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Andrew B. Kairalla MD, Editor
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Transcutaneous Hemoglobin
Rabe H, Stupp N, Özgün, M, et al. Measurement of Transcutaneous Hemoglobin Concentration by Noninvasive White-Light Spectroscopy in Infants. PEDIATRICS (Oct 2005);116: 841-843.
Objective. To compare transcutaneously spectroscopically measured hemoglobin values with venous hemoglobin values in infants.
Study Design. Prospective study in healthy preterm and term infants who were breathing spontaneously.
Results. Recordings were obtained from 85 stable infants (median gestational age at measurement: 36 weeks [range: 34–43 weeks]; median body weight: 1890 g [range: 1095–4360 g]). The spectroscopic hemoglobin values were corrected for inhomogeneous distribution of hemoglobin in the tissue. The venous and spectroscopic hemoglobin values were then compared by using the Bland-Altman method, which gave an error of <5%.
Conclusions. This pilot study could illustrate a good relation between the 2 methods for measuring hemoglobin. Larger studies are required to validate the spectroscopic method in those with conditions that affect the skin microcirculation (e.g., septicemia).
Comments: In theory, the ability to measure hemoglobin (or any other lab) transcutaneously sounds like a good idea. However, I’m not convinced that this test will ever find its way into clinical practice. First of all, hemoglobin is not a measure that usually requires continuous or frequent monitoring. Secondly, we are already getting rapid hemoglobin results from most of our blood gas machines and point-of-care testing devices using minimal blood. Thirdly, I seriously doubt that the transcutaneous measurement of hemoglobin will be accurate in the setting of peripheral vasoconstriction from any cause (hypothermia, hypovolemia, shock, etc). I was amazed at how the transcutaneous measurement of oxygen saturation revolutionized the practice of neonatology. Unfortunately, I don’t think that the TC Hemoglobin measurement will have a similar impact. ABK
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