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The changes of non-invasive hemoglobin and perfusion index of Pulse CO-Oximetry during induction of general anesthesia.

Park SG, Lee OH, Park YH, Shin HY, Kang H, Baek CW, Jung YH, Woo YC - Korean J Anesthesiol (2015)

Bottom Line: Also, a Pearson correlation coefficient analysis was used to analyze the correlation between the Hbbias and the PI.The Pearson correlation coefficient between the Hbbias and the PI was not statistically significant.The correlation between Hbbias and PI was not significant.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology and Pain Medicine, Chung-Ang University College of Medicine, Seoul, Korea.

ABSTRACT

Background: We hypothesized that induction of general anesthesia using sevoflurane improves the accuracy of non-invasive hemoglobin (SpHb) measurement of Masimo Radical-7® Pulse CO-Oximetry by inducing peripheral vasodilation and increasing the perfusion index (PI). The aim of this study is to investigate the change in the SpHb and the PI measured by Rad7 during induction of general anesthesia using sevoflurane.

Methods: The laboratory hemoglobin (Hblab) was measured before surgery by venous blood sampling. The SpHb and the PI was measured twice; before and after the induction of general anesthesia using sevoflurane. The changes of SpHb, Hbbias (Hbbias = SpHb - Hblab), and PI before and after the induction of general anesthesia were analyzed using a paired t-test. Also, a Pearson correlation coefficient analysis was used to analyze the correlation between the Hbbias and the PI.

Results: The SpHb and the PI were increased after the induction of general anesthesia using sevoflurane. There was a statistically significant change in the Hbbias from -2.8 to -0.7 after the induction of general anesthesia. However, the limit of agreement (2 SD) of the Hbbias did not change after the induction of general anesthesia. The Pearson correlation coefficient between the Hbbias and the PI was not statistically significant.

Conclusions: During induction of general anesthesia using sevoflurane, the accuracy of SpHb measurement was improved and precision was not changed. The correlation between Hbbias and PI was not significant.

No MeSH data available.


Related in: MedlinePlus

Bland and Altman plot of SpHb and Hblab (A) before induction of general anesthesia using sevoflurane and (B) after induction of general anesthesia using sevoflurane. The horizontal plain lines correspond to the mean of Hbbias and dotted lines correspond to the limits of agreement (2 SD). Each point represents the Hbbias of a single patient.
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Figure 1: Bland and Altman plot of SpHb and Hblab (A) before induction of general anesthesia using sevoflurane and (B) after induction of general anesthesia using sevoflurane. The horizontal plain lines correspond to the mean of Hbbias and dotted lines correspond to the limits of agreement (2 SD). Each point represents the Hbbias of a single patient.

Mentions: A total of 26 patients were enrolled, and none of them was withdrawn from the study. The demographic data of the patients are presented in Table 1. The changes of hemodynamic and measurements in pulse CO-Oximetry before and after induction of general anesthesia are listed in Table 2. The mean value of pre-SpHb was 11.4 ± 1.3 g/dl and post-SpHb was 13.5 ± 1.5 g/dl (P < 0.001). The PI also increased significantly after the induction of general anesthesia using sevoflurane (P < 0.001). Before induction of general anesthesia, PI < 1.0 was obtained in 46.2% (12/26) of patients and there was only 1 patient whose PI was over 2.0. However, there was no patient with PI below 1.0 after general anesthesia was performed and the lowest PI value was 3.2. The Bland and Altman plot showed a statistically significant change in the mean of Hbbias from -2.8 ± 0.8 g/dl before the induction of general anesthesia to -0.7 ± 0.7 g/dl after the induction of general anesthesia using sevoflurane (P < 0.001). However, the limits of agreement (2 SD) of the Hbbias before the induction of general anesthesia did not change and remained at same level after induction of general anesthesia using sevoflurane (Fig. 1). The Pearson correlation coefficient analysis showed that the SpHb and the Hblab were significantly correlated both before and after the induction of general anesthesia (P < 0.001) (Table 3). The power of the SpHb to explain the Hblab result was r2 = 0.75 before the induction of general anesthesia, and was r2 = 0.78 after the induction of general anesthesia using sevoflurane (Fig. 2).


