Purpose: The accuracy of spectrophotometric hemoglobin (SpHb) measurement with a pulse co-oximeter was analyzed in cases of intraoperative massive hemorrhage and compared with Hb levels determined through blood gas an...Purpose: The accuracy of spectrophotometric hemoglobin (SpHb) measurement with a pulse co-oximeter was analyzed in cases of intraoperative massive hemorrhage and compared with Hb levels determined through blood gas analysis (LabHb) as a reference. We aimed to determine the extent to which in vivo adjustment (ADJ) for results of initial blood gas analysis would improve the accuracy of SpHb measurement. Methods: Data on LabHb and SpHb levels were collected from cases with hemorrhage of 1000 g or more. Correlations and Bland-Altman analyses were used to determine the associations between data before and after ADJ. Results: ADJ slightly improved the correlation coefficient (Pearson r) between SpHb and LabHb levels from 0.65 to 0.72. In Bland-Altman analysis, ADJ reduced the bias from 1.76 ± 1.47 g/dL to 0.64 ± 1.43 g/dL, while the 95% limits of agreement of -1.12 to 4.64 g/dL (range: 5.77 g/dL) without ADJ improved to -2.16 to 3.44 g/dL (range: 5.59 g/dL) with ADJ. In four-quadrant analysis, other than samples in the exclusion zone, the total number analyzed was 326, and the concordance rate was 82%. Conclusion: Although the accuracy of SpHb measurement improves on ADJ, SpHb measurement cannot substitute for LabHb levels, and it is necessary to determine Hb levels with blood gas analysis in the laboratory. It remains unclear which measurement is superior for determining when to initiate blood transfusion to achieve better outcomes. To comply with conventional methods, LabHb measurements may be necessary.展开更多
目的比较脉搏血氧计连续无创法和血气分析法检测血红蛋白(Hb)的一致性。方法对69名择期全麻肝脏部分切除术患者,在术中同时采用连续无创法和血气分析法检测Hb,共获得164对数据。采用配对t检验,Bland-Altman分析方法和多元线性回归...目的比较脉搏血氧计连续无创法和血气分析法检测血红蛋白(Hb)的一致性。方法对69名择期全麻肝脏部分切除术患者,在术中同时采用连续无创法和血气分析法检测Hb,共获得164对数据。采用配对t检验,Bland-Altman分析方法和多元线性回归分析评估2种测量方法的一致性及可能的影响因素。结果连续无创法与血气分析法分别测得Hb(s/dL)为-12.7±1.9 vs 11.6±1.9(P〈0.05);Bland—Altman方法分析2种测量方法的偏倚值为(1.1±2.8)g/dL;95%一致性界限为(-1.7~3.9)g/dL;多元线性回归分析提示使偏倚值发生明显变化(P〈0.05)的变量包括有创Hb浓度(tHb)、平均动脉压(MAP)和灌注指数(PI)。结论Masimo Radical-7脉搏血氧计倾向于高估Hb,其准确性易受外界因素的影响;但术中维持稳定的血流动力学能够保持其检测误差的稳定,因而在肝脏部分切除术中对指导输血仍具有一定的参考意义。展开更多
目的探讨应用无创连续血红蛋白监测较传统实验室检测方法对创伤患者液体保护方面的优势作用。方法选择创伤急救患者110例,随机分为对照组50例应用Masimo Radical 7无创血红蛋白仪持续监测红蛋白含量(Red protein hemoglobin meter conti...目的探讨应用无创连续血红蛋白监测较传统实验室检测方法对创伤患者液体保护方面的优势作用。方法选择创伤急救患者110例,随机分为对照组50例应用Masimo Radical 7无创血红蛋白仪持续监测红蛋白含量(Red protein hemoglobin meter continuously monitor,SPHb)、观察组60例应用血气分析仪测定血红蛋白含量(Blood gas analyzer determination of hemoglobin,Hb),两组患者分别在各时间段进行检测:入室后、补液1 000 mL后、每增加1 000 mL时、出血量达500mL后每增加500 mL时、输注红细胞悬液2 U 10 min后、每增加2 U 10 min后。结果两组患者在各时间点进行检测比较结果 t=1.707,P>0.05,差异无统计学意义。对两种测定方法进行Bland-Altman一致性分析在一致性界限范围内两种测量结果最大差值为3 g/L临床上可以接受。结论无创连续血红蛋白监测应用于创伤外科抢救精确度高,且具有实时、无创,准确及时的为液体治疗提供可靠依据。展开更多
