The AccuFlow sensor: a novel digital health tool to assess intrapartum blood loss at cesarean delivery.
AccuFlow
intrapartum hemorrhage
obstetric hemorrhage
perfusion sensor
postpartum hemorrhage
surgical blood loss
Journal
Journal of perinatal medicine
ISSN: 1619-3997
Titre abrégé: J Perinat Med
Pays: Germany
ID NLM: 0361031
Informations de publication
Date de publication:
26 Oct 2023
26 Oct 2023
Historique:
received:
05
03
2023
accepted:
02
04
2023
medline:
23
10
2023
pubmed:
8
5
2023
entrez:
8
5
2023
Statut:
epublish
Résumé
During obstetric hemorrhage, peripheral vasoconstriction maintains heart rate and blood pressure until compensatory mechanisms are overwhelmed and patients deteriorate rapidly. Real-time perfusion measurements could quantify vasoconstriction, improving early recognition of hemorrhage and facilitating early intervention to reduce morbidity and mortality. The AccuFlow device makes rapid, non-invasive, quantitative measurements of perfusion, but has not been studied for hemorrhage detection or used in surgical settings. This study evaluated feasibility, tolerability, and preliminary efficacy of the AccuFlow for assessment of blood loss at cesarean delivery (CD). In this pilot study, sensors were applied to the wrist, forearm, bicep, and chest wall of 25 patients undergoing scheduled CD. Postoperatively, sensors were removed and patients rated the AccuFlow and the standard anesthesia monitoring equipment on a validated comfort rating scale for wearable computers (CRS). Blood loss was estimated by the surgical team (EBL) and calculated from change in hematocrit, weight, and height (CBL). CRS scores were compared via Wilcoxon signed ranks tests. Coefficients of correlation between sensor readings and CBL, and between EBL and CBL, were compared using Fisher's R-to-z transformation. There were no safety events; no participants requested device removal. CRS ratings of the AccuFlow and the standard monitoring equipment were similar (7.2 vs. 8.8, p=0.25). Change in wrist perfusion from delivery to dressing placement was more strongly correlated with CBL than was EBL (R=-0.48 vs. R=0.087, p=0.03). The AccuFlow sensor is well-tolerated and shows promise in detecting intrapartum hemorrhage, though larger studies are needed.
Identifiants
pubmed: 37155696
pii: jpm-2023-0101
doi: 10.1515/jpm-2023-0101
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
997-1005Informations de copyright
© 2023 Walter de Gruyter GmbH, Berlin/Boston.
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