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Accuracy of carboxyhemoglobin dilution method for the measurement of circulating blood volume
1Second Department of Surgery, Gunma University School of Medicine, Maebashi, Japan. ohkisato@akagi.sb.gunma-u.ac.jp
Insights
The carbon monoxide-labeled hemoglobin (CO-Hb) dilution method accurately measures circulating blood volume (BVc) in ICU patients, offering a safe and repeatable alternative to radioactive methods.
Area of Science:
- Critical Care Medicine
- Cardiovascular Surgery
- Diagnostic Methods
Background:
- Accurate management of circulating blood volume (BVc) is vital for intensive care unit (ICU) patients.
- Existing methods for BVc measurement may have limitations.
Purpose of the Study:
- To evaluate the accuracy and precision of the carbon monoxide-labeled hemoglobin (CO-Hb) dilution method (CO method) for BVc measurement.
- To compare the CO method against the established 51Cr-labeled erythrocyte dilution method (51Cr method).
Main Methods:
- A prospective study involving 18 patients undergoing coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB).
- BVc was measured using both CO and 51Cr methods 24 hours post-ICU admission.
- Paired data analysis and percentage error calculations were used to assess agreement.
Main Results:
- The CO method demonstrated small mean differences and standard deviations compared to the 51Cr method (-70.2 +/-184.8 mL).
- Low percentage errors (-0.49+/-1.29%) and a high correlation coefficient (r = 0.97) confirmed accuracy and precision.
- The CO method showed excellent agreement with the 51Cr method.
Conclusions:
- The CO method provides accurate BVc measurements comparable to the 51Cr method.
- The CO method is simple, repeatable, and safe, avoiding radioactivity exposure in the ICU setting.
- This offers a valuable, non-radioactive option for BVc monitoring in critical care.
Purpose:
The management of circulating blood volume (BVc) is crucial in intensive care unit (ICU) patients. The purpose of this study was to verify the accuracy and precision of the carbon monoxide-labeled hemoglobin (CO-Hb) dilution method (CO method) by comparing it with the 51Cr-labeled erythrocyte dilution method (51Cr method) for the measurement of BVc.
Methods:
A prospective study was performed in 18 patients who underwent coronary artery bypass grafting (CABG) under mild hypothermic cardiopulmonary bypass (CPB). The BVc was measured by both the CO method and the 51Cr method at 24 hr after ICU admission in order to verify the accuracy and precision of the CO method. Paired data were assessed in absolute terms, and percentage errors were calculated by the degree of agreement.
Results:
Small mean differences and standard deviations between the CO method and the 51Cr method (-70.2 +/-184.8 mL) and small percentage errors (-0.49+/-1.29%) indicated the accuracy and precision of the CO method, and a close correlation was observed (r = 0.97).
Conclusion:
The CO method can measure BVc with a similar degree of accuracy as the 51Cr method. It is simple, repeatable and safe without the risk of exposure to radioactivity in the ICU.