Transcutaneous Hemoglobin Screening in an Adult Orthopaedic Trauma Population
| Autor: | Emily Hu, Heather A. Vallier, Mary A. Breslin, Michael D Kavanagh, Alexander S Rascoe |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
medicine.medical_treatment Population Hemorrhage Fractures Bone Hemoglobins 03 medical and health sciences 0302 clinical medicine Humans Medicine Internal fixation Orthopedics and Sports Medicine Clinical significance Oximetry Prospective Studies education 030222 orthopedics education.field_of_study Venipuncture business.industry Trauma center 030208 emergency & critical care medicine General Medicine Orthopedics medicine.anatomical_structure Anesthesia Wounds and Injuries Surgery Hemoglobin Ankle business Blood drawing |
| Zdroj: | Journal of Orthopaedic Trauma. 34:e165-e169 |
| ISSN: | 0890-5339 |
| Popis: | OBJECTIVES To evaluate a noninvasive hemoglobin measurement device in an orthopaedic trauma population. DESIGN Prospective. SETTING Level 1 trauma center. PATIENTS/PARTICIPANTS One hundred five patients consecutively admitted to the orthopaedic trauma service after surgical treatment of fracture. INTERVENTION Transcutaneous hemoglobin (TcHgb) monitoring using the Masimo Pronto Pulse CO-Oximeter model with Rainbow SET Technology for spot TcHgb measurement. MAIN OUTCOME MEASUREMENTS TcHgb measurements and standard venipuncture hemoglobin (vHgb) were obtained. Patient preferences for each were recorded. RESULTS TcHgb measurements were obtained in 100 patients and compared with their corresponding vHgb measurements. The mean vHgb and TcHgb were 10.2 ± 1.9 g/dL and 11.2 ± 2.1 g/dL, respectively, and the mean difference was 1.1 ± 1.6 g/dL, which was statistically different from 0 (P < 0.001). In 76% of cases, the TcHgb device overestimated vHgb. In a subgroup of patients undergoing procedures with minimal expected blood loss (external fixators of knee or ankle, irrigation and debridement, or open reduction and internal fixation of ankle or calcaneal fractures), the mean difference between vHgb and TcHgb was 0.68 ± 1.6 g/dL (P = 0.06). CONCLUSIONS A preliminary study of TcHgb monitoring with the tested device as a potential screening mechanism to limit unnecessary blood draws showed statistical difference from vHgb; however, the mean bias 1.1 g/dL of hemoglobin was notably small. In a subgroup of patients undergoing procedures with minimal expected blood loss, the device may have merit. Larger studies are required to determine the clinical relevance of differences in measurements between the 2 methods. LEVEL OF EVIDENCE Diagnostic Level II. See Instructions for Authors for a complete description of levels of evidence. |
| Databáze: | OpenAIRE |
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