Validation of noninvasive hemoglobin measurement by pulse co-oximeter in newborn infants

Objective:to describe the accuracy of noninvasive hemoglobin (hb) obtained with pulse co-oximeter (sphb) compared with total hb (thb) from laboratory co-oximeter in neonates.study design:neonates with birth weight (bw) <3000 g admitted to lac+usc medical center neonatal intensive care unit were included. sphb was recorded using masimo radical-7 and compared with thb. a total of three data sets were obtained for each patient. regression analysis and bland–altman analysis were performed.result:sixty-one patients (mean±s.d., bw 1177±610 g and gestational age 28.7±3.9 weeks) were enrolled. the mean thb value was 13.9±2.0 g dl−1 and the mean sphb was 14.0±2.0 g dl−1. there was a moderately positive correlation between sphb and thb (r=0.66, p<0.001) with a bias and precision of −0.09±1.67 g dl−1. data from a subgroup of infants with gestational age ⩽32 weeks (52/61 patients) were analyzed, and the correlation coefficient was moderately positive (r=0.69, p<0.001) with a bias and precision of −0.23±1.60 g dl−1.conclusion:our results suggest that noninvasive sphb may be considered as an adjunct to invasive thb measurements in newborn infants <3000 g especially in preterm infants ⩽32 weeks of gestation.