Impact of Increased End-Tidal Carbon Dioxide on Continuous Noninvasive Hemoglobin Monitoring during Laparoscopic Gastrectomy: A Randomized Controlled Study

The pulse CO-Oximetry allows continuous, noninvasive monitoring of hemoglobin (SpHb). We assessed the impact of increased end-tidal carbon dioxide (EtCO<sub<2</sub<) on the accuracy and trending ability of SpHb in laparoscopic surgery. Participants (<i<n</i< = 64) were random...
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Autor*in:	Ha-Yeon Kim [verfasserIn] Jong-Bum Choi [verfasserIn] Sang-Uk Han [verfasserIn] Hye-Sun Lee [verfasserIn] Kyuhyeok Lee [verfasserIn] Ji-Eun Kim [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2022

Schlagwörter:	hemoglobins hypercapnia laparoscopy oximetry transcutaneous blood gas monitoring

Übergeordnetes Werk:	In: Journal of Personalized Medicine - MDPI AG, 2012, 12(2022), 2, p 160
Übergeordnetes Werk:	volume:12 ; year:2022 ; number:2, p 160

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc

DOI / URN:	10.3390/jpm12020160

Katalog-ID:	DOAJ081189931

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520			\|a The pulse CO-Oximetry allows continuous, noninvasive monitoring of hemoglobin (SpHb). We assessed the impact of increased end-tidal carbon dioxide (EtCO<sub<2</sub<) on the accuracy and trending ability of SpHb in laparoscopic surgery. Participants (<i<n</i< = 64) were randomly allocated to the low carbon dioxide (CO<sub<2</sub<) group (EtCO<sub<2</sub<: 30–35 mmHg) or the high CO<sub<2</sub< group (EtCO<sub<2</sub<: 40–45 mmHg). The SpHb and laboratory hemoglobin (tHb) were obtained during surgery. The correlation coefficient (r) between SpHb and tHb showed greater tendency in the low CO<sub<2</sub< group (r = 0.68) than in the high CO<sub<2</sub< group (r = 0.43). The bias (precision) was −1.18 (1.09) with a limit of agreement (LOA) of −3.31 to 0.95 in low CO<sub<2</sub< group and −1.02 (1.24) with a LOA of −3.45 to 1.42 in high CO<sub<2</sub< group; they did not differ significantly between the groups (<i<p</i< = 0.246). The low CO<sub<2</sub< group showed a high concordance rate of 95.9% and a moderate correlation between ΔSpHb and ΔtHb (r = 0.53). However, the high CO<sub<2</sub< group showed a concordance rate of 77.8% and no correlation between ΔSpHb and ΔtHb (r = 0.11). In conclusion, increased EtCO<sub<2</sub< significantly reduced the trending ability of SpHb during laparoscopic surgery. Caution should be executed when interpreting SpHb values during laparoscopic surgery in patients with hypercapnia.
