Clinical Application Of Non-invasive Continuous Hemoglobin Monitoring In Total Hip Replacement Arthroplasty

Objective:Applying Masimo Radical7(SPHb) in total hip replacementarthroplasty to monitor hemoglobin(Hb) continually, collecting blood gasanalyzing results (tHb) at specific time points. To analyze the correlationand consistency between SPHb and tHb, to assess the accuracy of SPHbin hemoglobin test during selective total hip replacement arthroplasty, andto discuss SPHb’s application value and superiority in blood conservationduring selective total hip replacement arthroplasty, and make a simpleanalysis for influencing factors of Masimo Radical7in measurement ofhemoglobin.Methods:According to the purpose of the research, the inclusion andexclusion criteria were formulated, and40eligible patients were selected.ASA I～Ⅲ, aged42～92, weighing46～80kg, undergoing selective totalhip replacement arthroplasty. Blood samples were taken in several timepoints for blood gas analysis:(1) after anesthesia before operation,(2)after infusion of1000ml fluid and another more1000ml,(3) when lost 500ml blood and another more500ml,(4)10min after transfusion of2unit red blood cell. At each time point, results of tHb by blood gasanalyzer were recorded，and the readings of the pulse hemoglobin (SPHb)as well. We compared SPHb and tHb with SPSS20.0to access thecorrelation and consistency of them.Results:We collected40patients including166groups of data,(1) t-test ofmatched data: the measuration results of tHb and SPHb were（105.73±10.899）g/L,（106.34±8.293）g/L, n=166. Using t-test of pairedmean test (t=1.707, P=0.09>0.05), there was no statistical significance asα=0.05. We thought that SPHb and tHb had no significant statistics inmeasuring Hb.(2) The comparision of Pearson’s relativity between twomethods: The correlation coefficient was r=0.919and we thought that therelativity of two measurements was good and they were highly relative.(3) Linear regression: We used tHb in blood gas analysis as anindependent variable X and SPHb as a dependent variable Y, using thelinear correlation equation Y=32.442+0.699X.(3) We used MedCalcsoftware to analyze two measurements for Bland-Altman consistency:Average bias of SPHb-tHb is0.6g/L. The limits of consistency is (-8.5～9.7)g/L. There were no spot beyond the limits of consistency.Conclusion:Compared with traditional methods, Masimo Radical7provides good accuracy to guide volume therapy and blood transfusion in total hipreplacement arthroplasty. In addition, It brings bigger advantage inperioperative blood reservation for its displaying trend of hemoglobin,Which can make a contribution to more efficient transfusion decision,more economic blood use and less complications of blood transfusion.