无创血红蛋白监测对血红蛋白水平低的患者的评价
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Evaluation of non-invasive hemoglobin monitoring in trauma patients with low hemoglobin levels
背景
出血是创伤患者死亡的主要原因。 血红蛋白测量水平的延迟可能导致无症状的患者不必要的输血或危重出血患者的输血延迟。在这项研究中，我们评估低血红蛋白水平创伤患者无创血红蛋白监测的精度。
方 法
实验包括了低血红蛋白水平（低于8g / dL）的外科手术患者。 在入院时和每次采集血样后，使用radical-7 Masimo装置同时测量血清血红蛋白。 通过两种方法（Delta-Sp-Hb和Delta-Lab-Hb）评估每个输注血液单位后血液血红蛋白的变化。 使用Bland-Altman和Pearson法分析确定Masimo装置测量的血红蛋白水平（Sp-Hb）与实验室血红蛋白水平（Lab-Hb）相比的精确度。
结 果
一百八十四个时间匹配的样本可供最终分析。 Bland-altman分析显示，与Lab-Hb相比，Sp-Hb具有出色的准确性，平均偏差为0.12 g / dL，一致性范围为-0.56 g / dL至0.79 g / dL。 两项指标之间的相关性都很好，Pearson相关系数为0.872。 Delta-Sp-Hb和Delta-Lab-Hb之间也有很好的一致性，平均偏差为-0.05，一致性范围从-0.62到0.51
结 论
与低血红蛋白水平的创伤患者的Lab-Hb测量相比，Sp-Hb具有精确的绝对值和趋势。
原始文献摘要
Albaladejo P, Samama C M, Sié P, et al. Management of Severe Bleeding in Patients Treated with Direct Oral Anticoagulants: An Observational Registry Analysis[J]. Anesthesiology, 2017.
Objective
Bleeding is a leading cause of death among trauma patients. Delayed assessment of blood hemoglobin levelmight result in either unnecessary blood transfusion in non-indicated patients or delayed blood transfusion in critically bleeding patients. In this study, we evaluate the precision of non-invasive hemoglobin monitoring in trauma patients with low hemoglobin levels.
Methods
We included trauma patients with low hemoglobin levels (less than 8g/dL) scheduled for surgical intervention. Blood samples were obtained on admission and after each blood unit with concomitant measurement of serum hemoglobin using radical-7 Masimo device. The change in blood hemoglobin after every transfused blood unit was also assessed by both methods (Delta-Sp-Hb and Delta-Lab-Hb). The precision of Masimo hemoglobin level (Sp-Hb) compared toLaboratory hemoglobin level (Lab-Hb) was determined using both Bland-Altman and Pearson correlation analyses.
Results
One hundred and eighty-four time matched samples were available for final analysis. Bland-
altman analysis showed excellent accuracy of Sp-Hb compared to Lab-Hb with mean bias of
0.12 g/dL and limits of agreement between -0.56 g/dL to 0.79 g/dL. Excellent correlation was
reported between both measures with Pearson correlation coefficient of 0.872. Excellent
agreement was also reported between both Delta-Sp-Hb and Delta-Lab-Hb with mean bias of -0.05 and limits of agreement from -0.62 to 0.51
Conclusions
Sp-Hb showed accurate precision in both absolute values and trend values compared to Lab-Hb measurement intro
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