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

In this study, we assessed the accuracy and performance of the system in surgical cases. The novel mobile monitoring system provides an accurate measurement of Hb mass on surgical sponges as compared with that of manual rinsing measurements and is significantly more accurate than 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

In this study, we measured surgical blood loss using a tablet computer programmed with a unique algorithm modeled after facial recognition technology. The aim of the study was to assess the accuracy and performance of the system on surgical laparotomy sponges in vitro. Mobile blood loss monitoring using the Triton system is accurate in assessing Hb mass on surgical sponges across a range of ambient light conditions, sponge saturation, saline contamination, and initial blood Hb. Utilization of this tool could significantly improve the accuracy of blood loss estimates.

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

This study aims to compare the accuracy of visual, quantitative gravimetric, and colorimetric methods used to determine blood loss during cesarean delivery procedures employing a hemoglobin extraction assay as the reference standard.  During cesarean delivery, measuring blood loss using colorimetric image analysis is superior to visual estimation and a gravimetric method. Implementation of colorimetric analysis may enhance the ability of management protocols to improve clinical outcomes.

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

Real-time monitoring of blood loss is critical in fluid management. Visual estimation remains the standard of care in estimating blood loss, yet is demonstrably inaccurate. Photometric analysis, which is the referenced “gold-standard” for measuring blood loss, is both time-consuming and costly. The purpose of this study was to evaluate the efficacy of a novel tablet-monitoring device for measurement of Hb loss during orthopaedic procedures. This novel system can accurately determine Hb loss contained within surgical sponges. We believe that this user-friendly software can be used for measurement of total intraoperative blood loss and thus aid in a more accurate fluid management protocols during orthopaedic surgical procedures.

Satish S, et al; Novel System for Rapid Assessment of Blood Loss in Elective Surgery and Cesarean Delivery. Obstetrics and Gynecology 2014 Volume 123 Number 8 (Supplement) p 67S

Visual and gravimetric methods of estimating blood loss are severely limited by human error and the presence of large volumes of amniotic fluid, irrigation, or both. The study goal was to assess accuracy of a novel system for intraoperative monitoring of hemoglobin (Hb) loss. This novel device may enhance the ability to rapidly and accurately quantitate ongoing bleeding and may enable health care providers to better manage fluid and blood product replacement in the setting of obstetric hemorrhage.

Mendoza J, et al; Survey of Anesthesiologists’ Transfusion Practices. Abstract presented 2012 SABM Meeting, Pittsburgh, PA.

The aim of this study was to assess anesthesiologists’ perception of the effect of deviation from euvolemia on reliability of Hgb/Hct determination. Anesthesiologists perceive deviation from euvolemia as a common occurrence and a potential confounding factor in the complicated transfusion decision-making process. The use of laboratory Hgb/Hct value is unreliable in this context and direct measurement of blood loss or Hgb mass may prove to be a more reliable parameter. An accurate method for quantifying intra-operative blood loss could significantly improve the accuracy of the transfusion decision-making process.

Konig G, et al; Blood Salvage Efficiency from Surgical Sponges. Anesthesia & Analgesia 2013 Volume 116 Number 5S S-120

Intraoperative blood salvage is typically only 40-60% efficient at returning blood lost back to the patient. Our hypothesis was that blood can be efficiently recovered from surgical sponges by rinsing with saline and mechanical agitation. Red cells can be efficiently recovered from surgical sponges by various methods of mechanical agitation in saline. These results suggest that lost efficiency in cell salvage due to blood retained in surgical sponges may be significantly reduced by rinsing surgical sponges. The results from the four surgical cases give preliminary data on the amount of red cells that can be salvaged from clinical cases.

Muniz-Castro J, et al; Accurate Measurement of Intraoperative Blood Loss Enables Prediction of Postoperative Day One Hemoglobin. SABM 2016. A&A Volume 123 Supplement 3, p 52-53

Clinicians frequently guide transfusion decisions by selecting a minimally acceptable Hgb level based on their patient’s clinical condition. While this “trigger” assumes that the patient is normovolemic, it is often applied in situations confounded by hemodilution or hemoconcentration. We postulated that accurate, contemporaneous measurement of surgical blood loss would facilitate prediction of postoperative day one (POD1) Hgb levels, potentially leading to more accurate intraoperative transfusion decisions. For patients in both transfused and not-transfused subgroups, Triton measurements were more predictive of actual POD1 Hgb values than the traditional estimations of blood loss

Muniz-Castro J, et al; Accurate Measurement of Intraoperative Blood Loss Leads to Appropriate Transfusion, Reduced Blood Utilization and Cost Savings. SABM 2016. A&A Volume 123 Supplement 13, p 30

Transfusion decisions during surgery are often based on hemoglobin (Hgb) levels and visually estimated blood loss, which are both known to be inaccurate. We postulated that accurate, real-time measurement of blood loss would lead to improved transfusion practice. In these patients as well as in the subgroup of the most critically ill, accurate monitoring of surgical blood loss led to a decrease in post-operative transfusions, more timely decision-making, and associated cost savings. Informed transfusion decisions result in fewer transfusions by avoiding both excessive hemodilution leading to unnecessary transfusion based on Hgb triggers, and also inappropriate over-transfusion.

Nowicki P, et al; Measurement of Intraoperative Hemoglobin in Pediatric Orthopedic Patients: Evaluation of a New Method. SABM 2016 A&A Volume 123 Supplement 13, p 4

To study a new method of intraoperative blood loss measurement in pediatric patients undergoing major orthopedic surgery and compare it to the standard “eyeball” approach. The Triton system blood loss estimate correlated better with the reference method compared to the gravimetric method. The visual estimate method in pediatric patients undergoing orthopedic surgery was very dissociated from the reference method. Intraoperative use of the Triton system in pediatric surgery patients offers a convenient and precise tool to monitor intraoperative blood loss and may guide better transfusion decision-making.