The changes of non-invasive hemoglobin and perfusion index of Pulse CO-Oximetry during induction of general anesthesia.

Park SG, Lee OH, Park YH, Shin HY, Kang H, Baek CW, Jung YH, Woo YC - Korean J Anesthesiol (2015)

Bland and Altman plot of SpHb and Hblab (A) before induction of general anesthesia using sevoflurane and (B) after induction of general anesthesia using sevoflurane. The horizontal plain lines correspond to the mean of Hbbias and dotted lines correspond to the limits of agreement (2 SD). Each point represents the Hbbias of a single patient.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4524933&req=5

Figure 1: Bland and Altman plot of SpHb and Hblab (A) before induction of general anesthesia using sevoflurane and (B) after induction of general anesthesia using sevoflurane. The horizontal plain lines correspond to the mean of Hbbias and dotted lines correspond to the limits of agreement (2 SD). Each point represents the Hbbias of a single patient.
Mentions: A total of 26 patients were enrolled, and none of them was withdrawn from the study. The demographic data of the patients are presented in Table 1. The changes of hemodynamic and measurements in pulse CO-Oximetry before and after induction of general anesthesia are listed in Table 2. The mean value of pre-SpHb was 11.4 ± 1.3 g/dl and post-SpHb was 13.5 ± 1.5 g/dl (P < 0.001). The PI also increased significantly after the induction of general anesthesia using sevoflurane (P < 0.001). Before induction of general anesthesia, PI < 1.0 was obtained in 46.2% (12/26) of patients and there was only 1 patient whose PI was over 2.0. However, there was no patient with PI below 1.0 after general anesthesia was performed and the lowest PI value was 3.2. The Bland and Altman plot showed a statistically significant change in the mean of Hbbias from -2.8 ± 0.8 g/dl before the induction of general anesthesia to -0.7 ± 0.7 g/dl after the induction of general anesthesia using sevoflurane (P < 0.001). However, the limits of agreement (2 SD) of the Hbbias before the induction of general anesthesia did not change and remained at same level after induction of general anesthesia using sevoflurane (Fig. 1). The Pearson correlation coefficient analysis showed that the SpHb and the Hblab were significantly correlated both before and after the induction of general anesthesia (P < 0.001) (Table 3). The power of the SpHb to explain the Hblab result was r2 = 0.75 before the induction of general anesthesia, and was r2 = 0.78 after the induction of general anesthesia using sevoflurane (Fig. 2).

Bottom Line: Also, a Pearson correlation coefficient analysis was used to analyze the correlation between the Hbbias and the PI.The Pearson correlation coefficient between the Hbbias and the PI was not statistically significant.The correlation between Hbbias and PI was not significant.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology and Pain Medicine, Chung-Ang University College of Medicine, Seoul, Korea.

ABSTRACT

Background: We hypothesized that induction of general anesthesia using sevoflurane improves the accuracy of non-invasive hemoglobin (SpHb) measurement of Masimo Radical-7® Pulse CO-Oximetry by inducing peripheral vasodilation and increasing the perfusion index (PI). The aim of this study is to investigate the change in the SpHb and the PI measured by Rad7 during induction of general anesthesia using sevoflurane.

Methods: The laboratory hemoglobin (Hblab) was measured before surgery by venous blood sampling. The SpHb and the PI was measured twice; before and after the induction of general anesthesia using sevoflurane. The changes of SpHb, Hbbias (Hbbias = SpHb - Hblab), and PI before and after the induction of general anesthesia were analyzed using a paired t-test. Also, a Pearson correlation coefficient analysis was used to analyze the correlation between the Hbbias and the PI.

Results: The SpHb and the PI were increased after the induction of general anesthesia using sevoflurane. There was a statistically significant change in the Hbbias from -2.8 to -0.7 after the induction of general anesthesia. However, the limit of agreement (2 SD) of the Hbbias did not change after the induction of general anesthesia. The Pearson correlation coefficient between the Hbbias and the PI was not statistically significant.

Conclusions: During induction of general anesthesia using sevoflurane, the accuracy of SpHb measurement was improved and precision was not changed. The correlation between Hbbias and PI was not significant.

No MeSH data available.


Related in: MedlinePlus