右美托咪啶小儿镇静在全屏静脉麻醉中作用课件.ppt

Graph shows the number of patients in each age group who experienced hypertension. Graph shows the number of patients in each age group who experienced hypotension. Pulmonary vascular resistance (PVR) over time for both dexmedetomidine doses. Little change is seen across time with either dose, except for 1 patient in each group. * * * * INTRODUCTION: Total hemoglobin (Hb) is one of the most frequently-ordered laboratory measurements in both acute and outpatient settings. Current laboratory methods are invasive, time consuming, and can only provide intermittent Hb measurements. Noninvasive and continuous Hb measurement would offer many advantages in the assessment of both acute and chronic anemia in a variety of clinical settings. The purpose of this study was to evaluate the accuracy of a new noninvasive Hb measurement technology called Pulse CO-Oximetry? compared to invasive laboratory measurement of Hb. METHODS: All data were collected under institutional review board approval and all patients provided written, informed consent. A self-calibrating Pulse CO-Oximeter (Masimo Rainbow SET, Masimo, Irvine, CA) with a spectrophotometric sensor (Rainbow DCI) with multiple wavelengths of light was utilized. The Pulse CO-Oximetry method discerns the distinctive light-absorption characteristics of different hemoglobin species and applies proprietary algorithms to determine Hb levels. Study subjects consisted of healthy adults, volunteers undergoing a hemodilution protocol, and surgery patients (liver transplant, caesarean section, or exploratory laparotomy). The hemodilution protocol consisted of replacing one unit of blood with 30 ml/ kg of saline. Each SpHb measurement was matched with a corresponding invasive Hb measurement from a laboratory CO-Oximeter (Radiometer model ABL-820). Bias, precision, and the average root mean square (ARMS) were calculated. RESULTS: Data were collected at three sites, Loma Linda Medical Center (Loma Linda, CA), Mayo Clinic (Jacksonville, FL)