US-based medical technology company Masimo has reported findings of a study of its two rainbow SET measurements, SpHb and PVI monitoring to address anesthesia-related mortality.

The prospective, single-centre, observational study investigated the clinical utility of Masimo’s Noninvasive and Continuous Hemoglobin (SpHb) Monitoring and PVI, which is the measurement of dynamic changes in the Perfusion Index (PI), occurring during one or more complete respiratory cycles.

Researchers from Centre Hospitalier Universitaire of Limoges, France (CHU Limoges) investigated the clinical utility of two Masimo rainbow SET measurements.

"Results suggested that integration of SpHb and PVI monitoring in a vascular filling algorithm facilitates earlier transfusion while decreasing mortality."

A total of 18,867 patients were divided into two groups in the study who were reviewed for a period of two eleven-month periods before and after using a clinical algorithm to guide transfusion and fluid administration.

A total of 34,50 patients were subjected to SpHb and PVI monitoring through Masimo’s Radical-7 Pulse CO-Oximeters.

Patients in the monitoring group received vascular filling with crystalloids or blood, according to the clinical algorithm.

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The monitored group patients, who received transfusions within the first postoperative 48 hours, were compared to that of the non-monitored group. This included the comparison of mortality rates for each group at 30 days and 90 days post surgery.

Based on cox-proportional hazard model, it was concluded that patients monitored with SpHb and PVI exhibited 30% reduction in mortality at 30 days and a 25% reduction in mortality at 90 days.

Results suggested that integration of SpHb and PVI monitoring in a vascular filling algorithm facilitates earlier transfusion while decreasing mortality at a scale of a whole hospital with various clinical practices and unselected patients.

Centre Hospitalier Universitaire of Limoges department of anesthesiology head Professor Nathan said: “Access to continuous monitoring of Hb levels and fluid responsiveness has changed the way we address blood and fluid management.

“By lowering inadequate fluid filling at the beginning of anesthesia, we are able to avoid diluting patients inadequately and this data helps us to guide precisely the amount of fluids or blood that must be given to patients on a case by case basis.”