Clinical implications of using non-invasive haemoglobin monitoring for red blood cell transfusion decision in hip arthroplasty.

Campos, Cristiana; Calheiros, José; Kreuzer, Matthias; Fernandes, Raquel; Pinto, Carla; Seabra, Manuel; Vide, Sérgio

doi:10.1016/j.transci.2020.102770

2020

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Title:: Clinical implications of using non-invasive haemoglobin monitoring for red blood cell transfusion decision in hip arthroplasty.
Document type:: Article; Journal Article
Author(s):: Campos, Cristiana; Calheiros, José; Kreuzer, Matthias; Fernandes, Raquel; Pinto, Carla; Seabra, Manuel; Vide, Sérgio
Abstract:: INTRODUCTION: The decision to transfuse red blood cells requires accurate haemoglobin concentration values. In this study, we evaluated if continuous non-invasive haemoglobin (SpHb) measurement could substitute laboratory determined haemoglobin (LabHb) in patients undergoing elective hip replacement. As secondary objective, we analyzed the trend of the difference between techniques. MATERIALS/METHODS: LabHb measurements were done using an automated analyser and SpHb measurements were acquired using Radical-7®. In randomly selected patients undergoing hip replacement, whenever blood was collected for LabHb, concomitant SpHb was recorded. Correlation, bias and accuracy of SpHb were calculated in comparison with LabHb. RESULTS: 108 paired measurements were obtained from 43 patients. The Pearson R of the correlation between SpHb and LabHb was 0.7 (p < 0.001). Bland-Altman test revealed a bias of 1 ± 1.4 g dL-1, meaning Lab Hb was recurrently higher than SpHb. Limits of agreement were [-1.7; 3.8]. Considering RBC transfusion threshold of 8 g dL-1, we found that in two situations transfusion decision would differ based on the measurement considered. Trending ability of SpHb study showed a significant difference between preoperative and postoperative LabHb-SpHb. DISCUSSION: There was a good correlation between SpHb and LabHb, while bias and limits of agreement were higher than those in literature. There was a limited trending ability of SpHb during the perioperative period. Despite this, using SpHb instead of LabHb for decision making regarding transfusion would only change the decision in 1.9 % of our cases. Our findings suggest that this device could be used as a reference but cannot replace venous puncture as gold standard.
Journal title abbreviation:: Transfus Apheresis Sci
Year:: 2020
Journal volume:: 59
Journal issue:: 4
Fulltext / DOI:: doi:10.1016/j.transci.2020.102770
Pubmed ID:: http://view.ncbi.nlm.nih.gov/pubmed/32381421
Print-ISSN:: 1473-0502
TUM Institution:: Klinik für Anästhesiologie (DHM)
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mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Klinik für Anästhesiologie und Intensivmedizin (Prof. Schneider)Klinik für Anästhesiologie (DHM)2020