• Minerva anestesiologica · May 2017

    Accuracy of non-invasive hemoglobin monitoring by pulse co-oximeter during liver transplantation.

    • Erdogan Kayhan Gulay G Department of Anesthesiology and Reanimation, Faculty of Medicine, İnönü University, Malatya, Turkey - drgulayer@yahoo.com., Yusuf Z Colak, Mukadder Sanli, Muharrem Ucar, and Huseyin I Toprak.
    • Department of Anesthesiology and Reanimation, Faculty of Medicine, İnönü University, Malatya, Turkey - drgulayer@yahoo.com.
    • Minerva Anestesiol. 2017 May 1; 83 (5): 485-492.

    BackgroundHemoglobin level monitoring is essential during liver transplantation (LT) due to substantial blood loss. We evaluated the accuracy of non-invasive and continuous hemoglobin monitoring (SpHb) obtained by a transcutaneous spectrophotometry-based technology (Masimo Corporation, Irvine, CA) compared with conventional laboratory Hb measurement (HbL) during LT. Additionally, we made subgroup analyses for distinct surgical phases that have special features and hemodynamic problems and thus may affect the accuracy of SpHb.MethodsDuring LT, blood samples were obtained twice for each of the three phases of LT (pre-anhepatic, anhepatic, and neohepatic) and were analyzed by the central laboratory. The HbL measurements were compared with SpHb obtained at the time of the blood draws.ResultsA total of 282 data pairs obtained from 53 patients were analyzed. The SpHb values ranged from 6.9 to 17.7 g/dL, and the HbL values ranged from 5.4 to 17.1 g/dL. The correlation coefficient between SpHb and HbL was 0.73 (P<0.001), and change in SpHb versus change in HbL was 0.76 (P<0.001). The sensitivity value determined using a 4-quadrant plot was 79%. The bias and precision of SpHb to HbL were 0.86±1.58 g/dL; the limits of agreement were -2.25 to 3.96 g/dL. The overall correlation between SpHb and HbL remained stable in different phases of surgical procedure.ConclusionsSpHb was demonstrated to have a clinically acceptable accuracy of hemoglobin measurement in comparison with a standard laboratory device when used during LT. This technology can be useful as a trend monitor during all surgical phases of LT and can supplement HbL to optimize transfusion decisions or to detect occult bleeding.

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