文摘Purpose: The accuracy of spectrophotometric hemoglobin (SpHb) measurement with a pulse co-oximeter was analyzed in cases of intraoperative massive hemorrhage and compared with Hb levels determined through blood gas analysis (LabHb) as a reference. We aimed to determine the extent to which in vivo adjustment (ADJ) for results of initial blood gas analysis would improve the accuracy of SpHb measurement. Methods: Data on LabHb and SpHb levels were collected from cases with hemorrhage of 1000 g or more. Correlations and Bland-Altman analyses were used to determine the associations between data before and after ADJ. Results: ADJ slightly improved the correlation coefficient (Pearson r) between SpHb and LabHb levels from 0.65 to 0.72. In Bland-Altman analysis, ADJ reduced the bias from 1.76 ± 1.47 g/dL to 0.64 ± 1.43 g/dL, while the 95% limits of agreement of -1.12 to 4.64 g/dL (range: 5.77 g/dL) without ADJ improved to -2.16 to 3.44 g/dL (range: 5.59 g/dL) with ADJ. In four-quadrant analysis, other than samples in the exclusion zone, the total number analyzed was 326, and the concordance rate was 82%. Conclusion: Although the accuracy of SpHb measurement improves on ADJ, SpHb measurement cannot substitute for LabHb levels, and it is necessary to determine Hb levels with blood gas analysis in the laboratory. It remains unclear which measurement is superior for determining when to initiate blood transfusion to achieve better outcomes. To comply with conventional methods, LabHb measurements may be necessary.
文摘目的比较脉搏血氧计连续无创法和血气分析法检测血红蛋白(Hb)的一致性。方法对69名择期全麻肝脏部分切除术患者,在术中同时采用连续无创法和血气分析法检测Hb,共获得164对数据。采用配对t检验,Bland-Altman分析方法和多元线性回归分析评估2种测量方法的一致性及可能的影响因素。结果连续无创法与血气分析法分别测得Hb(s/dL)为-12.7±1.9 vs 11.6±1.9(P〈0.05);Bland—Altman方法分析2种测量方法的偏倚值为(1.1±2.8)g/dL;95%一致性界限为(-1.7~3.9)g/dL;多元线性回归分析提示使偏倚值发生明显变化(P〈0.05)的变量包括有创Hb浓度(tHb)、平均动脉压(MAP)和灌注指数(PI)。结论Masimo Radical-7脉搏血氧计倾向于高估Hb,其准确性易受外界因素的影响;但术中维持稳定的血流动力学能够保持其检测误差的稳定,因而在肝脏部分切除术中对指导输血仍具有一定的参考意义。
文摘目的探讨应用无创连续血红蛋白监测较传统实验室检测方法对创伤患者液体保护方面的优势作用。方法选择创伤急救患者110例,随机分为对照组50例应用Masimo Radical 7无创血红蛋白仪持续监测红蛋白含量(Red protein hemoglobin meter continuously monitor,SPHb)、观察组60例应用血气分析仪测定血红蛋白含量(Blood gas analyzer determination of hemoglobin,Hb),两组患者分别在各时间段进行检测:入室后、补液1 000 mL后、每增加1 000 mL时、出血量达500mL后每增加500 mL时、输注红细胞悬液2 U 10 min后、每增加2 U 10 min后。结果两组患者在各时间点进行检测比较结果 t=1.707,P>0.05,差异无统计学意义。对两种测定方法进行Bland-Altman一致性分析在一致性界限范围内两种测量结果最大差值为3 g/L临床上可以接受。结论无创连续血红蛋白监测应用于创伤外科抢救精确度高,且具有实时、无创,准确及时的为液体治疗提供可靠依据。