吸入氧分数对无创血红蛋白测量的影响：两种监测仪的平行评估

Influence of Fraction of Inspired Oxygen on Noninvasive Hemoglobin Measurement: Parallel Assessment of 2 Monitors.

作者信息

Gayat Etienne, Imbert Nicolas, Roujansky Ariane, Lemasle Léa, Fischler Marc

机构信息

From the *Department of Anesthesiology and Critical Care Medicine, Saint Louis - Lariboisière-Fernand Widal University Hospital; †Medical School, Paris Diderot University, Paris, France; ‡UMR-S942, INSERM, Paris, France; and §Department of Anaesthesia, Hôpital Foch, Suresnes, France, and Université Versailles Saint-Quentin en Yvelines, France.

出版信息

Anesth Analg. 2017 Jun;124(6):1820-1823. doi: 10.1213/ANE.0000000000001783.

DOI:10.1213/ANE.0000000000001783

PMID:28221201

Abstract

BACKGROUND

Previous reports have brought specific attention to the relationship between oxygenation of the patient and the accuracy of noninvasive measurement of hemoglobin (Hb) using an optical sensor. This study aimed to assess prospectively the relationship between fraction of inspired oxygen (FIO2) and the bias of the measurement of Hb by the use of 2 different noninvasive monitors compared with the classic invasive technique.

METHODS

Forty-four patients were included prospectively. In each individual, Hb level was determined noninvasively by monitor Pronto-7™ (Masimo Corporation, Irvine, CA) and by monitor NBM-200MP™ (OrSense Ltd, Petah-Tikva, Israel), with the probe placed on 2 fingers on the same hand of the patient. Three measures were performed, first under breathing air and 2 others when fraction of expired oxygen rose to 50% ± 5% and to 90 ± 5%. Simultaneously, a nurse collected a venous blood sample, which was sent immediately to the hematology laboratory for Hb measurement. The main outcome measurement was the mean bias between noninvasive and invasive measurements.

RESULTS

Results show no change in median bias [interquartile range] with FIO2 for Pronto-7 (from 1.1 g/dL [0.0-2.0] in FIO2 21% to 1.0 g/dL [0.2-1.5] in FIO2 100%), but increasingly negative median bias with increasing FIO2 for NBM-200MP (from -0.3 g/dL [-1.3 to 0.3] in FIO2 21% to -0.8 g/dL [-1.5 to -0.1] in FIO2 100%, P = .04).

DISCUSSION

This study showed that noninvasive measurement of Hb could be influenced by inspired fraction of oxygen when the monitor NBM-200MP is used.

摘要

背景

先前的报告特别关注了患者的氧合作用与使用光学传感器进行血红蛋白（Hb）无创测量准确性之间的关系。本研究旨在前瞻性评估吸入氧分数（FIO2）与使用两种不同无创监测仪测量Hb的偏差之间的关系，并与经典有创技术进行比较。

方法

前瞻性纳入44例患者。在每个个体中，通过Pronto-7™监测仪（Masimo公司，加利福尼亚州欧文市）和NBM-200MP™监测仪（OrSense有限公司，以色列佩塔提克瓦）无创测定Hb水平，探头置于患者同一只手的两根手指上。进行了三次测量，第一次在呼吸空气时进行，另外两次在呼出氧分数升至50%±5%和90±5%时进行。同时，一名护士采集静脉血样本，立即送往血液学实验室进行Hb测量。主要结局指标是无创测量与有创测量之间的平均偏差。