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
Saturation of peripheral oxygen （SpO2） is one of the most important parameters of vital signs. Pulse oximeter based on near-infrared spectroscopy is commonly used as a non-invasive method to measure SpO2 yl. Current...Saturation of peripheral oxygen （SpO2） is one of the most important parameters of vital signs. Pulse oximeter based on near-infrared spectroscopy is commonly used as a non-invasive method to measure SpO2 yl. Currently, medical device manufacturers as well as metrology measurement agencies in China usually use pulse oximeter simulator as the commonly accepted functional calibration equipment for pulse oximeters. So far, no experimental protocol or devices can be used to test the accuracy and reliability of a pulse oximeter simulator. Therefore, a set of new metrology apparatus with the name of calibration device for pulse oximeter simulator have been designed in order to make a traceable system for the calibration or verification of pulse oximeter simulators. The principles and some research methods of this calibration device for pulse oximeter simulator will be discussed in this paper. Besides that, many experiments have been applied in order to guarantee the accuracy as well as traceability of this set of device.展开更多
Background: Our paper aimed to investigate whether there was a correlation among the pulse oximetry, cerebral oximetry (CO) and MetHb (methemoglobin) values of a patient with congenital methemoglobinemia who underwent...Background: Our paper aimed to investigate whether there was a correlation among the pulse oximetry, cerebral oximetry (CO) and MetHb (methemoglobin) values of a patient with congenital methemoglobinemia who underwent a laparoscopic cholecystectomy operation. Case: The 35-year-old male patient with a weight of 70 kg, body massindex (BMI) of 21, American Society of Anesthesia status-2(ASA-2) category who was planned for laparoscopic cholecystectomy operation was identified to have been diagnosed with congenital methemoglobinemia as per his medical history was methemoglobin levels ranged between 12% and 20% according to the periodical measurements taken for the past 3 years. The patient received standard monitoring during anesthesia and device monitoring with a cerebral oximeter (Invos 5100C somatic/cerebral oximeter, Covidien) and a CO-oximetry (Rad ?87 “Rainbow”, Masimo Inc., Irvine, CA) device to continuously follow up his MetHb values was also added. During the intra-operative follow-up, the patient’s methemoglobin level rose to 16%, his peripheral oxygen saturation levels decreased to 86% and his cerebral oximetry values were identified to have also decreased;therefore, methylene blue (MB) was intravenously administered to the patient. The patient continued to be followed up in the post-operative period and he did not develop any complications. Discussion: Appropriate treatment and monitoring enabled the prevention of potential complications. We believe that monitoring with NIRS and MASIMO CO-oximetry device will enable physicians to perform a safe follow-up and treatment in the intraoperative and postoperative follow-up of methemoglobinemia patients.展开更多
目的:评估脉搏灌注指数(pulse oximeter perfusion index,PI)在判断老年男性患者低位硬膜外麻醉阻滞效果中的应用。方法:66例美国麻醉医师协会(American Society of Anesthesiologists,ASA)Ⅰ~Ⅲ级、年龄≥60岁的男性患者经硬膜外导管给...目的:评估脉搏灌注指数(pulse oximeter perfusion index,PI)在判断老年男性患者低位硬膜外麻醉阻滞效果中的应用。方法:66例美国麻醉医师协会(American Society of Anesthesiologists,ASA)Ⅰ~Ⅲ级、年龄≥60岁的男性患者经硬膜外导管给予2%利多卡因后观察30 min,记录针刺皮肤测痛时双侧脚趾PI、针刺皮肤测痛时痛觉的变化以及提睾反射消失的时间。PI的变化率≥100%、痛觉及提睾反射消失考虑硬膜外麻醉阻滞有效。不同时刻PI的比较使用单因素重复测量方差分析,PI与提睾反射及针刺皮肤测痛预测硬膜外麻醉的成功率在各时刻点的比较使用配对四格表资料的卡方检验。结果:硬膜外腔给药后2 min PI逐渐增加,4 min痛觉开始减退,20 min提睾反射开始消失。在硬膜外腔给药后10、20及30 min各时刻点所有患者的PI均增加100%(P=0.000),针刺皮肤测痛的结果是0/66、45/66(χ2=24.973,P=0.000)、66/66,提睾反射消失的结果是0/66、51/66(χ2=16.923,P=0.000)、66/66。结论:PI是评估老年男性患者低位硬膜外麻醉阻滞效果的早期、客观指标。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Saturation of peripheral oxygen （SpO2） is one of the most important parameters of vital signs. Pulse oximeter based on near-infrared spectroscopy is commonly used as a non-invasive method to measure SpO2 yl. Currently, medical device manufacturers as well as metrology measurement agencies in China usually use pulse oximeter simulator as the commonly accepted functional calibration equipment for pulse oximeters. So far, no experimental protocol or devices can be used to test the accuracy and reliability of a pulse oximeter simulator. Therefore, a set of new metrology apparatus with the name of calibration device for pulse oximeter simulator have been designed in order to make a traceable system for the calibration or verification of pulse oximeter simulators. The principles and some research methods of this calibration device for pulse oximeter simulator will be discussed in this paper. Besides that, many experiments have been applied in order to guarantee the accuracy as well as traceability of this set of device.
