TY - JOUR
T1 - Blood transfusion decisions cannot be based on percutaneous haemoglobin measurements
AU - Spronk, Angela
AU - De Jong, Renate
AU - Koopman, Seppe
AU - Hoeks, Sanne
AU - Stolker, Robert Jan
N1 - Publisher Copyright:
© 2021 Via Medica. All rights reserved.
PY - 2021
Y1 - 2021
N2 - Background: Percutaneous measurement of haemoglobin (SpHb) has been an emerging technique in the past decades. It has been suggested that SpHb measurement could be used as a trend monitor and as a supportive tool for easier and faster transfusion decision-making. The aim of this study was to investigate whether SpHb monitoring is a useful instrument in transfusion decision-making. Methods: Patients scheduled for surgery with expected blood loss over 800 mL were included in the study. SpHb was measured using a Masimo Rainbow probe. Blood samples were drawn before and after surgery and, if clinically indicated, during surgery. Moreover, perfusion parameters were analysed, as well as transfusion triggers. Results: Based on transfusion triggers 27.1% of patients would not have been transfused according to National Guidelines (14.5% transfused in error, 12.5% not transfused when indicated). Invasive haemoglobin (invasive Hb) and SpHb were obtained 266 times in 75 patients. The mean invasive Hb was 7.37 ± 1.34 mmol L-1and SpHb was 6.47 ± 0.81 mmol L-1 (P < 0.001). Bland-Altman analysis corrected for multiple measurements revealed proportional bias of-4.05 + 0.72 Hb (least bias at Hb 5.62) Conclusions: The precision of the SpHb measurement exceeded the acceptable range of error. We concluded that SpHb measurement using the Rainbow device is too unreliable to be an acceptable alternative to invasive Hb measurement, or even as a trend monitor or decision support tool.
AB - Background: Percutaneous measurement of haemoglobin (SpHb) has been an emerging technique in the past decades. It has been suggested that SpHb measurement could be used as a trend monitor and as a supportive tool for easier and faster transfusion decision-making. The aim of this study was to investigate whether SpHb monitoring is a useful instrument in transfusion decision-making. Methods: Patients scheduled for surgery with expected blood loss over 800 mL were included in the study. SpHb was measured using a Masimo Rainbow probe. Blood samples were drawn before and after surgery and, if clinically indicated, during surgery. Moreover, perfusion parameters were analysed, as well as transfusion triggers. Results: Based on transfusion triggers 27.1% of patients would not have been transfused according to National Guidelines (14.5% transfused in error, 12.5% not transfused when indicated). Invasive haemoglobin (invasive Hb) and SpHb were obtained 266 times in 75 patients. The mean invasive Hb was 7.37 ± 1.34 mmol L-1and SpHb was 6.47 ± 0.81 mmol L-1 (P < 0.001). Bland-Altman analysis corrected for multiple measurements revealed proportional bias of-4.05 + 0.72 Hb (least bias at Hb 5.62) Conclusions: The precision of the SpHb measurement exceeded the acceptable range of error. We concluded that SpHb measurement using the Rainbow device is too unreliable to be an acceptable alternative to invasive Hb measurement, or even as a trend monitor or decision support tool.
UR - http://www.scopus.com/inward/record.url?scp=85109850278&partnerID=8YFLogxK
U2 - 10.5114/ait.2021.105658
DO - 10.5114/ait.2021.105658
M3 - Article
C2 - 34006050
AN - SCOPUS:85109850278
SN - 1642-5758
VL - 53
SP - 103
EP - 107
JO - Anaesthesiology Intensive Therapy
JF - Anaesthesiology Intensive Therapy
IS - 2
ER -