The accuracy of noninvasive and continuous total hemoglobin measurement by pulse CO-oximetry in human subjects undergoing hemodilution

Mark R. MacKnet, Martin Allard, Richard Lee Applegate, James Rook

Research output: Contribution to journalArticle

109 Citations (Scopus)

Abstract

Background: Total hemoglobin (tHb) is one the most frequently ordered laboratory measurements. Pulse CO-Oximetry™ (Masimo Corp., Irvine, CA) is a multi-wavelength spectrophotometric method for noninvasive and continuous hemoglobin monitoring (SpHb). In this study, we evaluated the accuracy of SpHb compared with laboratory CO-Oximeter measurement of tHb from arterial blood samples in 20 healthy volunteer subjects undergoing hemodilution. Methods: After enrollment, approximately 500 mL of blood was drawn from subjects through an arterial or venous catheter. Each subject then rapidly received crystalloid IV fluid to compensate for the decrease in intravascular volume and reduce the hemoglobin concentration. Subjects received a maximum of 30 mL/kg IV fluid. SpHb was continuously monitored and recorded, and serial arterial blood samples were taken during the procedure. SpHb accuracy was analyzed by pairing SpHb and tHb measurements after the arterial blood draw with the resulting tHb test result. Bias, precision, and the average root-mean-square error were calculated. Results: One hundred sixty-five tHb measurements were collected. The average decrease in tHb during the blood removal and hemodilution procedure was 2.4 ± 0.8 g/dL (mean ± SD). The average difference between 335 paired measurements of SpHb and tHb was-0.15 g/dL, 1 SD of the difference was 0.92 g/dL, and the average root-mean-square difference was 0.94 g/dL. The difference between SpHb and tHb was <2.0 g/dL for 97% of the measurements. The difference was <1.5 g/dL for 97% of the measurements when tHb was <10 g/dL. Conclusions: Pulse CO-Oximetry-based SpHb measurement is accurate within 1.0 g/dL (1 SD) compared with laboratory CO-Oximeter tHb measurement in subjects undergoing hemodilution.

Original languageEnglish (US)
Pages (from-to)1424-1426
Number of pages3
JournalAnesthesia and Analgesia
Volume111
Issue number6
DOIs
StatePublished - Dec 2010
Externally publishedYes

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Hemodilution
Oximetry
Carbon Monoxide
Hemoglobins
Healthy Volunteers
Catheters

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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The accuracy of noninvasive and continuous total hemoglobin measurement by pulse CO-oximetry in human subjects undergoing hemodilution. / MacKnet, Mark R.; Allard, Martin; Applegate, Richard Lee; Rook, James.

In: Anesthesia and Analgesia, Vol. 111, No. 6, 12.2010, p. 1424-1426.

Research output: Contribution to journalArticle

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abstract = "Background: Total hemoglobin (tHb) is one the most frequently ordered laboratory measurements. Pulse CO-Oximetry™ (Masimo Corp., Irvine, CA) is a multi-wavelength spectrophotometric method for noninvasive and continuous hemoglobin monitoring (SpHb). In this study, we evaluated the accuracy of SpHb compared with laboratory CO-Oximeter measurement of tHb from arterial blood samples in 20 healthy volunteer subjects undergoing hemodilution. Methods: After enrollment, approximately 500 mL of blood was drawn from subjects through an arterial or venous catheter. Each subject then rapidly received crystalloid IV fluid to compensate for the decrease in intravascular volume and reduce the hemoglobin concentration. Subjects received a maximum of 30 mL/kg IV fluid. SpHb was continuously monitored and recorded, and serial arterial blood samples were taken during the procedure. SpHb accuracy was analyzed by pairing SpHb and tHb measurements after the arterial blood draw with the resulting tHb test result. Bias, precision, and the average root-mean-square error were calculated. Results: One hundred sixty-five tHb measurements were collected. The average decrease in tHb during the blood removal and hemodilution procedure was 2.4 ± 0.8 g/dL (mean ± SD). The average difference between 335 paired measurements of SpHb and tHb was-0.15 g/dL, 1 SD of the difference was 0.92 g/dL, and the average root-mean-square difference was 0.94 g/dL. The difference between SpHb and tHb was <2.0 g/dL for 97{\%} of the measurements. The difference was <1.5 g/dL for 97{\%} of the measurements when tHb was <10 g/dL. Conclusions: Pulse CO-Oximetry-based SpHb measurement is accurate within 1.0 g/dL (1 SD) compared with laboratory CO-Oximeter tHb measurement in subjects undergoing hemodilution.",
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