Kim Ha-Yeon, Choi Jong-Bum, Han Sang-Uk, Lee Hye-Sun, Lee Kyuhyeok, Kim Ji-Eun
Department of Anesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon 16499, Korea.
Department of Surgery, Ajou University School of Medicine, Suwon 16499, Korea.
J Pers Med. 2022 Jan 26;12(2):160. doi: 10.3390/jpm12020160.
The pulse CO-Oximetry allows continuous, noninvasive monitoring of hemoglobin (SpHb). We assessed the impact of increased end-tidal carbon dioxide (EtCO) on the accuracy and trending ability of SpHb in laparoscopic surgery. Participants ( = 64) were randomly allocated to the low carbon dioxide (CO) group (EtCO: 30-35 mmHg) or the high CO group (EtCO: 40-45 mmHg). The SpHb and laboratory hemoglobin (tHb) were obtained during surgery. The correlation coefficient (r) between SpHb and tHb showed greater tendency in the low CO group (r = 0.68) than in the high CO group (r = 0.43). The bias (precision) was -1.18 (1.09) with a limit of agreement (LOA) of -3.31 to 0.95 in low CO group and -1.02 (1.24) with a LOA of -3.45 to 1.42 in high CO group; they did not differ significantly between the groups ( = 0.246). The low CO group showed a high concordance rate of 95.9% and a moderate correlation between ΔSpHb and ΔtHb (r = 0.53). However, the high CO group showed a concordance rate of 77.8% and no correlation between ΔSpHb and ΔtHb (r = 0.11). In conclusion, increased EtCO significantly reduced the trending ability of SpHb during laparoscopic surgery. Caution should be executed when interpreting SpHb values during laparoscopic surgery in patients with hypercapnia.
脉搏血氧饱和度仪可对血红蛋白（SpHb）进行连续、无创监测。我们评估了呼气末二氧化碳（EtCO）增加对腹腔镜手术中SpHb准确性和趋势监测能力的影响。参与者（n = 64）被随机分配至低二氧化碳（CO）组（EtCO：30 - 35 mmHg）或高CO组（EtCO：40 - 45 mmHg）。在手术过程中获取SpHb和实验室血红蛋白（tHb）。SpHb与tHb之间的相关系数（r）在低CO组（r = 0.68）比高CO组（r = 0.43）显示出更大的趋势性。低CO组的偏差（精密度）为 -1.18（1.09），一致性界限（LOA）为 -3.31至0.95；高CO组的偏差为 -1.02（1.24），LOA为 -3.45至1.42；两组之间无显著差异（P = 0.246）。低CO组显示出95.9%的高一致性率以及ΔSpHb与ΔtHb之间的中度相关性（r = 0.53）。然而，高CO组显示出77.8%的一致性率且ΔSpHb与ΔtHb之间无相关性（r = 0.11）。总之，EtCO增加显著降低了腹腔镜手术期间SpHb的趋势监测能力。在对高碳酸血症患者进行腹腔镜手术时解读SpHb值时应谨慎。
