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Impact of Increased End-Tidal Carbon Dioxide on Continuous Noninvasive Hemoglobin Monitoring during Laparoscopic Gastrectomy: A Randomized Controlled Study

Authors
 Ha-Yeon Kim  ;  Jong-Bum Choi  ;  Sang-Uk Han  ;  Hye-Sun Lee  ;  Kyuhyeok Lee  ;  Ji-Eun Kim 
Citation
 JOURNAL OF PERSONALIZED MEDICINE, Vol.12(2) : 160, 2022-01 
Journal Title
JOURNAL OF PERSONALIZED MEDICINE
Issue Date
2022-01
Keywords
hemoglobins ; hypercapnia ; laparoscopy ; oximetry ; transcutaneous blood gas monitoring
Abstract
The pulse CO-Oximetry allows continuous, noninvasive monitoring of hemoglobin (SpHb). We assessed the impact of increased end-tidal carbon dioxide (EtCO2) on the accuracy and trending ability of SpHb in laparoscopic surgery. Participants (n = 64) were randomly allocated to the low carbon dioxide (CO2) group (EtCO2: 30-35 mmHg) or the high CO2 group (EtCO2: 40-45 mmHg). The SpHb and laboratory hemoglobin (tHb) were obtained during surgery. The correlation coefficient (r) between SpHb and tHb showed greater tendency in the low CO2 group (r = 0.68) than in the high CO2 group (r = 0.43). The bias (precision) was -1.18 (1.09) with a limit of agreement (LOA) of -3.31 to 0.95 in low CO2 group and -1.02 (1.24) with a LOA of -3.45 to 1.42 in high CO2 group; they did not differ significantly between the groups (p = 0.246). The low CO2 group showed a high concordance rate of 95.9% and a moderate correlation between ΔSpHb and ΔtHb (r = 0.53). However, the high CO2 group showed a concordance rate of 77.8% and no correlation between ΔSpHb and ΔtHb (r = 0.11). In conclusion, increased EtCO2 significantly reduced the trending ability of SpHb during laparoscopic surgery. Caution should be executed when interpreting SpHb values during laparoscopic surgery in patients with hypercapnia.
Files in This Item:
T202300687.pdf Download
DOI
10.3390/jpm12020160
Appears in Collections:
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
Lee, Hye Sun(이혜선) ORCID logo https://orcid.org/0000-0001-6328-6948
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/193152
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