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. 2015 Aug 31:9:422-6.
doi: 10.2174/1874325001509010422. eCollection 2015.

Real Time Intraoperative Monitoring of Blood Loss with a Novel Tablet Application

Behnam Sharareh  1 , Spencer Woolwine  1 , Siddarth Satish  2 , Peter Abraham  1 , Ran Schwarzkopf  1
Affiliations

Real Time Intraoperative Monitoring of Blood Loss with a Novel Tablet Application

Behnam Sharareh et al. Open Orthop J. .

Abstract

Introduction: Real-time monitoring of blood loss is critical in fluid management. Visual estimation remains the standard of care in estimating blood loss, yet is demonstrably inaccurate. Photometric analysis, which is the referenced "gold-standard" for measuring blood loss, is both time-consuming and costly. The purpose of this study was to evaluate the efficacy of a novel tablet-monitoring device for measurement of Hb loss during orthopaedic procedures.

Methods: This is a prospective study of 50 patients in a consecutive series of joint arthroplasty cases. The novel System with Feature Extraction Technology was used to measure the amount of Hb contained within surgical sponges intra-operatively. The system's measures were then compared with those obtained via gravimetric method and photometric analysis. Accuracy was evaluated using linear regression and Bland-Altman analysis.

Results: Our results showed a significant positive correlation between Triton tablet system and photometric analysis with respect to intra-operative hemoglobin and blood loss at 0.92 and 0.91, respectively.

Discussion: This novel system can accurately determine Hb loss contained within surgical sponges. We believe that this user-friendly software can be used for measurement of total intraoperative blood loss and thus aid in a more accurate fluid management protocols during orthopaedic surgical procedures.

Keywords: Fluid management; gravimetric method; hemoglobin loss; intraoperative blood loss; photometric analysis; total joint arthroplasty.

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Figures

Fig. (1)
Fig. (1)
Image of the Triton System in use during an operation. The nurse holding the examined laparotomy sponge is seen in the screen while the image is captured. The application displays the laparotomy sponge count as well as the individual sponge Hb amount and the cumulative Hb loss over the entire operation.
Fig. (2)
Fig. (2)
A plot of the association between the Estimated Hb loss by the Triton System and the assay Hb loss using the reference method.
Fig. (3)
Fig. (3)
A Bland-Altman plot of the differences between the tablet application’s measures of Hb loss and the reference measures versus the average of the two measures.
Fig. (4)
Fig. (4)
Accuracy comparison of Estimated Blood Loss (EBL, ml) measured via the Triton System and the Gravimetric method, against the reference method. a) Triton EBL and Assay EBL per case, b) Gravimetric EBL and Assay EBL per case.
See this image and copyright information in PMC

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