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allfields	10.3390/jpm12020160 doi (DE-627)DOAJ081189931 (DE-599)DOAJ95dcbe87a6dc46cc9fa3643a2b879d0b DE-627 ger DE-627 rakwb eng Ha-Yeon Kim verfasserin aut Impact of Increased End-Tidal Carbon Dioxide on Continuous Noninvasive Hemoglobin Monitoring during Laparoscopic Gastrectomy: A Randomized Controlled Study 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier The pulse CO-Oximetry allows continuous, noninvasive monitoring of hemoglobin (SpHb). We assessed the impact of increased end-tidal carbon dioxide (EtCO<sub<2</sub<) on the accuracy and trending ability of SpHb in laparoscopic surgery. Participants (<i<n</i< = 64) were randomly allocated to the low carbon dioxide (CO<sub<2</sub<) group (EtCO<sub<2</sub<: 30–35 mmHg) or the high CO<sub<2</sub< group (EtCO<sub<2</sub<: 40–45 mmHg). The SpHb and laboratory hemoglobin (tHb) were obtained during surgery. The correlation coefficient (r) between SpHb and tHb showed greater tendency in the low CO<sub<2</sub< group (r = 0.68) than in the high CO<sub<2</sub< group (r = 0.43). The bias (precision) was −1.18 (1.09) with a limit of agreement (LOA) of −3.31 to 0.95 in low CO<sub<2</sub< group and −1.02 (1.24) with a LOA of −3.45 to 1.42 in high CO<sub<2</sub< group; they did not differ significantly between the groups (<i<p</i< = 0.246). The low CO<sub<2</sub< group showed a high concordance rate of 95.9% and a moderate correlation between ΔSpHb and ΔtHb (r = 0.53). However, the high CO<sub<2</sub< group showed a concordance rate of 77.8% and no correlation between ΔSpHb and ΔtHb (r = 0.11). In conclusion, increased EtCO<sub<2</sub< significantly reduced the trending ability of SpHb during laparoscopic surgery. Caution should be executed when interpreting SpHb values during laparoscopic surgery in patients with hypercapnia. hemoglobins hypercapnia laparoscopy oximetry transcutaneous blood gas monitoring Medicine R Jong-Bum Choi verfasserin aut Sang-Uk Han verfasserin aut Hye-Sun Lee verfasserin aut Kyuhyeok Lee verfasserin aut Ji-Eun Kim verfasserin aut In Journal of Personalized Medicine MDPI AG, 2012 12(2022), 2, p 160 (DE-627)71862713X (DE-600)2662248-8 20754426 nnns volume:12 year:2022 number:2, p 160 https://doi.org/10.3390/jpm12020160 kostenfrei https://doaj.org/article/95dcbe87a6dc46cc9fa3643a2b879d0b kostenfrei https://www.mdpi.com/2075-4426/12/2/160 kostenfrei https://doaj.org/toc/2075-4426 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 12 2022 2, p 160
spelling	10.3390/jpm12020160 doi (DE-627)DOAJ081189931 (DE-599)DOAJ95dcbe87a6dc46cc9fa3643a2b879d0b DE-627 ger DE-627 rakwb eng Ha-Yeon Kim verfasserin aut Impact of Increased End-Tidal Carbon Dioxide on Continuous Noninvasive Hemoglobin Monitoring during Laparoscopic Gastrectomy: A Randomized Controlled Study 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier The pulse CO-Oximetry allows continuous, noninvasive monitoring of hemoglobin (SpHb). We assessed the impact of increased end-tidal carbon dioxide (EtCO<sub<2</sub<) on the accuracy and trending ability of SpHb in laparoscopic surgery. Participants (<i<n</i< = 64) were randomly allocated to the low carbon dioxide (CO<sub<2</sub<) group (EtCO<sub<2</sub<: 30–35 mmHg) or the high CO<sub<2</sub< group (EtCO<sub<2</sub<: 40–45 mmHg). The SpHb and laboratory hemoglobin (tHb) were obtained during surgery. The correlation coefficient (r) between SpHb and tHb showed greater tendency in the low CO<sub<2</sub< group (r = 0.68) than in the high CO<sub<2</sub< group (r = 0.43). The bias (precision) was −1.18 (1.09) with a limit of agreement (LOA) of −3.31 to 0.95 in low CO<sub<2</sub< group and −1.02 (1.24) with