非侵入性血红蛋白测量是否适用于接受手术前麻醉咨询的儿童?
Katja Mohnke1, Julia Smetiprach1, Yuri Paumen1
1Department of Anesthesiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
Journal of clinical monitoring and computing
|July 20, 2024
概括
儿童的非侵入性血红蛋白测量 (SpHb) 显示出快速查的潜力,但需要进一步验证. 调整的截止值提高了灵敏度,但准确性仍然不足以在儿科手术前诊断绝对的贫血.
科学领域:
- 儿科麻醉学 儿科麻醉学
- 医疗器械 医疗器械
- 临床诊断 临床诊断 临床诊断
背景情况:
- 儿童手术前贫血存在诊断方面的挑战,原因是患者的厌恶和技术上的困难,传统的血液抽取.
- 非侵入性血红蛋白监测为传统方法提供了潜在的替代方案,特别是在儿童群体中.
- 准确的贫血评估对于优化儿童外科手术期间管理至关重要.
研究的目的:
- 在手术前麻醉咨询期间,评估非侵入性血红蛋白测量 (SpHb) 与儿童实验室血红蛋白 (labHb) 相比的适宜性和准确性.
- 评估SpHb在儿科患者贫血查的诊断性能.
- 确定SpHb是否可以成为儿童手术前贫血评估的可靠工具.
主要方法:
- 一项前性研究,涉及62名儿童 (年龄≤17岁) 接受手术前麻醉咨询.
- 进行了非侵入性血红蛋白 (SpHb) 测量,并与标准实验室血红蛋白 (labHb) 水平进行了比较.
- 统计分析包括偏差,共识极限,根平均平方误差,回归分析和重新测试可靠性.
主要成果:
- 在大多数儿童中,SpHb测量是成功的,偏差为0.3g/dl,与实验室Hb相比,一致度极限为-2.26至+2.8g/dl.
- 使用标准切断值,SpHb对贫血检测的灵敏度为57.1%,特异性为96.3%.
- 根据年龄调整的SpHb截止值实现了100%的灵敏度,尽管整体准确性被认为不足以确定诊断.
结论:
- 非侵入性血红蛋白测量 (SpHb) 是儿童的快速程序,但其目前的准确性不足以诊断贫血.
- 需要进一步的研究来确认计算的SpHb截止值在儿科手术前查贫血的有用性.
- 虽然有希望,但SpHb需要额外的验证才能取代实验室血红蛋白检测以确定儿童的贫血诊断.
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