The Value of Continuous Noninvasive Hemoglobin Monitoring Using Masimo Radical -7 Pulse CO-Oximeter in Intraoperative Blood Transfusion Practice During Obstetric Procedures
Condition: Masimo Radical Pulse Co-oximeter in Intraoperative Blood Transfusion Practice During Obestatric Procedure
Study type: Observational [Patient Registry]

Summary: 
      The principle aim of this study is to detect the accurracy of Masimo Radical-7¿ Pulse
      CO-Oximeter in relation to laboratory hemoglobin and estimated blood loss in intraoperative
      blood transfusion practice during obstetric procedures with high risk of bleeding.
    

Detailed description: 
      Photoplethysmography of peripheral perfusion can be displayed by pulse oximeters. While the
      pulse oximeterplethysmogram represents a volume change and the arterial line blood pressure
      tracing represents a pressure change, it has been demonstrated that cyclical shifts in the
      plethysmogram reflect similar cyclic changes in the blood pressure tracing and that these
      changes reflect changes in the intravascular volume status of patients.Plethysmography
      Variability Index (PVI) is a measure of the dynamic changes in the perfusion index (PI) that
      occur during the respiratory cycle . PVI = ﴾PI Max - PI Min﴿ ÷ PI Maxx 100 %.

      PVI has the potential to provide useful information concerning changes in the balance between
      intrathoracic airway pressure and intravascular fluid volume. Trending of PVI may be useful
      in monitoring surgical patients, both intraoperatively and postoperatively, for appropriate
      hydration states. For example, a rising PVI may indicate developing hypovolemia and gives an
      alarm for the need of appropriate fluid and or blood products transfusion supported by the
      patient hemoglobin level.

      Continuous Hb monitoring may allow a more rapid detection of clinically significant blood
      loss, and has the potential to significantly improve perioperative transfusion practices, may
      enable a more rapid assessment of a patient's condition and more appropriate blood management
      and even perhaps reduce needless transfusions.
    

Intervention name(s): of Masimo Radical-7¿ Pulse CO-Oximeter
Intervention type(s): Device
Intervention description(s): The Masimo pulse oximetry model:
The pulse oximetry model which Masimo developed accounts for saturation values contributed by the true arterial signal, and by one or more motion or noise signals. lt is assumed that under conditions of motion, the detected IR and RD signals comprise both the true arterial saturation signal and a venous (or non-arterial) motion noise signal. Masimo uses a highly sophisticated adaptive filter with, Discrete saturation transform (DST) four other parallel engines, to leverage each algorithm's unique strengths to ensure accurate readings through all patient conditions. Masimo SET's most powerful algorithm is Signal extraction technology (SET). All algorithms depend upon assumptions. The more assumptions, the weaker the algorithm. DST makes only one assumption -that arterial blood has a higher oxygenation than venous - making it the most powerful pulse oximetry algorithm
Other intervention name(s): Puls Oximeter
Observational model: Cohort
Time perspective: Cross-Sectional
Sampling method: Probability Sample
Study population: 
        Basic subject demographics summary of age, weight, height, patient position, basal lab Hb,
        and start time of ADC. Basic summary of number of patients, estimated blood loss,
        transfusions, fluids given, mean arterial blood pressure, central venous pressure, fomites
        number and urine output.