Comparative Study of Hemoglobin Values Measured by Continuous Non-invasive and Whole Blood Hemoglobin Monitors for Guiding Blood Transfusion in Major Oncosurgical Procedures

TL;DR

This study compares non-invasive and invasive hemoglobin monitoring devices during major cancer surgeries, finding similar results with the non-invasive option being safer.

Contribution

Demonstrates that non-invasive hemoglobin monitoring is as effective as invasive methods for guiding transfusions in oncological surgery.

Findings

Non-invasive and invasive hemoglobin measurements were not significantly different during surgery.

Blood transfusion requirements were comparable between the two monitoring methods.

Non-invasive monitoring avoids biohazard exposure without compromising accuracy.

Abstract

Background: Patients undergoing major oncological procedures are at risk of significant perioperative blood loss, leading to increased morbidity and mortality. Transfusions of blood products are associated with complications and adverse effects. Invasive (HemoCue® Hb 301 System (HemoCue AB, Angelholm, Sweden)) and continuous non-invasive (Masimo Radical-7 SpHb® (Masimo Corporation, CA, USA)) monitoring devices have been used as real-time hemoglobin monitors to guide blood transfusion.

Aim: Our study aims to compare the values of both devices for guiding blood transfusion in major abdominal oncosurgical procedures.

Methods: The study was conducted over 18 months on 32 patients scheduled for elective major abdominal oncological procedures. Patients were quasi-randomized for hemoglobin measurement into two groups. Group I (HemoCue® Hb 301 System) (n=16): Invasive values were obtained at baseline and intraoperatively (every 30 minutes). Group II (Masimo Radical-7 SpHb®) (n=16): Continuous non-invasive hemoglobin monitor. Both groups were compared for the measurement of hemoglobin. IBM SPSS Statistics for Windows, Version 21 (Released 2012; IBM Corp., Armonk, New York, United States) was used for statistical analysis.

Results: The mean hemoglobin of the Masimo Radical-7 SpHb® group and the HemoCue® Hb 301 System group during the intraoperative period was not significantly different between the two groups. The blood products transfused between the Masimo Radical-7 SpHb® and the HemoCue® Hb 301 System group were comparable (p=0.917).

Conclusion: Patients of the Masimo Radical-7 SpHb® (non-invasive) had comparable hemoglobin values to the HemoCue® Hb 301 System group (invasive) throughout the surgery. The units of packed red blood cells (PRBC) transfusions were comparable in both groups. The Masimo Radical-7 SpHb® group had the added benefit of being non-invasive with no biohazard exposure.