Abstract
Introduction: Patients undergoing major oncological surgery may suffer from severe bleeding. Sometimes, it is difficult to anesthesiologist to take decision about timing of administration blood products to such patients. The aim of this study is to evaluate the use of continuous noninvasive hemoglobin monitoring as a guide for blood transfusion practice. Methods: One hundred patients undergoing elective abdominal cancer surgeries were randomly allocated into two groups, Group I (n = 50): laboratory Hb was obtained at baseline (immediate preoperative), intraoperative (when to suggest transfusion triggering value) and immediate postoperative. Group II (n = 50): The probe of Masimo for SpHb monitoring was applied immediately after induction of anesthesia at the index finger. Laboratory Hb was obtained at baseline (immediate preoperative), intraoperative (when to suggest transfusion triggering value) and immediate postoperative. Results: A number of transfused units of RBC were significantly lower in SpHb group than in control group (p value 0.05). Conclusion: SpHb monitoring had clinically acceptable absolute and trend accuracy. SpHb monitoring altered transfusion decision making and resulted in decreased RBC utilization and decreased RBC costs while facilitating earlier transfusions when indicated.
Highlights
IntroductionIt is difficult to anesthesiologist to take decision about timing of administration blood products to such patients
Patients undergoing major oncological surgery may suffer from severe bleeding
The aim of this study is to evaluate the use of continuous noninvasive intraoperative hemoglobin monitoring using Masimo Radical-7TM Pulse CO-Oximeter during elective abdominal cancer surgeries as a guide for blood transfusion practice
Summary
It is difficult to anesthesiologist to take decision about timing of administration blood products to such patients. Methods: One hundred patients undergoing elective abdominal cancer surgeries were randomly allocated into two groups, Group I (n = 50): laboratory Hb was obtained at baseline (immediate preoperative), intraoperative (when to suggest transfusion triggering value) and immediate postoperative. SpHb monitoring altered transfusion decision making and resulted in decreased RBC utilization and decreased RBC costs while facilitating earlier transfusions when indicated. It is difficult to anesthesiologist to take decision about timing of administration blood products to patients undergoing cancer surgery, especially there are no clear indications or consensus guidelines exist. Laboratory hemoglobin (Hb) is the primary indicator of the need for blood transfusion [5] It is only intermittently available and results can be delayed. A reliable, real-time monitor is needed to guide blood and fluid resuscitation [7]
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