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[CONTINUOUS HEMOGLOBIN MONITORING USING PULSE CO-OXIMETRY IN CARDIAC SURGERY.]
Anesteziologiia I Reanimatologiia
|March 1, 2018
Summary
Continuous hemoglobin monitoring using pulse co-oximetry lacks accuracy in the early postoperative cardiac surgery period. Factors like vascular tone and hypoperfusion significantly impact results, limiting its clinical applicability.
Area of Science:
- Cardiovascular Surgery
- Anesthesiology
- Critical Care Medicine
Background:
- Continuous hemoglobin monitoring is crucial for managing hemodynamics in cardiac surgery patients.
- Pulse co-oximetry offers a non-invasive method for real-time hemoglobin assessment.
Purpose of the Study:
- To evaluate the accuracy of continuous hemoglobin monitoring via pulse co-oximetry.
- To identify factors influencing measurement accuracy in the early postoperative phase of cardiac surgery.
Main Methods:
- Prospective observational study involving 43 cardiac surgery patients (27 off-pump CABG, 16 complex/combined CPB).
- Continuous hemoglobin monitoring (SpHb) was compared with arterial blood hemoglobin (Hbart).
Main Results:
- A positive correlation was observed between SpHb and Hb in both groups (rho =0.29, p < 0.05 and rho=0.34; p<0.005).
- Bland-Altman analysis revealed wide limits of agreement: -6.0 ± 41.0 g/l (off-pump) and 7.7 ± 31.0 g/l (CPB).
Conclusions:
- Pulse co-oximetry-based hemoglobin measurement lacks acceptable accuracy in the early postoperative period following cardiac surgery.
- Vascular tone, systemic, and regional tissue hypoperfusion significantly affect the reliability of this monitoring technology.
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