a LOA of −3.45 to 1.42 in high CO<sub<2</sub< group; they did not differ significantly between the groups (<i<p</i< = 0.246). The low CO<sub<2</sub< group showed a high concordance rate of 95.9% and a moderate correlation between ΔSpHb and ΔtHb (r = 0.53). However, the high CO<sub<2</sub< group showed a concordance rate of 77.8% and no correlation between ΔSpHb and ΔtHb (r = 0.11). In conclusion, increased EtCO<sub<2</sub< significantly reduced the trending ability of SpHb during laparoscopic surgery. Caution should be executed when interpreting SpHb values during laparoscopic surgery in patients with hypercapnia. hemoglobins hypercapnia laparoscopy oximetry transcutaneous blood gas monitoring Medicine R Jong-Bum Choi verfasserin aut Sang-Uk Han verfasserin aut Hye-Sun Lee verfasserin aut Kyuhyeok Lee verfasserin aut Ji-Eun Kim verfasserin aut In Journal of Personalized Medicine MDPI AG, 2012 12(2022), 2, p 160 (DE-627)71862713X (DE-600)2662248-8 20754426 nnns volume:12 year:2022 number:2, p 160 https://doi.org/10.3390/jpm12020160 kostenfrei https://doaj.org/article/95dcbe87a6dc46cc9fa3643a2b879d0b kostenfrei https://www.mdpi.com/2075-4426/12/2/160 kostenfrei https://doaj.org/toc/2075-4426 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 12 2022 2, p 160
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allfieldsGer	10.3390/jpm12020160 doi (DE-627)DOAJ081189931 (DE-599)DOAJ95dcbe87a6dc46cc9fa3643a2b879d0b DE-627 ger DE-627 rakwb eng Ha-Yeon Kim verfasserin aut Impact of Increased End-Tidal Carbon Dioxide on Continuous Noninvasive Hemoglobin Monitoring during Laparoscopic Gastrectomy: A Randomized Controlled Study 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier The pulse CO-Oximetry allows continuous, noninvasive monitoring of hemoglobin (SpHb). We assessed the impact of increased end-tidal carbon dioxide (EtCO<sub<2</sub<) on the accuracy and trending ability of SpHb in laparoscopic surgery. Participants (<i<n</i< = 64) were randomly allocated to the low carbon dioxide (CO<sub<2</sub<) group (EtCO<sub<2</sub<: 30–35 mmHg) or the high CO<sub<2</sub< group (EtCO<sub<2</sub<: 40–45 mmHg). The SpHb and laboratory hemoglobin (tHb) were obtained during surgery. The correlation coefficient (r) between SpHb and tHb showed greater tendency in the low CO<sub<2</sub< group (r = 0.68) than in the high CO<sub<2</sub< group (r = 0.43). The bias (precision) was −1.18 (1.09) with a limit of agreement (LOA) of −3.31 to 0.95 in low CO<sub<2</sub< group and −1.02 (1.24) with a LOA of −3.45 to 1.42 in high CO<sub<2</sub< group; they did not differ significantly between the groups (<i<p</i< = 0.246). The low CO<sub<2</sub< group showed a high concordance rate of 95.9% and a moderate correlation between ΔSpHb and ΔtHb (r = 0.53). However, the high CO<sub<2</sub< group showed a concordance rate of 77.8% and no correlation between ΔSpHb and ΔtHb (r = 0.11). In conclusion, increased EtCO<sub<2</sub< significantly reduced the trending ability of SpHb during laparoscopic surgery. Caution should be executed when interpreting SpHb values during laparoscopic surgery in patients with hypercapnia. hemoglobins hypercapnia laparoscopy oximetry transcutaneous blood gas monitoring Medicine R Jong-Bum Choi verfasserin aut Sang-Uk Han verfasserin aut Hye-Sun Lee verfasserin aut Kyuhyeok Lee verfasserin aut Ji-Eun Kim verfasserin aut In Journal of Personalized Medicine MDPI AG, 2012 12(2022), 2, p 160 (DE-627)71862713X (DE-600)2662248-8 20754426 nnns volume:12 year:2022 number:2, p 160 https://doi.org/10.3390/jpm12020160 kostenfrei https://doaj.org/article/95dcbe87a6dc46cc9fa3643a2b879d0b kostenfrei https://www.mdpi.com/2075-4426/12/2/160 kostenfrei https://doaj.org/toc/2075-4426 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 12 2022 2, p 160
