Evidence

 

Outcome Studies

 

Rubenstein A, et al; Clinical Experience with the Implementation of Accurate Measurement of Blood Loss during Cesarean Delivery:  Influences on Hemorrhage Recognition and Allogeneic Transfusion. American Journal of Perinatology. 2017, e-pub ahead of print

This 2781 patient study compared the outcomes of C-sections performed using traditional visual estimation versus those performed using the Triton system.  Triton showed over 4x more hemorrhage recognition (>1000cc blood loss cases) yet resulted in significantly less blood use per transfusion.  In addition, hospital stay was shorter for patients in whom Triton was used.  The authors conclude that use of the Triton system appeared to improve care, perhaps due to earlier recognition and treatment of post-partum hemorrhage.


Bernal N, et al; Accurate Measurement of Intraoperative Blood Loss during Wound Excision Leads to More Appropriate Transfusion and Reduced Blood Utilization. Journal of Anesthesia & Clinical Research. 2017, Volume 8: Issue 11

This study in burn patients was focused on the potential impact of Triton on transfusion practice.  The use of Triton (n=221) versus traditional visual blood loss estimation (n=178) significantly decreased the average dose of transfusion.  Furthermore, transfusion decision making was more efficient as evidenced by fewer patients requiring multiple transfusion episodes and delayed post-operative transfusions.


Thurer R, et al; Accurate Measurement of Intraoperative Blood Loss Improves Prediction of Postoperative Hemoglobin Levels. Journal of Anesthesia & Clinical Research.  2017, Volume 8: Issue 7

This analysis from the aforementioned burn study shows that post-operative day 1 hemoglobin levels are better predicted when using Triton to measure blood loss as compared to visual estimation.  This potentially impacts proper transfusion decision-making surrounding surgery.


Accuracy Studies

 

Doctorvaladan, S, et al; Accuracy of Blood Loss Measurement during Cesarean Delivery. Am J Perinatol Rep 2017:7e93-e100.

This in-vivo study of 50 C-sections compared the accuracy and precision of visual, quantitative gravimetric (weighing), and Triton to a validated assay as a reference standard.  Triton showed superior accuracy and precision when analyzing total surgical blood loss in both sponges and canisters as compared to both visual estimation and the gravimetric method.


Konig G, et al; In Vitro Evaluation of a Novel System for Monitoring Surgical Hemoglobin Loss. Anesthesia & Analgesia 2014 Volume 119 Issue 3, p 595-600

This in-vitro study concludes that the Triton device is accurate when measuring blood content on surgical sponges in an OR setting.  207 sponges of different brands and with varying amounts of blood and saline were measured under 3 different ambient light conditions for a total of 621 measurements.  Bland-Altman analysis revealed a bias of only 0.01g Hgb per sponge compared to the pre-measured amounts.


Konig G, et al; In Vitro Evaluation of a Novel Image Processing Device to Estimate Surgical Blood Loss in Suction Canisters. Anesthesia & Analgesia 2018, epub ahead of print

This in-vitro study concludes that the Triton device is accurate when measuring blood content within suction canisters in an OR setting.  207 unique canisters were created with varying amounts of blood, saline, and % hemolysis and measured under 3 different ambient light conditions for a total of 621 measurements.  Bland-Altman analysis revealed an average bias of 4.1g Hgb compared to the reference assay.


Holmes A, et al; Clinical Evaluation of a Novel System for Monitoring Surgical Hemoglobin Loss. Anesthesia & Analgesia 2014 Volume 119 Issue 3, p 588-594

This in-vivo study focused on Triton’s accuracy analyzing sponge Hgb content compared to both gravimetric analysis and a reference standard (Hgb extraction from rinsed sponges).  46 patients treated within orthopedics, general surgery, cardiac surgery and obstetrics were included.  Bland-Altman analysis showed superiority of the Triton system compared to the gravimetric method, and showed clinically meaningful accuracy during surgical use.


Sharareh B, et al; Real Time Intraoperative Monitoring of Blood Loss with a Novel Tablet Application. The Open Orthopedics Journal 2016 Volume 9, p 422-426

This is a 50-patient study focused on the feasibility and accuracy of Triton during orthopedic surgery.  Real-time Triton measurements gathered throughout the course of surgery were compared to both gravimetric analysis and a photometric “gold standard” method.  The results showed that Triton was significantly correlated with the photometric method and more accurate than the gravimetric method.


Konig G, et al; Real-time evaluation of an image analysis system for monitoring surgical hemoglobin loss. Journal of Clinical Monitoring and Computing 2017, April 7. epub ahead of print

In this study, the real-time accuracy and performance of Triton was evaluated throughout the duration of 50 surgical cases. Surgeries included orthopedic, general surgery, urology, and obstetrics. Real-time use of the Triton system to measure Hb loss on sponges proved to be feasible and accurate throughout the duration of surgery.