Noninvasive hemoglobin monitoring for maintaining hemoglobin concentration within the target range during major noncardiac surgery : A randomized controlled trial
Copyright © 2023 Elsevier Inc. All rights reserved..
STUDY OBJECTIVE: The effect of noninvasive CO-oximetry hemoglobin (SpHb) monitoring on the clinical outcomes of patients undergoing surgery remains unclear. This trial aimed to evaluate whether SpHb monitoring helps maintain hemoglobin levels within a predefined target range during major noncardiac surgeries with a potential risk of intraoperative hemorrhage.
DESIGN: A single-center, prospective, randomized controlled trial.
SETTING: University hospital.
PATIENTS: One hundred and thirty patients undergoing elective noncardiac surgery with a potential risk of hemorrhage.
INTERVENTIONS: Patients were randomly allocated to undergo either SpHb-guided management (SpHb group) or usual care (control group).
MEASUREMENTS: The primary outcome was the rate of deviation of the total hemoglobin concentration (determined from laboratory testing) from a pre-specified target range (8-14 g/dL). This was defined as the number of laboratory tests revealing such deviations divided by the total number of laboratory tests performed during the surgery.
MAIN RESULTS: The primary outcome occurred significantly less frequently in the SpHb group as compared to that in the control group (15/555 [2.7%]) vs. 68/598 [11.4%]; relative risk, 0.24; 95% confidence interval, 0.13-0.41; P < 0.001). Fewer point-of-care blood tests were performed in the SpHb group than in the control group (median [interquartile range], 2 [1-4] vs. 4 [2-5]; P < 0.001). There were no significant intergroup differences in the number of patients who received red blood cell transfusions during surgery (SpHb vs. control, 33.8% vs. 46.2%; P = 0.201). The incidence of unnecessary red blood cell preparation (>2 units) was lower in the SpHb group than in the control group (3.1% vs. 16.9%; P = 0.024).
CONCLUSIONS: Compared with routine care, SpHb-guided management resulted in significantly lower rates of hemoglobin deviation outside the target range intraoperatively in patients undergoing major noncardiac surgeries with a potential risk of hemorrhage.
CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov (identifier: NCT03816514).
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:93 |
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| Enthalten in: |
Journal of clinical anesthesia - 93(2024) vom: 30. März, Seite 111326 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Park, Sun-Kyung [VerfasserIn] |
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| Links: |
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| Themen: |
Blood loss |
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| Anmerkungen: |
Date Completed 15.01.2024 Date Revised 12.03.2024 published: Print-Electronic ClinicalTrials.gov: NCT03816514 Citation Status MEDLINE |
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| doi: |
10.1016/j.jclinane.2023.111326 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM364800992 |
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| 100 | 1 | |a Park, Sun-Kyung |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Noninvasive hemoglobin monitoring for maintaining hemoglobin concentration within the target range during major noncardiac surgery |b A randomized controlled trial |
| 264 | 1 | |c 2024 | |
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| 500 | |a Date Completed 15.01.2024 | ||
| 500 | |a Date Revised 12.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a ClinicalTrials.gov: NCT03816514 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 Elsevier Inc. All rights reserved. | ||
| 520 | |a STUDY OBJECTIVE: The effect of noninvasive CO-oximetry hemoglobin (SpHb) monitoring on the clinical outcomes of patients undergoing surgery remains unclear. This trial aimed to evaluate whether SpHb monitoring helps maintain hemoglobin levels within a predefined target range during major noncardiac surgeries with a potential risk of intraoperative hemorrhage | ||
| 520 | |a DESIGN: A single-center, prospective, randomized controlled trial | ||
| 520 | |a SETTING: University hospital | ||
| 520 | |a PATIENTS: One hundred and thirty patients undergoing elective noncardiac surgery with a potential risk of hemorrhage | ||
| 520 | |a INTERVENTIONS: Patients were randomly allocated to undergo either SpHb-guided management (SpHb group) or usual care (control group) | ||
| 520 | |a MEASUREMENTS: The primary outcome was the rate of deviation of the total hemoglobin concentration (determined from laboratory testing) from a pre-specified target range (8-14 g/dL). This was defined as the number of laboratory tests revealing such deviations divided by the total number of laboratory tests performed during the surgery | ||
| 520 | |a MAIN RESULTS: The primary outcome occurred significantly less frequently in the SpHb group as compared to that in the control group (15/555 [2.7%]) vs. 68/598 [11.4%]; relative risk, 0.24; 95% confidence interval, 0.13-0.41; P < 0.001). Fewer point-of-care blood tests were performed in the SpHb group than in the control group (median [interquartile range], 2 [1-4] vs. 4 [2-5]; P < 0.001). There were no significant intergroup differences in the number of patients who received red blood cell transfusions during surgery (SpHb vs. control, 33.8% vs. 46.2%; P = 0.201). The incidence of unnecessary red blood cell preparation (>2 units) was lower in the SpHb group than in the control group (3.1% vs. 16.9%; P = 0.024) | ||
| 520 | |a CONCLUSIONS: Compared with routine care, SpHb-guided management resulted in significantly lower rates of hemoglobin deviation outside the target range intraoperatively in patients undergoing major noncardiac surgeries with a potential risk of hemorrhage | ||
| 520 | |a CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov (identifier: NCT03816514) | ||
| 650 | 4 | |a Randomized Controlled Trial | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Blood loss | |
| 650 | 4 | |a Blood transfusion | |
| 650 | 4 | |a Hemoglobins | |
| 650 | 4 | |a Noncardiac surgery | |
| 650 | 4 | |a Noninvasive hemoglobin monitoring | |
| 650 | 4 | |a Surgical | |
| 650 | 7 | |a Hemoglobins |2 NLM | |
| 700 | 1 | |a Hur, Chahnmee |e verfasserin |4 aut | |
| 700 | 1 | |a Kim, Young-Won |e verfasserin |4 aut | |
| 700 | 1 | |a Yoo, Seokha |e verfasserin |4 aut | |
| 700 | 1 | |a Lim, Young-Jin |e verfasserin |4 aut | |
| 700 | 1 | |a Kim, Jin-Tae |e verfasserin |4 aut | |
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