allfieldsSound	10.3390/jpm12020160 doi (DE-627)DOAJ081189931 (DE-599)DOAJ95dcbe87a6dc46cc9fa3643a2b879d0b DE-627 ger DE-627 rakwb eng Ha-Yeon Kim verfasserin aut Impact of Increased End-Tidal Carbon Dioxide on Continuous Noninvasive Hemoglobin Monitoring during Laparoscopic Gastrectomy: A Randomized Controlled Study 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier The pulse CO-Oximetry allows continuous, noninvasive monitoring of hemoglobin (SpHb). We assessed the impact of increased end-tidal carbon dioxide (EtCO<sub<2</sub<) on the accuracy and trending ability of SpHb in laparoscopic surgery. Participants (<i<n</i< = 64) were randomly allocated to the low carbon dioxide (CO<sub<2</sub<) group (EtCO<sub<2</sub<: 30–35 mmHg) or the high CO<sub<2</sub< group (EtCO<sub<2</sub<: 40–45 mmHg). The SpHb and laboratory hemoglobin (tHb) were obtained during surgery. The correlation coefficient (r) between SpHb and tHb showed greater tendency in the low CO<sub<2</sub< group (r = 0.68) than in the high CO<sub<2</sub< group (r = 0.43). The bias (precision) was −1.18 (1.09) with a limit of agreement (LOA) of −3.31 to 0.95 in low CO<sub<2</sub< group and −1.02 (1.24) with a LOA of −3.45 to 1.42 in high CO<sub<2</sub< group; they did not differ significantly between the groups (<i<p</i< = 0.246). The low CO<sub<2</sub< group showed a high concordance rate of 95.9% and a moderate correlation between ΔSpHb and ΔtHb (r = 0.53). However, the high CO<sub<2</sub< group showed a concordance rate of 77.8% and no correlation between ΔSpHb and ΔtHb (r = 0.11). In conclusion, increased EtCO<sub<2</sub< significantly reduced the trending ability of SpHb during laparoscopic surgery. Caution should be executed when interpreting SpHb values during laparoscopic surgery in patients with hypercapnia. hemoglobins hypercapnia laparoscopy oximetry transcutaneous blood gas monitoring Medicine R Jong-Bum Choi verfasserin aut Sang-Uk Han verfasserin aut Hye-Sun Lee verfasserin aut Kyuhyeok Lee verfasserin aut Ji-Eun Kim verfasserin aut In Journal of Personalized Medicine MDPI AG, 2012 12(2022), 2, p 160 (DE-627)71862713X (DE-600)2662248-8 20754426 nnns volume:12 year:2022 number:2, p 160 https://doi.org/10.3390/jpm12020160 kostenfrei https://doaj.org/article/95dcbe87a6dc46cc9fa3643a2b879d0b kostenfrei https://www.mdpi.com/2075-4426/12/2/160 kostenfrei https://doaj.org/toc/2075-4426 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 12 2022 2, p 160
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author	Ha-Yeon Kim
spellingShingle	Ha-Yeon Kim misc hemoglobins misc hypercapnia misc laparoscopy misc oximetry misc transcutaneous blood gas monitoring misc Medicine misc R Impact of Increased End-Tidal Carbon Dioxide on Continuous Noninvasive Hemoglobin Monitoring during Laparoscopic Gastrectomy: A Randomized Controlled Study
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topic_title	Impact of Increased End-Tidal Carbon Dioxide on Continuous Noninvasive Hemoglobin Monitoring during Laparoscopic Gastrectomy: A Randomized Controlled Study hemoglobins hypercapnia laparoscopy oximetry transcutaneous blood gas monitoring
topic	misc hemoglobins misc hypercapnia misc laparoscopy misc oximetry misc transcutaneous blood gas monitoring misc Medicine misc R
topic_unstemmed	misc hemoglobins misc hypercapnia misc laparoscopy misc oximetry misc transcutaneous blood gas monitoring misc Medicine misc R
topic_browse	misc hemoglobins misc hypercapnia misc laparoscopy misc oximetry misc transcutaneous blood gas monitoring misc Medicine misc R
