Clinical Chemistry
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Clinical Chemistry 54: 264-272, 2008. First published December 10, 2007; 10.1373/clinchem.2007.093948
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(Clinical Chemistry. 2008;54:264-272.)
© 2008 American Association for Clinical Chemistry, Inc.

Reviews

Noninvasive Optical, Electrical, and Acoustic Methods of Total Hemoglobin Determination

John W. McMurdy1,a, Gregory D. Jay1,3, Selim Suner1,3 and Gregory Crawford1,2

1 Division of Engineering, Brown University, Providence, RI;
2 Department of Physics, Brown University, Providence, RI;
3 Department of Emergency Medicine, The Rhode Island Hospital, Providence, RI.

aAddress correspondence to this author at: Brown University, Division of Engineering, Box D, Providence, RI 02912. Fax (401) 863-9120; e-mail john_mcmurdy{at}brown.edu.

Background: Anemia is an underdiagnosed, significant public health concern afflicting >2 billion people worldwide. The detrimental effects of tissue oxygen deficiency on the cardiovascular system and concurrent appearance of anemia with numerous high-risk disorders highlight the importance of clinical screening. Currently there is no universally accepted, clinically applicable, noninvasive hemoglobin/hematocrit screening tool. The need for such a device has prompted an investigation into a breadth of techniques.

Methods: A synopsis of the literature and current directions of research in noninvasive total hemoglobin measurement was collected. Contributions highlighted in this review are limited to those studies conducted with a clinical aspect, and most include in vivo patient studies.

Results: The review of potential techniques presented here includes optoacoustic spectroscopy, spectrophotometric imaging, diffuse reflectance spectroscopy, transcutaneous illumination, electrical admittance plethysmography, and photoplethysmography. The technological performance, relative benefits of each approach, potential instrumentation design considerations, and future directions are discussed in each subcategory.

Conclusions: Many techniques reviewed here have shown excellent accuracy, sensitivity, and specificity in measuring hemoglobin/hematocrit, thus in the near future a new clinically viable tool for noninvasive hemoglobin/hematocrit monitoring will likely be widely used for patient care. Limiting factors in clinical adoption will likely involve technology integration into the current standard of care in each field routinely dealing with anemia.






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Copyright © 2008 by the American Association for Clinical Chemistry.