Comparison of noninvasive hemoglobin values and complete bloodhemoglobin values in hemorrhagic patients

Comparison of Noninvasive Hemoglobin Values and Complete Blood Hemoglobin Values in Hemorrhagic Patients Introduction and Objective: This study aims to compare the bedside Radical-97TM Pulse CO-Oximeter® (Masimo Corp, Irvine, CA, USA) (noninvasive) hemoglobin measurements and hemogram (invasive) hemoglobin data obtained simultaneously in patients, who have 500 cc of bleeding prediction, undergoing elective or emergency surgery at the Dicle University Hospital operating room, in terms of predicting the safety of the noninvasive method. Materials and Methods: This study included 20 patients in the 18-65 age group, who underwent elective or emergency surgery and have more than 500 cc predicted bleeding. Informed consent from the patients and patient relatives were obtained to conduct the study. All patients were monitored during anesthesia. Arterial monitoring was performed when necessary. Bedside noninvasive serial hemoglobin (Hb) measurements of the patients included in the study were made using the finger sensor probe of Radical-97TM Pulse CO-Oximeter® (Masimo Corp, Irvine, CA, USA), which perform measurements through a spectrophotometric method, from the fourth fingertip of the non-dominant hand. Results: There was a positive correlation between the invasive Hb values at the beginning of the operation, during the bleeding, at the end of the operation and the noninvasive Hb values measured at the beginning of the operation, during the bleeding, and at the end of the operation. In the first measurements, a positive and significant correlation was found between invasive basal Hb values and noninvasive Hb values (r=0.951, p<0.001). In the second measurements, correlation between the invasive Hb values and noninvasive Hb values at the time of bleeding was found to be positive and significant (r=0.921, p<0.001). In the third measurements, the correlation between invasive Hb values and noninvasive Hb values at the end of operation was found to be positive and significant (r = 0.930, p<0.001). Conclusion: It is beneficial to use Pulse CO-Oximeter since it is easy to carry, noninvasive, able to perform continuous measurement, enables appropriate management of the bleeding to be performed prior to conventional laboratory Hb measurements, enables early detection of intensive transfusion need, potentially reduces early morbidity and mortality when combined with surgical and non-surgical methods of aggressive treatment of hemorrhage, limits blood transfusion to only those patients who are truly needed since increased blood transfusion may be related to morbidity and mortality, reduces costs in this regard, and decreases repeated need of blood samples, which may contribute to progressive anemia in the patients in the intensive care unit (ICU). Keywords: Hemorrhage, Noninvasive Hemoglobin, Rad-97.