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title	Impact of Increased End-Tidal Carbon Dioxide on Continuous Noninvasive Hemoglobin Monitoring during Laparoscopic Gastrectomy: A Randomized Controlled Study
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title_full	Impact of Increased End-Tidal Carbon Dioxide on Continuous Noninvasive Hemoglobin Monitoring during Laparoscopic Gastrectomy: A Randomized Controlled Study
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title_sort	impact of increased end-tidal carbon dioxide on continuous noninvasive hemoglobin monitoring during laparoscopic gastrectomy: a randomized controlled study
title_auth	Impact of Increased End-Tidal Carbon Dioxide on Continuous Noninvasive Hemoglobin Monitoring during Laparoscopic Gastrectomy: A Randomized Controlled Study
abstract	The pulse CO-Oximetry allows continuous, noninvasive monitoring of hemoglobin (SpHb). We assessed the impact of increased end-tidal carbon dioxide (EtCO<sub<2</sub<) on the accuracy and trending ability of SpHb in laparoscopic surgery. Participants (<i<n</i< = 64) were randomly allocated to the low carbon dioxide (CO<sub<2</sub<) group (EtCO<sub<2</sub<: 30–35 mmHg) or the high CO<sub<2</sub< group (EtCO<sub<2</sub<: 40–45 mmHg). The SpHb and laboratory hemoglobin (tHb) were obtained during surgery. The correlation coefficient (r) between SpHb and tHb showed greater tendency in the low CO<sub<2</sub< group (r = 0.68) than in the high CO<sub<2</sub< group (r = 0.43). The bias (precision) was −1.18 (1.09) with a limit of agreement (LOA) of −3.31 to 0.95 in low CO<sub<2</sub< group and −1.02 (1.24) with a LOA of −3.45 to 1.42 in high CO<sub<2</sub< group; they did not differ significantly between the groups (<i<p</i< = 0.246). The low CO<sub<2</sub< group showed a high concordance rate of 95.9% and a moderate correlation between ΔSpHb and ΔtHb (r = 0.53). However, the high CO<sub<2</sub< group showed a concordance rate of 77.8% and no correlation between ΔSpHb and ΔtHb (r = 0.11). In conclusion, increased EtCO<sub<2</sub< significantly reduced the trending ability of SpHb during laparoscopic surgery. Caution should be executed when interpreting SpHb values during laparoscopic surgery in patients with hypercapnia.
abstractGer	The pulse CO-Oximetry allows continuous, noninvasive monitoring of hemoglobin (SpHb). We assessed the impact of increased end-tidal carbon dioxide (EtCO<sub<2</sub<) on the accuracy and trending ability of SpHb in laparoscopic surgery. Participants (<i<n</i< = 64) were randomly allocated to the low carbon dioxide (CO<sub<2</sub<) group (EtCO<sub<2</sub<: 30–35 mmHg) or the high CO<sub<2</sub< group (EtCO<sub<2</sub<: 40–45 mmHg). The SpHb and laboratory hemoglobin (tHb) were obtained during surgery. The correlation coefficient (r) between SpHb and tHb showed greater tendency in the low CO<sub<2</sub< group (r = 0.68) than in the high CO<sub<2</sub< group (r = 0.43). The bias (precision) was −1.18 (1.09) with a limit of agreement (LOA) of −3.31 to 0.95 in low CO<sub<2</sub< group and −1.02 (1.24) with a LOA of −3.45 to 1.42 in high CO<sub<2</sub< group; they did not differ significantly between the groups (<i<p</i< = 0.246). The low CO<sub<2</sub< group showed a high concordance rate of 95.9% and a moderate correlation between ΔSpHb and ΔtHb (r = 0.53). However, the high CO<sub<2</sub< group showed a concordance rate of 77.8% and no correlation between ΔSpHb and ΔtHb (r = 0.11). In conclusion, increased EtCO<sub<2</sub< significantly reduced the trending ability of SpHb during laparoscopic surgery. Caution should be executed when interpreting SpHb values during laparoscopic surgery in patients with hypercapnia.
