Continuous hemoglobin monitoring during massive blood transfusion in a multivisceral pediatric transplant patient

Ankit Agrawal; Amy B. Beethe; James N. Sullivan; Benjamin M. Jones; Jennifer J. Adams; Amy L. Duhacheck-Stapleman

doi:10.1016/j.jclinane.2013.02.014

Continuous hemoglobin monitoring during massive blood transfusion in a multivisceral pediatric transplant patient

Ankit Agrawal, Amy B. Beethe, James N. Sullivan, Benjamin M. Jones, Jennifer J. Adams, Amy L. Duhacheck-Stapleman

Research output: Contribution to journal › Article › peer-review

6 Scopus citations

Abstract

A 10 year old, 25 kg girl, who was formerly a conjoined twin at the heart, diaphragm, liver, duodenum, bile ducts, and intestine, was admitted for a repeat liver, small bowel, pancreas, and kidney multivisceral transplant after having intestinal and liver failure. Intraoperatively, the patient had excessive bleeding, coagulopathy, and acidosis. Pulse co-oximetry was used for continuous monitoring of hemoglobin (Hb) during the procedure. Although noninvasive Hb appeared to follow a trend that correlated with arterial Hb concentration, it did not show accurate agreement with measured values from intermittent blood gas analysis. It may not be reliable during cases with abnormal physiology, rapid blood loss, and massive transfusion.

Original language	English (US)
Pages (from-to)	578-581
Number of pages	4
Journal	Journal of Clinical Anesthesia
Volume	25
Issue number	7
DOIs	https://doi.org/10.1016/j.jclinane.2013.02.014
State	Published - Nov 2013

Keywords

Blood transfusion
Kidney
Liver
Multi-organ transplantation
Pancreas
Pediatric transplantation, small bowel

ASJC Scopus subject areas

Anesthesiology and Pain Medicine

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10.1016/j.jclinane.2013.02.014

Cite this

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title = "Continuous hemoglobin monitoring during massive blood transfusion in a multivisceral pediatric transplant patient",

abstract = "A 10 year old, 25 kg girl, who was formerly a conjoined twin at the heart, diaphragm, liver, duodenum, bile ducts, and intestine, was admitted for a repeat liver, small bowel, pancreas, and kidney multivisceral transplant after having intestinal and liver failure. Intraoperatively, the patient had excessive bleeding, coagulopathy, and acidosis. Pulse co-oximetry was used for continuous monitoring of hemoglobin (Hb) during the procedure. Although noninvasive Hb appeared to follow a trend that correlated with arterial Hb concentration, it did not show accurate agreement with measured values from intermittent blood gas analysis. It may not be reliable during cases with abnormal physiology, rapid blood loss, and massive transfusion.",

keywords = "Blood transfusion, Kidney, Liver, Multi-organ transplantation, Pancreas, Pediatric transplantation, small bowel",

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AU - Agrawal, Ankit

AU - Beethe, Amy B.

AU - Sullivan, James N.

AU - Jones, Benjamin M.

AU - Adams, Jennifer J.

AU - Duhacheck-Stapleman, Amy L.

PY - 2013/11

Y1 - 2013/11

N2 - A 10 year old, 25 kg girl, who was formerly a conjoined twin at the heart, diaphragm, liver, duodenum, bile ducts, and intestine, was admitted for a repeat liver, small bowel, pancreas, and kidney multivisceral transplant after having intestinal and liver failure. Intraoperatively, the patient had excessive bleeding, coagulopathy, and acidosis. Pulse co-oximetry was used for continuous monitoring of hemoglobin (Hb) during the procedure. Although noninvasive Hb appeared to follow a trend that correlated with arterial Hb concentration, it did not show accurate agreement with measured values from intermittent blood gas analysis. It may not be reliable during cases with abnormal physiology, rapid blood loss, and massive transfusion.

AB - A 10 year old, 25 kg girl, who was formerly a conjoined twin at the heart, diaphragm, liver, duodenum, bile ducts, and intestine, was admitted for a repeat liver, small bowel, pancreas, and kidney multivisceral transplant after having intestinal and liver failure. Intraoperatively, the patient had excessive bleeding, coagulopathy, and acidosis. Pulse co-oximetry was used for continuous monitoring of hemoglobin (Hb) during the procedure. Although noninvasive Hb appeared to follow a trend that correlated with arterial Hb concentration, it did not show accurate agreement with measured values from intermittent blood gas analysis. It may not be reliable during cases with abnormal physiology, rapid blood loss, and massive transfusion.

KW - Blood transfusion

KW - Kidney

KW - Liver

KW - Multi-organ transplantation

KW - Pancreas

KW - Pediatric transplantation, small bowel

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Continuous hemoglobin monitoring during massive blood transfusion in a multivisceral pediatric transplant patient

Abstract

Keywords

ASJC Scopus subject areas

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