Operating Rooms, Kyushu University Hospital, Fukuoka 812-8582, Japan.
Department of Anesthesiology and Critical Care, Kyushu University Graduate School of Medicine, Fukuoka 812-8582, Japan.
J Clin Anesth. 2014 Dec;26(8):643-7. doi: 10.1016/j.jclinane.2014.04.012. Epub 2014 Oct 20.
To validate intraoperative pulse hemoglobin (SpHb) measurements in anesthetized patients with large forearm temperature - fingertip temperature gradients.
prospective and observational study.
Operating room of a university hospital.
28 patients undergoing surgery during general anesthesia, requiring arterial blood withdrawal.
Radial arterial blood pressure, forearm and fingertip skin surface temperatures, and SpHb were monitored.
Paired SpHb and arterial hemoglobin (Hb) measurements at different skin-surface temperature gradients.
A total of 175 paired SpHb and arterial Hb measurements were analyzed. The mean SpHb to arterial Hb differences in each group were 0.33 ± 1.41g/dL in the < 1°C group of the forearm temperature - fingertip temperature gradient, -0.31 ± 1.24g/dL in the 1 - 2°C group, - 0.59 ± 1.11g/dL in the 2 - 3°C group, and - 0.53 ± 0.87g/dL in the > 3°C group (P < 0.05). The percentage of nonmeasurable SpHb due to low perfusion state was 0% (0 of 115 paired measurements) in the < 1°C group, 6.7% (2 of 30 pairs) in the 1 - 2°C group, 16.7% (3 of 18 pairs) in the 2 - 3°C group, and 66.7% (8 of 12 pairs) in the > 3°C group.
SpHb measured at fingertip was significantly affected by the perfusion state, with lower perfusion associated with lower SpHb. Thermoregulatory vasoconstriction affects measurement of SpHb.
验证在大前臂温度-指尖温度梯度下麻醉患者的术中脉搏血红蛋白（SpHb）测量值。
前瞻性和观察性研究。
大学医院的手术室。
28 名在全身麻醉下接受手术并需要动脉采血的患者。
监测桡动脉血压、前臂和指尖皮肤表面温度以及 SpHb。
不同皮肤表面温度梯度下的 SpHb 和动脉血红蛋白（Hb）的配对测量值。
共分析了 175 对 SpHb 和动脉 Hb 测量值。在每个组中，前臂温度-指尖温度梯度的<1°C 组中 SpHb 与动脉 Hb 的平均差值为 0.33±1.41g/dL，1-2°C 组为-0.31±1.24g/dL，2-3°C 组为-0.59±1.11g/dL，>3°C 组为-0.53±0.87g/dL（P<0.05）。由于灌注状态低而无法测量的 SpHb 的百分比在<1°C 组中为 0%（115 对测量值中的 0 对），在 1-2°C 组中为 6.7%（30 对中的 2 对），在 2-3°C 组中为 16.7%（18 对中的 3 对），在>3°C 组中为 66.7%（12 对中的 8 对）。
指尖测量的 SpHb 受到灌注状态的显著影响，灌注越低，SpHb 越低。体温调节性血管收缩会影响 SpHb 的测量。
