Establishment of continuous monitoring method of hemoglobin level using non-invasive instrument

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We evaluated new instrument, Astrim (Sysmex) that can detect hemoglobin level non-invasively, for the purpose of the clinical usage such as continuous monitoring. The effects of biological conditions on hemoglobin detection by Astrim, and possibility of application to autologous blood collection were studied.1.The effects of morphological changes of RBCWe studied about the effects of fragmented red cells (FRC) on hemoglobin detection by Astrim. FRC were produced from washed red cells by heart treatment. There was no affection of FRC on hemoglobin detection in the samples containing FRC in the ratio of up to 18%. O the other hand, hemolytic samples obtained by freezing-thawing method gave us slightly lower data in comparison with those obtained by automatic hematology analyzer. Moreover, spherocytes made in hypotonic solution affected to obtain higher data than true values.2.The effects of clinically available drugThe effects of several drugs that can be used for the patients in severe … More condition were studied. In these drugs, addition of soybean oil, Intrafat^R, resulted in slightly higher data than true valus. However, as only 2g/dL change was observed in the blood sample containing 10% soybean oil, no clinical restriction will be required.3.Development of new detection probe suitable for wristsBecause original Astrim, which use permeable characteristics of near-infrared radiations for middle finger, cannot be applied to severely ill patients, new detection probe suitable for wrists using reflection radiation has been developed.4.Application to pre-evaluation for the patients who undergo autologous blood storageOne hundred and twenty two hemoglobin values before blood collection from 52 patients were evaluated with both Astrim and conventional hematology analyzer. The values obtained by Astrim (NINV-Hb) significantly correlated with those by hematology analyzer (TR-Hb) (r=0.527, p<0.0001). There was no relationship between the ratio of NINV-Hb/TR-Hb and MCV nor RDW. As in the 8 cases the differences of the two method were larger than 2.1, these patients were considered not suitable for Astrim trial. In the remaining 44 cases, 49 second or later blood collection exhibited more than 12g/dL hemoglobin by Astrim. In these cases, all detection with one exception exhibited more than 11g/dL of TR-Hb. It seems to be possible to omit hematological pre-check for these patients. Less