Total Hemoglobin (SpHb®)

Limitations of Traditional Methods Alone

Limitations of Traditional Methods Alone

 

Without SpHb, clinicians are often limited to invasive blood samples, which provide intermittent and delayed laboratory hemoglobin results

Masimo - sphb conventional

Value of SpHb Monitoring

Value of SpHb Monitoring

 

SpHb can be used in conjunction with traditional laboratory methods to obtain real-time visibility to changes, or lack of changes, in hemoglobin between invasive blood samples

masimo_value_of_sphb_graph

SpHb trend monitoring may provide additional insight between invasive blood samples when:

  • The SpHb trend is stable and the clinician may otherwise think hemoglobin is dropping.
  • The SpHb trend is rising and the clinician may otherwise think hemoglobin is not rising fast enough.
  • The SpHb trend is dropping and the clinician may otherwise think hemoglobin is stable.

Clinical Case

Clinical Case

 
Masimo - SpHb - Clinical Case Graph

SpHb was retrospectively obtained for the surgical case shown to the left, in which clinicians could not assess the hemoglobin trend between invasive blood samples during the procedure.1

SpHb Utility

SpHb Utility

 

Studies have shown that SpHb may help clinicians reduce blood transfusions in both low- and high-blood-loss surgeries.2,3

A randomized trial of 327 patients undergoing elective orthopedic surgery, conducted at Massachusetts General Hospital (MGH), found that the use of continuous, noninvasive hemoglobin monitoring reduced the rate of transfusions when compared to standard care without continuous, noninvasive hemoglobin monitoring.2

% of Patients Receiving RBC Transfusion2

Masimo - % of Patients Receiving RBC Transfusion

A prospective cohort study of 106 neurosurgical patients found that adding SpHb monitoring to standard-of-care blood management resulted in decreased blood utilization in high-blood-loss neurosurgery, while also facilitating earlier transfusions.3*

Average Units Transfused Per Patient3

Masimo - Average Units Transfused Per Patient

Clinical decisions regarding red blood cell transfusions should be based on the clinician’s judgment considering among other factors: patient condition, continuous SpHb monitoring, and laboratory diagnostic tests using blood samples.

* Study Protocol: The transfusion threshold of 10g/dL was predetermined by the study protocol and may not be appropriate for all patients. The blood sampling technique was the same for patients in both the control and the test group. Arterial blood was drawn from a 20 gauge radial artery cannula into 2mL ethylenediaminetetraacetic acid collection tubes, thoroughly mixed then sent immediately to the central lab for analysis by a hematology analyzer. The reference laboratory device used for hemoglobin measurements in the study was a Coulter GEN-S Hematology Analyzer.

Case Example: SpHb Alongside PVi®

Case Example: SpHb Alongside PVi®

 

Provided alongside SpHb on rainbow® Pulse CO-Oximetry sensors, Pleth Variability Index (PVi) provides a continuous noninvasive measure of the relative variability in the photoplethysmograph (pleth) during respiratory cycles that may be used as a dynamic indicator of fluid responsiveness in select populations of mechanically ventilated adult patients.4 The following hepatic surgery case depicts the effect of dilution on total hemoglobin upon the infusion of 2.5L of crystalloid.5

Masimo - PVi Alongside SpHb Graph

PVi and SpHb Support Clinicians in Improving Patient Outcomes

PVi and SpHb Support Clinicians in Improving Patient Outcomes

 
Masimo - Limoges Study Outcomes infographic arrows down

A single-center quality initiative involving 18,716 patients in the OR, ICU, and PACU was implemented in Limoges, France. The study used a Goal-directed Therapy (GDT) protocol with PVi in conjunction with a blood transfusion protocol based on SpHb. Results demonstrated that monitoring with SpHb and PVi integrated in a vascular filling algorithm was associated with earlier transfusion and reduced 30- and 90-day mortality by 33% and 29%, respectively, on a whole hospital scale.6

SpHb Monitoring Across the Continuum of Care

SpHb Monitoring Across the Continuum of Care

 

Monitoring hemoglobin continuously and noninvasively through different care areas

Masimo - SpHb - Continuum of Care
Masimo - SpHb - Continuum of Care
Masimo - SpHb - Continuum of Care
Masimo - SpHb - rainbow SET Technology Platform

Upgradable rainbow SET® Technology Platform

 

Masimo rainbow SET is a noninvasive monitoring platform featuring Masimo SET® Measure-through Motion and Low Perfusion™ pulse oximetry with the option to measure multiple additional parameters.

Learn More About Masimo SpHb®

Learn More About Masimo SpHb®

 

Improving Outcomes with SpHb

References:

  1. 1.

    Peiris P. et al. Proceeding for the Society for the Advancement of Blood Medicine 2010 Annual Meeting. Abs 4091.

  2. 2.

    Ehrenfeld et al. J Blood Disorders Transf. 2014. 5:9.

  3. 3.

    Awada WN et al. J Clin Monit Comput. DOI 10.1007/s10877-015-9660-4.

  4. 4.

    Cannesson et al. J Cardiothorac Vas Anes. 2010.

  5. 5.

    Perel. Critical Care. 2017;21:291.

  6. 6.

    Cros et al. J Clin Monit Comput. Aug 2019:1-9. Study utilized a goal-directed fluid therapy protocol with PVi® in conjunction with a blood transfusion protocol based on SpHb.

RESOURCES

 
Masimo - Thumbnail of Video, Breakthrough Technology. Breakthrough Outcomes

Video

Masimo - Thumbnail of Video, Improve Outcomes with Continuous Total Hemoglobin (SpHb®)

Video

Masimo - Link to webpage thumbnail

Follow the link for available PVi studies.

Masimo - Thumbnail of SpHb Studies

Follow the link for available SpHb studies.

Masimo - Thumbnail of  Noninvasive and Continuous SpHb
Follow the link to receive more information about Noninvasive and Continuous SpHb.
Masimo - Noninvasive and Continuous Hemoglobin (SpHb) Monitoring
Brochure
Masimo - Noninvasive and Continuous Hemoglobin Whitepaper
Whitepaper
Masimo - Brochure Perioperative Care Solutions
Brochure
Masimo - Product Information, RD rainbow Sensors

Product Information

Masimo - Thumbnail of SpHb Rev O

Product Information

Masimo - Brochure Perioperative Care Solutions
Brochure

Clinical decisions regarding red blood cell transfusions should be based on the clinician’s judgment considering among other factors: patient condition, continuous SpHb monitoring, and laboratory diagnostic tests using blood samples. SpHb monitoring is not intended to replace laboratory blood testing.

The accuracy of PVi in predicting fluid responsiveness is variable and influenced by numerous patient, procedure, and device-related factors. PVi measures the variation in the plethysmography amplitude but does not provide measurements of stroke volume or cardiac output. Fluid management decisions should be based on a complete assessment of the patient’s condition and should not be based solely on PVi.

Caution: Federal (USA) law restricts this device to sale by or on the order of a physician. See instructions for use for full prescribing information, including indications, contraindications, warnings, and precautions.