Intra-operative Monitoring of Blood Loss

University Medical Center Groningen30 enrolled

Overview

Certain types of surgery are associated with occult blood loss, which is hard to detect intraoperatively by intermittent conventional, invasive Hb concentration measurements using the clinical standard of Hb monitoring by satellite laboratory analysis (Hbsatlab). The investigators want to see whether continuous non-invasive transcutaneous Hb measurement using a finger sensor (SpHb), (a) reduces the total time (area under the curve, AUC) a patient's Hb is below a predetermined transfusion threshold (HbAUC) for administration of red blood cell concentrate (RBC), and (b) prevents a decrease in total oxygen delivery (DO2) possibly associated with transfusion below a critical haemoglobin concentration. Furthermore, the investigators want to study if SpHb monitoring changes the timing of RBC administration and reduces the need for intra- and post-operative RBC transfusion.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Undetected Intraoperative Blood Loss

Interventions

blood transfusion, intermittent Hbsatlab measurementPROCEDURE

In the Hbsatlab group, RBC administration and its timing will be based on intermittent Hbsatlab measurement (routine care)

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patients at the age of 18 years or older, planned for elective surgery at-risk for undetected blood loss. * American Society of Anesthesiologists (ASA) classification I, II, III, IV Exclusion Criteria: * Patient refusal * Emergency surgery

Outcomes

Primary Outcomes

HbAUC

the total time a patient's Hb is below a predetermined transfusion threshold (HbAUC) for administration of red blood cell concentrate

Time frame: during operation

Secondary Outcomes

blood transfusions

the number of perioperative blood transfusions

Time frame: intra- and post operative up to 48h