文摘Background: Our paper aimed to investigate whether there was a correlation among the pulse oximetry, cerebral oximetry (CO) and MetHb (methemoglobin) values of a patient with congenital methemoglobinemia who underwent a laparoscopic cholecystectomy operation. Case: The 35-year-old male patient with a weight of 70 kg, body massindex (BMI) of 21, American Society of Anesthesia status-2(ASA-2) category who was planned for laparoscopic cholecystectomy operation was identified to have been diagnosed with congenital methemoglobinemia as per his medical history was methemoglobin levels ranged between 12% and 20% according to the periodical measurements taken for the past 3 years. The patient received standard monitoring during anesthesia and device monitoring with a cerebral oximeter (Invos 5100C somatic/cerebral oximeter, Covidien) and a CO-oximetry (Rad ?87 “Rainbow”, Masimo Inc., Irvine, CA) device to continuously follow up his MetHb values was also added. During the intra-operative follow-up, the patient’s methemoglobin level rose to 16%, his peripheral oxygen saturation levels decreased to 86% and his cerebral oximetry values were identified to have also decreased;therefore, methylene blue (MB) was intravenously administered to the patient. The patient continued to be followed up in the post-operative period and he did not develop any complications. Discussion: Appropriate treatment and monitoring enabled the prevention of potential complications. We believe that monitoring with NIRS and MASIMO CO-oximetry device will enable physicians to perform a safe follow-up and treatment in the intraoperative and postoperative follow-up of methemoglobinemia patients.
文摘目的:评估脉搏灌注指数(pulse oximeter perfusion index,PI)在判断老年男性患者低位硬膜外麻醉阻滞效果中的应用。方法:66例美国麻醉医师协会(American Society of Anesthesiologists,ASA)Ⅰ~Ⅲ级、年龄≥60岁的男性患者经硬膜外导管给予2%利多卡因后观察30 min,记录针刺皮肤测痛时双侧脚趾PI、针刺皮肤测痛时痛觉的变化以及提睾反射消失的时间。PI的变化率≥100%、痛觉及提睾反射消失考虑硬膜外麻醉阻滞有效。不同时刻PI的比较使用单因素重复测量方差分析,PI与提睾反射及针刺皮肤测痛预测硬膜外麻醉的成功率在各时刻点的比较使用配对四格表资料的卡方检验。结果:硬膜外腔给药后2 min PI逐渐增加,4 min痛觉开始减退,20 min提睾反射开始消失。在硬膜外腔给药后10、20及30 min各时刻点所有患者的PI均增加100%(P=0.000),针刺皮肤测痛的结果是0/66、45/66(χ2=24.973,P=0.000)、66/66,提睾反射消失的结果是0/66、51/66(χ2=16.923,P=0.000)、66/66。结论:PI是评估老年男性患者低位硬膜外麻醉阻滞效果的早期、客观指标。
