J Korean Med Sci.  2008 Aug;23(4):674-677. 10.3346/jkms.2008.23.4.674.

Prediction of Plasma Hemoglobin Concentration by Near-Infrared Spectroscopy

• Lee Y
• Lee S
• In J
• Chung SH
• Yon JH

• KMID: 1785828
• DOI: http://doi.org/10.3346/jkms.2008.23.4.674

Abstract

The estimation of plasma hemoglobin concentration (Hb) is among one of the daily activities in the practice of clinical anesthesiology. The near-infrared spectroscopy of the brain (rSO2) represents a balance between cerebral oxygen delivery and consumption. This study was designed to assess the value of rSO2 in the prediction of the Hb level while other variables were mathematically controlled. Thirty healthy adult patients undergoing spine surgery, expected to have a moderate degree of intraoperative bleeding, were enrolled in this study. General anesthesia was given and ventilation was mechanically controlled. Measurement of Hb and PaCO2 were performed at random periods of time. We obtained a total of 97 data combinations for the 30 study patients. The Hb was regressed by independent variables including rSO2 and PaCO2. A multilinear regression analysis was performed and the final regression equation was expressed only with statistically significant variables. The measured Hb was tightly regressed with three variables. The final regression equation was Hb=+8.580+0.238.rSO2-0.338.PaCO2-0.004.anesthetic exposure duration (Tmin) (p=0.000, r(2)=0.809). Near-infrared spectroscopy was shown to be a valuable predictor of plasma Hb in the clinical anesthesiology setting.

Keyword

Spectroscopy, Near-Infrared; Hemoglobins; Noninvasive Monitoring

MeSH Terms

Adult
Aged
Brain/metabolism
Cerebrovascular Circulation
Female
Hemoglobins/*analysis
Humans
Male
Middle Aged
Oximetry
Oxygen/metabolism
Spectroscopy, Near-Infrared/*methods

Figure

• 

  Fig. 1 Multilinear regression analysis of Hb by rSO2 and PaCO2. Regression equation was Hb=+8.332+0.238 · rSO2-0.338 · PaCO2 (p=0.000, r2=0.809). Changes of rSO2 and PaCO2 reflected the changes of Hb.

• 

  Fig. 2 Standardized residuals vs. Hb before (triangle-up symbols and dotted line) and after (round symbols and straight line) lowess technique. A window is placed about χ (Hb); data points that lie inside the window are weighted so that nearby points get the weight and a robust weighted regression is to predict y value at χ. The parameter, controlling the window's size, is set at 0.2.

• 

  Fig. 3 Scatter plot of standardized residuals (predicted Hb-Hb) and Hb before (a) and after (b) lowess techniques. Lowess'ed data points were fitted linearly more successfully, which revealed the existence of hemoglobin dependence of prediction of Hb by rSO2. Predicted Hb tends to underestimate Hb at higher Hb, while overestimate Hb at lower Hb.

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