Abstract
BackgroundPatients undergoing complex spine surgery present with multilevel spinal involvement, advanced age, and multiple comorbidities. Surgery is associated with significant blood loss and remarkable hemodynamic changes. The present study aimed to investigate the accuracy and trending ability of a non-invasive continuous method to monitor hemoglobin (SpHb) concentrations using a Radical-7™ Pulse CO-Oximeter in complex spine surgery.MethodsForty-nine patients who underwent complex spine surgery were enrolled in this prospective observational study. Multiple time points were established for data collection throughout the operation. Simultaneous SpHb–total hemoglobin (tHb) paired data were recorded for analyses. Linear regression analysis, Bland–Altman plot, four-quadrant plot, and Critchley polar plot were used to assess the accuracy and trending ability of the monitor.ResultsA total of 272 pairs of SpHb-tHb data were available and were divided into two groups based on the perfusion index (PI): PI values ≥1.0 (n = 200) and PI values < 1.0 (n = 72). The correction coefficients (r) between SpHb and tHb were 0.6946 and 0.6861 in the groups with PI values ≥1.0 and < 1.0, respectively (P < 0000.1). In the ≥1.0 group, the mean bias was − 0.21 g/dL and the percentage error (PE) was 15.85%, whereas in the < 1.0 group, the mean bias was − 0.04 g/dL and the PE was 17.42%. Four-quadrant plot revealed a concordance rate of 85.11%, whereas the Critchley polar plot showed a concordance rate of 67.21%.ConclusionsThe present study demonstrates the acceptable accuracy of the Radical-7™ Pulse CO-Oximeter even with a low PI. However, the trending ability was limited and unsatisfactory.
Highlights
Patients undergoing complex spine surgery present with multilevel spinal involvement, advanced age, and multiple comorbidities
Ehrenfeld et al have reported that the Noninvasive and continuous hemoglobin concentration (SpHb)-guided blood management in various orthopedic surgeries was associated with a 4% absolute reduction in the risk of blood transfusion compared with the standard care without the monitoring of SpHb values
Of the 50 patients initially enrolled in the study, one was excluded due to failure of the arterial line during the surgery, resulting in a total of 49 patients who were included in the final analysis
Summary
Patients undergoing complex spine surgery present with multilevel spinal involvement, advanced age, and multiple comorbidities. The present study aimed to investigate the accuracy and trending ability of a non-invasive continuous method to monitor hemoglobin (SpHb) concentrations using a Radical-7TM Pulse CO-Oximeter in complex spine surgery. The Masimo Radical-7TM Pulse CO-Oximeter (Masimo Corporation, Irvine, USA) is a commercially available device to monitor hemoglobin concentration, providing a real-time, continuous, non-invasive measurement during various major surgeries and in critical populations under intensive care. Complex spine surgery procedures have increasingly been performed over the past few decades [6, 7], with a reported complication rate of 7% [8] The population undergoing these types of complex procedures characteristically present with multilevel spinal involvement, advanced age, and multiple comorbidities [8,9,10]. The present study aimed to validate the accuracy and trending ability of SpHb measured using Radical-7TM Pulse CO-Oximeter during major spine surgeries
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
