Application Of Non-invasive Hemoglobin Monitoring In Emergency Department Patients

Background:The detection of hemoglobin values is one of the routine inspection items in medical examination,which has important clinical value for anemia diagnosis,disease evaluation,therapeutic guidance,and treatment assessment.Currently,hemoglobin values can be determined invasively by analyzing blood via laboratory automatic hematology analyzer,and the measurement result is accurate and reliable.In addition,the laboratory testing is considered the gold standard method for detecting hemoglobin values in clinical practice.However,the laboratory detection of hemoglobin values has several major disadvantages,such as traumatic,time consuming and intermittent.In recent years,with the rapid development of near infrared spectroscopy(NIR)analysis technique,the non-invasive hemoglobin monitor has been developed and gradually applied in clinical practice.The instrument is not only convenient for clinical use,but also can monitor the hemoglobin values and its changing trends with non-invasive,immediate,continuous and dynamic,which has a broad application prospect in the field of medical examination.As a new technique for measuring hemoglobin values,non-invasive hemoglobin monitoring(SpHb)is of great concern for measuring accuracy in clinical practice.Objective:The aims of the present study are to explore the accuracy of non-invasive hemoglobin monitoring in emergency department patients and related influencing factors,in order to evaluate the clinical value for the application of non-invasive hemoglobin monitoring.Methods:1?Three hundred adult emergency department patients with stable disease were enrolled in this study.Non-invasive continuous hemoglobin concentration(SpHb)was monitored by non-invasive pulse CO-Oximetry NT1G.And then the venous blood samples were collected and true hemoglobin level(tHb)was measured by Sysmex XE-5000 automatic hematology analyzer.The data of SpHb and tHb were compared and analyzed using SPSS 22.0 and MedCalc.2.Thirty-eight adult patients suffering from severe bleeding were enrolled in this study.SpHb was monitored continually by non-invasive pulse CO-Oximetry NT1G and recorded 5 minutes after intravenous line placement,30 minutes after red blood cells transfusion,and 4 hours after red blood cells transfusion.The venous blood samples were collected and tHb was measured by Sysmex XE-5000 automatic hematology analyzer at above mentioned time points.The data of SpHb and tHb were compared and analyzed using SPSS 22.0 and MedCalc.Results:1?In the emergency department patients with stable disease,there was a significant correlation between SpHb and tHb,but the consistency among the different methods was poor and the difference was significant.SpHb consistently underestimated the patient's true hemoglobin level.The accuracy of SpHb needed to be further improved.In addition,SpHb was susceptible to a variety of factors.The accuracy of SpHb decreased with increasing tHb,and increased with the increasing PI.For patients with normal hemoglobin and mild anemia,SpHb could provide reference basis for clinical decision-making in blood transfusion.2?In the acute hemorrhagic patients with marked hemodynamic instability,there was a significant correlation and a good consistency between SpHb and tHb.There was little difference among the different methods.SpHb was an accurate method to monitor the true hemoglobin level.For patients with moderate and severe anemia,SpHb also could provide reference basis for clinical decision-making in blood transfusion.Conclusion:A variety of clinical and nonclinical variables have an impact on the accuracy of non-invasive hemoglobin monitoring,and there is a significant difference in the accuracy of measurement in different emergency department patients.The accuracy of SpHb needs to be further improved.Currently,SpHb is not yet an acceptable substitute for laboratory hemoglobin measurements.However,SpHb can reflect the true hemoglobin level and its changing trends to some extent.SpHb can be used for dynamically monitoring the development of disease and evaluating the efficacy of treatment,which can be used as the guiding basis for the management of blood transfusion,especially for the treatment of critical patients.In overall,SpHb should be applied extensively in the emergency department.