ESAIC Recommends Noninvasive, Continuous Hemoglobin Monitoring

Norso Medical partner company - Masimo - today announced that updated guidelines published by the European Society of Anaesthesiology and Intensive Care (ESAIC) highlight the value of noninvasive, continuous hemoglobin (Hb) monitoring in helping clinicians manage perioperative bleeding. Referencing studies using technologies such as Masimo SpHb®, the guidelines note that “the use of noninvasive Hb-monitoring methods may be a practical approach to monitor[ing] the Hb concentration continuously and without accumulating additional blood losses.”1

Noting that in this area of care it is “essential to remain informed by the latest evidence,” the ESAIC, which has pledged to revisit its perioperative blood management guidelines at least every five years, has just published its updated findings, the result of a systematic review of research published from 2015 to 2021. Noting that managing bleeding during surger

y is complex and “involves multiple assessment tools and strategies to ensure optimal patient care,” the guidelines cover numerous modalities, disciplines, scenarios, and patient populations – including how noninvasive, continuous hemoglobin monitoring offers a valuable way to improve blood management.

In the updated guidelines, the ESAIC notes a major drawback to measuring hemoglobin during surgery using blood gas analyzers and invasive blood sampling: “single measurements taken at different time points may not depict accurate values.” In addition, they note, excess blood sampling can lead to iatrogenic blood loss and hospital-acquired anemia.

While noninvasive hemoglobin monitoring is not intended to replace invasive blood sampling, it may offer a “practical approach to monitor[ing] the Hb concentration continuously and without accumulating additional blood losses.” The guidelines also note its value “for trend analysis and to monitor changes in addition to laboratory-measured Hb concentrations during the intervals between invasive blood sampling and Hb measurements.” The guidelines continue, “Having access to continuous measurements of Hb concentrations offers timely detection of changes in Hb concentrations and adjustment, if necessary, in the clinical setting.”

In their summary of the guidance derived from their systematic literature review, the g

uidelines also note that when severe bleeding and volume shifts are expected or occurring, “continuous noninvasive haemoglobin monitoring may be considered for trend analyses and for reducing blood sampling for invasive laboratory measurement of haemoglobin concentration, especially in children.”

Noting that in this area of care it is “essential to remain informed by the latest evidence,” the ESAIC, which has pledged to revisit its perioperative blood management guidelines at least every five years, has just published its updated findings, the result of a systematic review

of research published from 2015 to 2021. Noting that managing bleeding during surgery is complex and “involves multiple assessment tools and strategies to ensure optimal patient care,” the guidelines cover numerous modalities, disciplines, scenarios, and patient populations – including how noninvasive, continuous hemoglobin monitoring offers a valuable way to improve blood management.

In the updated guidelines, the ESAIC notes a major drawback to measuring hemoglobin during surgery using blood gas analyzers and invasive blood sampling: “single measurements taken at different time points may not depict accurate values.” In addition, they note

, excess blood sampling can lead to iatrogenic blood loss and hospital-acquired anemia. While noninvasive hemoglobin monitoring is not intended to replace invasive blood sampling, it may offer a “practical approach to monitor[ing] the Hb concentration continuously and without accumulating additional blood losses.” The guidelines also note its value “for trend analysis and to monitor changes in addition to laboratory-measured Hb concentrations during the intervals between invasive blood sampling and Hb measurements.” The guidelines continue, “Having access to continuous measurements of Hb concentrations offers timely detection of changes in Hb concentrations and adjustment, if necessary, in the clinical setting.”

In their summary of the guidance derived from their systematic literature review, the guidelines

also note that when severe bleeding and volume shifts are expected or occurring, “continuous noninvasive haemoglobin monitoring may be considered for trend analyses and for reducing blood sampling for invasive laboratory measurement of haemoglobin concentration, especially in children.”

Dr. William C. Wilson, Chief Medical Officer, Masimo, added, “With laboratory measurements, and even with bedside point-of-care hemoglobin testing, results are intermittent, sampling errors can occur, and performing these tests can be distracting during complex cases and while caring for critically ill patients. SpHb monitoring provides real-time v

isibility to hemoglobin levels throughout the continuum of care and has the advantages of trend analysis as well as reductions in workload and delay, enabling clinicians to adjust blood management and observe results simultaneously.”

Joe Kiani, Founder and CEO of Masimo, said, “Since its introduction 15 years ago, we’ve been heartened to see more and more clinicians around the world adopt SpHb as their standard of care, more and more clinical studies demonstrate its utility, and more and more esteemed organizations like ESAIC recognize the benefits of noninvasive h

emoglobin monitoring. The result of years of development and continued refinement, powered by our expertise in advanced signal processing techniques, SpHb plays a critical role in our mission to improve patient outcomes, reduce the cost of care, and ultimately, improve life.”

SpHb is not intended to replace laboratory blood testing. 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.

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