Skip Navigation



BJA Advance Access published online on December 23, 2005
British Journal of Anaesthesia, doi:10.1093/bja/aei302
This Article
Right arrow Full Text (PDF)
Right arrow Supplementary data
Right arrow All Versions of this Article:
96/2/186    most recent
aei302v1
Right arrow E-Letters: Submit a response to the article
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Sawano, M.
Right arrow Articles by Tsutsumi, H.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Sawano, M.
Right arrow Articles by Tsutsumi, H.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© The Board of Management and Trustees of the British Journal of Anaesthesia 2005. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org
Accepted October 10, 2005

Laboratory Investigation

Bedside red cell volumetry by low-dose carboxyhaemoglobin dilution using expiratory gas analysis

M. Sawano 1 *, T. Mato 1, and H. Tsutsumi 1

1 Department of Emergency Medicine and Critical Care, Saitama Medical Center, 1981 Tsujido-machi, Kamoda, Kawagoe-shi, Saitama 350-8550, Japan

* To whom correspondence should be addressed.
M. Sawano, E-mail: sawanom-tky{at}umin.ac.jp


  Abstract

Background. We developed a non-invasive, continuous, high-resolution method of measuring carboxyhaemoglobin fraction (COHb%) using expiratory gas analysis (EGA). We assessed whether application of EGA to carboxyhaemoglobin dilution provides red cell volume (RCV) measurement with accuracy equivalent to that of CO-haemoximetry, with a smaller infusion volume of carbon-monoxide-saturated autologous blood (COB).

Method. We assessed the agreement between repeated COHb% measurements by EGA and simultaneous measurement by CO-haemoximetry, using Bland and Altman plot, in healthy subjects and patients with artificially controlled ventilation and no radiological evidence of pulmonary oedema or atelectasis. We assessed the agreement between RCV measurements by EGA with infusion of 20 ml of COB (RCVEGA) and RCV measurements by CO-haemoximetry with infusion of 100 ml of COB (RCVHEM), in healthy subjects.

Results. The ‘limits of agreement’ between COHb% measurement by EGA (1 min average) and CO-haemoximetry were -0.09 and 0.08% in healthy subjects, and -0.11 and 0.09% in patients. Given the resolution of CO-haemoximetry (0.1%), the accuracy of EGA was equivalent to or greater than that of CO-haemoximetry. The ‘limits of agreement’ between RCVEGA and RCVHEM were -0.14 and 0.15 litre. Given the average resolution of RCVHEM (0.14 litre), the accuracy of RCVEGA was equivalent to that of RCVHEM.

Conclusion. EGA provided non-invasive, accurate, continuous, high-resolution COHb% measurements. Applying EGA to carboxyhaemoglobin dilution, we achieved RCV measurements with accuracy equivalent to that of CO-haemoximetry, with one-fifth of the COB infusion volume. However, clinical application of the method is limited to patients with no radiological evidence of pulmonary oedema or atelectasis.

Keywords: blood, volume; measurement techniques, gas exchange; monitoring, carboxyhaemoglobin.
Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 Anesth. Analg.Home page
T. Adachi, K. Hirota, T. Hara, Y. Sasaki, and Y. Hara
Exhaled Carbon Monoxide Levels Change in Relation to Inspired Oxygen Fraction During General Anesthesia
Anesth. Analg., September 1, 2007; 105(3): 696 - 699.
[Abstract] [Full Text] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.