abstract_unstemmed	The pulse CO-Oximetry allows continuous, noninvasive monitoring of hemoglobin (SpHb). We assessed the impact of increased end-tidal carbon dioxide (EtCO<sub<2</sub<) on the accuracy and trending ability of SpHb in laparoscopic surgery. Participants (<i<n</i< = 64) were randomly allocated to the low carbon dioxide (CO<sub<2</sub<) group (EtCO<sub<2</sub<: 30–35 mmHg) or the high CO<sub<2</sub< group (EtCO<sub<2</sub<: 40–45 mmHg). The SpHb and laboratory hemoglobin (tHb) were obtained during surgery. The correlation coefficient (r) between SpHb and tHb showed greater tendency in the low CO<sub<2</sub< group (r = 0.68) than in the high CO<sub<2</sub< group (r = 0.43). The bias (precision) was −1.18 (1.09) with a limit of agreement (LOA) of −3.31 to 0.95 in low CO<sub<2</sub< group and −1.02 (1.24) with a LOA of −3.45 to 1.42 in high CO<sub<2</sub< group; they did not differ significantly between the groups (<i<p</i< = 0.246). The low CO<sub<2</sub< group showed a high concordance rate of 95.9% and a moderate correlation between ΔSpHb and ΔtHb (r = 0.53). However, the high CO<sub<2</sub< group showed a concordance rate of 77.8% and no correlation between ΔSpHb and ΔtHb (r = 0.11). In conclusion, increased EtCO<sub<2</sub< significantly reduced the trending ability of SpHb during laparoscopic surgery. Caution should be executed when interpreting SpHb values during laparoscopic surgery in patients with hypercapnia.
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title_short	Impact of Increased End-Tidal Carbon Dioxide on Continuous Noninvasive Hemoglobin Monitoring during Laparoscopic Gastrectomy: A Randomized Controlled Study
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We assessed the impact of increased end-tidal carbon dioxide (EtCO<sub<2</sub<) on the accuracy and trending ability of SpHb in laparoscopic surgery. Participants (<i<n</i< = 64) were randomly allocated to the low carbon dioxide (CO<sub<2</sub<) group (EtCO<sub<2</sub<: 30–35 mmHg) or the high CO<sub<2</sub< group (EtCO<sub<2</sub<: 40–45 mmHg). The SpHb and laboratory hemoglobin (tHb) were obtained during surgery. The correlation coefficient (r) between SpHb and tHb showed greater tendency in the low CO<sub<2</sub< group (r = 0.68) than in the high CO<sub<2</sub< group (r = 0.43). The bias (precision) was −1.18 (1.09) with a limit of agreement (LOA) of −3.31 to 0.95 in low CO<sub<2</sub< group and −1.02 (1.24) with a LOA of −3.45 to 1.42 in high CO<sub<2</sub< group; they did not differ significantly between the groups (<i<p</i< = 0.246). The low CO<sub<2</sub< group showed a high concordance rate of 95.9% and a moderate correlation between ΔSpHb and ΔtHb (r = 0.53). However, the high CO<sub<2</sub< group showed a concordance rate of 77.8% and no correlation between ΔSpHb and ΔtHb (r = 0.11). In conclusion, increased EtCO<sub<2</sub< significantly reduced the trending ability of SpHb during laparoscopic surgery. 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Impact of Increased End-Tidal Carbon Dioxide on Continuous Noninvasive Hemoglobin Monitoring during Laparoscopic Gastrectomy: A Randomized Controlled Study

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