Hemorrhage Clinical Trial
Official title:
Non-Invasive Hemoglobin Monitoring in the Patient With Suspected Hemorrhage
This study will evaluate the accuracy of two rapid methods of measuring hemoglobin in patients with suspected hemorrhage. These methods will be compared with standard laboratory measurements.
Anemia and bleeding are major causes of morbidity and mortality in both surgical and
nonsurgical patients. The current standard of care for monitoring patients at risk for
bleeding is serial measurement of hemoglobin levels. At present, the photometric
cyanmethemoglobin method is the most widely used technique for monitoring hemoglobin in the
lab, and is currently the gold standard. However, this method has potential for delay before
final results are obtained.
Immediate hemoglobin measurements are available with portable point-of-care devices such as
the iSTAT, which can produce a measurement of hemoglobin concentration in less than 1
minute. Unfortunately, the accuracy of this device has been reported to vary with hemoglobin
level, and as such may not be as accurate in detecting blood loss when compared with the
gold standard of laboratory analysis.
Recently, a noninvasive, spectrophotometry-based monitoring technology has been developed.
This novel technology measures the differential optical density of wavelengths of light
passed through the finger in a method similar to conventional pulse oximetry. While some
studies have reported that this device appears to be accurate in patients undergoing
elective surgical procedures, more recent work suggests that this accuracy degrades with
increased blood loss, lower oximeter signal quality and lower absolute Hgb values.
We will evaluate the accuracy of point-of-care and non-invasive SpHb measurements and
utility of continuous hemoglobin monitoring in an intensive care unit setting. If these
methods of rapid hemoglobin measurement can be validated in patients at risk for ongoing
hemorrhage, use of this technology may result in earlier detection of ongoing hemorrhage,
expedite appropriate treatment, and improve patient outcomes.
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Observational Model: Cohort, Time Perspective: Prospective
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