Masimo announces that the University of Virginia Medical Center has added new clinical capabilities that allow clinicians to noninvasively and continuously monitor hemoglobin blood levels using Masimo SpHb® and respiration rate using Masimo RRa™.
UVA Medical Center now leverages Masimo Radical-7® Pulse CO-Oximeters with noninvasive hemoglobin (SpHb®) – clinically shown to reduce risky and unnecessary blood transfusions while dramatically reducing costs1 – in its operating rooms, obstetric, and surgical intensive care units.
"We use the Radical-7 with SpHb primarily for complex spine cases, where we have a particular need to track hemoglobin levels on a continuous basis," said Dr. Marcel Durieux , MD, of UVA Medical Center's Department of Anesthesiology. "Having a trending measure rather than having to rely only on intermittent blood gas measurement is helpful, and it allows us to better time when to get a blood gas."
Hemoglobin levels are used as a primary indicator for red blood cell (RBC) transfusion, but laboratory measurements are only available intermittently and results can be delayed in the period between blood draw and laboratory analysis. This time gap of information can lead to sub-optimal transfusion decisions.2 Because SpHb monitoring provides real-time directional trends in hemoglobin – such as indicating stable hemoglobin when it may be perceived to be dropping, and rising hemoglobin when it may be perceived to not be rising fast enough – it can help clinicians initiate necessary transfusions faster. A recent study from Cairo University in Egypt showed that once clinicians determined a transfusion was needed, they were able to initiate transfusions 82% faster – in about 9 minutes, compared to about 50 minutes for patients not being monitored by SpHb.1
That same study also showed SpHb can reduce unnecessary and risky RBC transfusions, which can improve patient outcomes while lowering the cost of care.1 RBC transfusion is one of the most frequent procedures performed in U.S. hospitals, with one in 10 patients receiving one or more blood units.3 RBC transfusion overuse can increase patient risk and cost of care. Multiple observational studies have shown that patients receiving RBC transfusions have an 88% higher mortality rate, 69% higher infection rate, and 250% higher rate of acute respiratory distress syndrome.4
While some clinicians are concerned about withholding RBC transfusions, multiple randomized controlled trials indicate that restrictive transfusion practices – those in which significantly lower hemoglobin triggers are used to determine need for transfusion – are safe.5 In addition, the cost of each RBC unit is estimated between $522 and $1,183 per unit, without including morbidity-associated costs.6
In its post-anesthesia care areas, UVA Medical Center also will be leveraging Masimo Acoustic Respiration Rate (RRa™) – enabling clinicians to noninvasively and continuously assess patient breathing to facilitate earlier detection of respiratory compromise and patient distress. Featuring an innovative adhesive sensor with an integrated acoustic transducer that is easily and comfortably applied to the patient's neck, RRa helps to meet APSF guidelines for monitoring post-operative patients.7
"UVA Medical Center enjoys a well-earned reputation for providing quality patient care," said Joe Kiani , CEO and founder of Masimo. "We at Masimo are honored to have been a partner with UVA for many years, and we're committed to continuing to provide the advanced, high-quality medical technology this leading healthcare organization needs to help further improve patient outcomes and reduce costs."
1 Wael NA, Maher F. Reduction in Red Blood Cell Transfusions during Neurosurgery with Noninvasive and Continuous Hemoglobin Monitoring. Proceedings of the Society for Technology in Anesthesia Annual Meeting ; 2013 Jan 9-12; Phoenix AZ. Available here.
2 Friedman MT et al. Arch Pathol Lab Med. 2006 Apr;130(4):474-9.
3 AHRQ. Inpatient Sample. 1997-2007.
4 Marik PE.et.al. Crit Care Med. 2008;36(9):2667-74
5 Carson et al. Cochrane Database Syst Rev. 2012 Apr 18;4:CD002042.
6 Shander A et al. Transfusion. 2010;50(4):753-765.
7 Weinger MB. Dangers of postoperative opioids: APSF workshop and white paper address prevention of postoperative respiratory complications; APSF Newsletter. 2006; 21(4): 61-88.