthy volunteer subjects undergoing hemodilution.
After enrollment, approximately 500 mL of blood was drawn from subjects through an arterial or venous catheter. Each subject then rapidly received crystalloid i.v. fluid to compensate for the decrease in intravascular volume and reduce the hemoglobin concentration. Subjects received a maximum of 30 mL/kg i.v. fluid. SpHb was continuously monitored and recorded, and serial arterial blood samples were taken during the procedure. SpHb accuracy was analyzed by pairing SpHb and tHb measurements after the arterial blood draw with the resulting tHb test result. Bias, precision, and the average root-mean-square error were calculated.
One hundred sixty-five tHb measurements were collected. The average decrease in tHb during the blood removal and hemodilution procedure was 2.4 ± 0.8 g/dL (mean ± SD). The average difference between 335 paired measurements of SpHb and tHb was -0.15 g/dL, 1 SD of the difference was 0.92 g/dL, and the average root-mean-square difference was 0.94 g/dL. The difference between SpHb and tHb was <2.0 g/dL for 97% of the measurements. The difference was <1.5 g/dL for 97% of the measurements when tHb was <10 g/dL.
Pulse CO-Oximetry-based SpHb measurement is accurate within 1.0 g/dL (1 SD) compared with laboratory CO-Oximeter tHb measurement in subjects undergoing hemodilution.
总血红蛋白（tHb）是最常被订购的实验室测量指标之一。脉搏 CO- 血氧仪（Masimo 公司，加利福尼亚州欧文市）是一种非侵入性和连续血红蛋白监测的多波长分光光度法（SpHb）。在这项研究中，我们评估了 SpHb 与实验室 CO- 血氧计测量动脉血样 tHb 的准确性，该研究在 20 名接受血液稀释的健康志愿者中进行。
入组后，通过动脉或静脉导管从受试者中抽取约 500 毫升血液。然后，每位受试者迅速接受晶体液静脉输液，以补偿血管内容积的减少并降低血红蛋白浓度。受试者接受最大 30 毫升/公斤静脉输液。连续监测并记录 SpHb，并在过程中采集连续的动脉血样。SpHb 准确性通过在抽取动脉血后将 SpHb 和 tHb 测量值与 tHb 测试结果进行配对分析来进行分析。计算偏差、精度和平均均方根误差。
共采集 165 次 tHb 测量值。在血液去除和血液稀释过程中，tHb 的平均下降量为 2.4 ± 0.8 g/dL（平均值 ± SD）。SpHb 和 tHb 的 335 对测量值之间的平均差值为-0.15 g/dL，差值的 1 SD 为 0.92 g/dL，平均均方根差值为 0.94 g/dL。97%的测量值差值<2.0 g/dL。当 tHb<10 g/dL 时，97%的测量值差值<1.5 g/dL。
在接受血液稀释的受试者中，与实验室 CO- 血氧计 tHb 测量相比，基于脉搏 CO- 血氧仪的 SpHb 测量在 1.0 g/dL（1 SD）内是准确的。
