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Accuracy of Determining Hemoglobin Level Using Occlusion Spectroscopy in Patients with Severe Gastrointestinal Bleeding.
MedLine Citation:
PMID:  23314168     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND:: In patients presenting with severe hemorrhage, the authors conducted an equivalence trial that compared noninvasive occlusion spectroscopy and the capillary blood method to determine hemoglobin level. METHODS:: This prospective observational study included patients admitted to their intensive care unit for gastrointestinal bleeding. A ring-shaped sensor, connected to a NBM-200MP (OrSense, Nes Ziona, Israel), was fitted onto the patient's thumb to intermittently measure hemoglobin (SotHb). During the first 24 h after admission, venous hemoglobin level, considered as the reference method, was determined at the laboratory every 8 h and was compared to SotHb and the capillary blood method. The primary endpoint was the proportion of inaccurate measurements, defined as greater than 15% difference compared with reference values or their unavailability for any technical reason. RESULTS:: The study was scheduled to include 68 patients but was stopped prematurely after an interim analysis of 34 patients. The proportion of inaccuracies revealed that SotHb could not be considered equivalent to the capillary blood method (47% [95% CI, 43-51] and 24% [95% CI, 20-28]). Considering venous hemoglobin level as a reference method, the mean biases for SotHb (n = 133) and the capillary blood method (n = 135) were, respectively, -0.4 ± 2.0 and 0.8 ± 1.2 g/dl (P < 0.05). SotHb was associated with an increased incidence of failed transfusion. The inaccuracy of SotHb tended to be increased in patients receiving vasopressor agents. CONCLUSIONS:: Noninvasive determination of hemoglobin level based on occlusion spectroscopy lacks accuracy in patients presenting with severe gastrointestinal bleeding and cannot be considered equivalent to the capillary-based method. This inaccuracy seems to be moderately influenced by the infusion of vasopressor agents.
Authors:
Julien Coquin; Amandine Bertarrex; Antoine Dewitte; Laurent Lefèvre; Olivier Joannes-Boyau; Catherine Fleureau; Stéphane Winnock; Sébastien Leuillet; Gérard Janvier; Alexandre Ouattara
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-11
Journal Detail:
Title:  Anesthesiology     Volume:  -     ISSN:  1528-1175     ISO Abbreviation:  Anesthesiology     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1300217     Medline TA:  Anesthesiology     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
* Fellow in Anesthesiology, † Resident in Anesthesiology, Université de Bordeaux, Adaptation cardiovasculaire à l'ischémie, Pessac, France; CHU de Bordeaux, Service d'Anesthésie-Réanimation II, Bordeaux, France. ‡ Staff Anesthesiologist, CHU de Bordeaux, Service d'Anesthésie-Réanimation II, Bordeaux, France; § Senior Biostatistician, Biofortis, a Mérieux NutriSciences Company, Saint-Herblain, France. ‖ Professor of Anesthesiology, Université de Bordeaux, Adaptation cardiovasculaire à l'ischémie, Pessac, France; CHU de Bordeaux, Service d'Anesthésie-Réanimation II, Bordeaux, France. # Professor of Anesthesiology, Chairman, Université de Bordeaux, Adaptation cardiovasculaire à l'ischémie, Pessac, France; CHU de Bordeaux, Service d'Anesthésie-Réanimation II, Bordeaux, France. INSERM, Adaptation cardiovasculaire à l'ischémie, Pessac, France.
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