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The Efficacy of Noninvasive Hemoglobin Measurement by Pulse CO-Oximetry in Neonates

Jung, Young Hwa MD; Lee, Juyoung MD; Kim, Han-Suk MD, PhD; Shin, Seung Han MD; Sohn, Jin A. MD; Kim, Ee-Kyung MD, PhD; Choi, Jung-Hwan MD, PhD

Pediatric Critical Care Medicine: January 2013 - Volume 14 - Issue 1 - p 70–73
doi: 10.1097/PCC.0b013e318260117d
Neonatal Intensive Care

Objective: To evaluate clinical applicability of noninvasive hemoglobin (Hb) measurement with a pulse CO-oximeter in neonates.

Design: Prospective comparison study.

Setting: Neonatal ICU.

Patients: Fifty-six preterm and term infants with median age = 20 days (range = 1–98 days) and median weight = 1,440g (range = 530–4,230g).

Interventions: Hb measurements by Pulse CO-Oximetry (Masimo Radical-7) were recorded immediately prior to venous samplings.

Measurements and Main Results: The collected data were compared with the corresponding venous Hb level obtained in laboratory testing, and a total of 137 data pairs were analyzed. Noninvasive Hb values measured with a pulse CO-oximeter were significantly correlated with the venous Hb levels (correlation coefficient, r = 0.758; p < 0.001). Hb values measured with a pulse CO-oximeter were higher than those measured with a laboratory hematology analyzer (13.3±2.6g/dL vs. 12.5±3.1g/dL). In terms of the agreement between the laboratory analyzer and the pulse CO-oximeter, 94.8% of the measurements fell within two standard deviations of the mean difference.

Conclusion: Noninvasive Hb measurements with Pulse CO-Oximetry provide clinically acceptable accuracy, and they were significantly correlated with laboratory Hb measurement in neonates. In terms of the clinical applicability, noninvasive Hb monitoring with a pulse CO-oximeter could be useful in the early detection of Hb changes in neonates.

All authors: Department of Pediatrics, Seoul National University College of Medicine, Seoul, Republic of Korea.

Drs. Jung and Lee contributed equally.

The authors have not disclosed any potential conflicts of interest.

For information regarding this article, E-mail: Han-Suk Kim, MD, PhD,

©2013The Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies