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Time required for blood sampling and analysis may cause Hb measurement to lag clinical conditions, thus continuous intraoperative Hb trend monitoring may provide useful information. This multicenter study was designed to compare three methods of determining intraoperative Hb changes (trend accuracy) to laboratory determined Hb changes. Adult surgical patients with planned arterial catheterization were studied. With each blood gas analysis performed, pulse cooximetry hemoglobin (SpHb) was recorded, and arterial blood Hb was measured by hematology (tHb), arterial blood gas cooximetry (ABGHb), and point of care (aHQHb) analyzers. Hb change was calculated and trend accuracy assessed by modified Bland\u2013Altman analysis. Secondary measures included Hb measurement change direction agreement. Trend accuracy mean bias (95% limits of agreement; g\/dl) for SpHb was 0.10 (\u2212\u20091.14 to 1.35); for ABGHb was \u2212\u20090.02 (\u2212\u20091.06 to 1.02); and for aHQHb was 0.003 (\u2212\u20090.95 to 0.95). Changes more than\u2009\u00b1\u20090.5\u00a0g\/dl agreed with tHb changes more than\u2009\u00b1\u20090.25\u00a0g\/dl in 94.2% (88.9\u201397.0%) SpHb changes, 98.9% (96.1\u201399.7%) ABGHb changes and 99.0% (96.4\u201399.7%) aHQHb changes. Sequential changes in SpHb, ABGHb and aHQHb exceeding\u2009\u00b1\u20090.5\u00a0g\/dl have similar agreement to the direction but not necessarily the magnitude of sequential tHb change. While Hb blood tests should continue to be used to inform transfusion decisions, intraoperative continuous noninvasive SpHb decreases more than \u2212\u20090.5\u00a0g\/dl could be a good indicator of the need to measure tHb.<\/jats:p>","DOI":"10.1007\/s10877-019-00428-3","type":"journal-article","created":{"date-parts":[[2019,12,3]],"date-time":"2019-12-03T23:02:45Z","timestamp":1575414165000},"page":"883-892","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Multicenter comparison of three intraoperative hemoglobin trend monitoring methods"],"prefix":"10.1007","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1454-4549","authenticated-orcid":false,"given":"Richard L.","family":"Applegate II","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia M.","family":"Applegate","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maxime","family":"Cannesson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prith","family":"Peiris","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beth L.","family":"Ladlie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaus","family":"Torp","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,12,3]]},"reference":[{"key":"428_CR1","doi-asserted-by":"publisher","unstructured":"Clevenger B, Mallett SV, Klein AA, Richards T. 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BMJ. 2016;352:i1351. https:\/\/doi.org\/10.1136\/bmj.i1351.","journal-title":"BMJ"}],"updated-by":[{"DOI":"10.1007\/s10877-020-00566-z","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2020,7,31]],"date-time":"2020-07-31T00:00:00Z","timestamp":1596153600000}}],"container-title":["Journal of Clinical Monitoring and Computing"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s10877-019-00428-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s10877-019-00428-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s10877-019-00428-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,31]],"date-time":"2023-08-31T21:55:35Z","timestamp":1693518935000},"score":1,"resource":{"primary":{"URL":"http:\/\/link.springer.com\/10.1007\/s10877-019-00428-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,12,3]]},"references-count":44,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2020,10]]}},"alternative-id":["428"],"URL":"https:\/\/doi.org\/10.1007\/s10877-019-00428-3","relation":{"correction":[{"id-type":"doi","id":"10.1007\/s10877-020-00566-z","asserted-by":"object"}]},"ISSN":["1387-1307","1573-2614"],"issn-type":[{"value":"1387-1307","type":"print"},{"value":"1573-2614","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,12,3]]},"assertion":[{"value":"3 October 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 November 2019","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 December 2019","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"31 July 2020","order":4,"name":"change_date","label":"Change Date","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Correction","order":5,"name":"change_type","label":"Change Type","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"In the original publication of the article, the ABGHb graph of Fig.\u00a02 was incorrectly rendered during conversion from black and white to color. The figure shows hemoglobin results from the 3 compared monitoring methods to results obtained by laboratory hematology analyzer. Importantly this illustration of secondary outcome was not used for statistical comparisons but is intended to show relative accuracy of the 3 monitoring methods. The corrected Fig. 2 is given in this erratum.","order":6,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"PP, BL, and PMA have nothing to disclose. RLA, MC and KT disclose each has been principal investigator in studies for which the Departments of Anesthesiology at their institutions received funding from Masimo Corporation and have served as consultants to Masimo Corporation scientific advisory boards. Dr. Torp holds regular shares in Masimo in an amount of less than $50,000. Dr. Cannesson is a consultant for Edwards Lifesciences and Masimo Corp, and has funded research from Edwards Lifesciences and Masimo Corp. He is also the founder of Sironis owns patents and receive royalties for closed loop hemodynamic management that have been licensed to Edwards Lifesciences. Dr. Cannesson\u2019s Department receives funding from the NIH (R01GM117622; R01 NR013012; U54HL119893; 1R01HL144692).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}}]}}