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

我们评估了新的非侵入性检测血红蛋白水平的仪器Astrim(Sysmex)，以达到连续监测等临床用途。研究了生物条件对Astrim检测血红蛋白的影响，以及将其应用于自体采血的可能性。1.红细胞形态变化的影响研究了碎裂红细胞(FRC)对Astrim检测血红蛋白的影响。FRC是由洗过的红细胞通过心脏治疗而产生的。当FRC含量达到18%时，FRC对血红蛋白的检测没有影响。另一方面，与全自动血细胞分析仪相比，冻融法获得的溶血标本提供的数据略低。此外，在低渗溶液中制成的球状细胞影响获得比真实值更高的数据。2.临床可用药物的效果几种药物可用于重症…患者的效果对更多条件进行了研究。在这些药物中，添加大豆油，INTRAFAT^R，导致的数据略高于真值。由于原有ASTERM利用中指近红外辐射的渗透特性，不适用于重症患者，因此开发了适用于手腕的反射辐射检测探头。4.应用于自体采血患者的预评估应用Astrim和常规血细胞分析仪对52例患者采血前的122个血红蛋白值进行了检测。Astrim(nINV-Hb)与血细胞分析仪(tr-Hb)检测结果呈显著正相关(r=0.527，p&lt；0.0001)。NINV-Hb/Tr-Hb与MCV、RDW无相关性。由于在8例患者中，两种方法的差异大于2.1，这些患者被认为不适合进行ASTERM试验。在其余44例患者中，49例第二次或更晚采血时Astrim检测的Hb>12g/dL。在这些病例中，除一个例外情况外，所有检测结果均显示tr-Hb超过11g/dL。似乎可以省略这些患者的血液学预检查。较少

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