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

Abstract

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

Materials and Methods: We conducted a prospective study for preterm or term neonates admitted to NICU of Seoul National University Childrens Hospital, Seoul, Korea. After IRB approval and informed consents from their parents, 56 neonates were enrolled in the study. Hb measurements by the Masimo Radical-7TM (Rainbow Pulse CO-Oximeter®, Masimo Corp., Irvine, CA, USA) were recorded just prior to venous samplings and the collected data was compared with the corresponding venous Hb value by laboratory test.

Results: The collected data were com¬pared 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-Oximetry were significantly cor¬related with the venous Hb levels (correlation coefficient, r = .758

p < .001). Hb values measured with a pulse CO-Oximetry were higher than those measured with a laboratory hematology analyzer (13.3 ± 2.6 g/dL vs. 12.5 ± 3.1 g/dL). In terms of the agreement be¬tween the laboratory analyzer and the pulse CO-oximetry, 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-Oximetry could be useful in the early detection of Hb changes in neonates.

Keywords : hemoglobin

hemoglobinopathy

monitoring

neonatal intensive care

premature infant

Student Number : 2012-22727