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

J Perinatol. 2015 Aug;35(8):617-20. doi: 10.1038/jp.2015.12. Epub 2015 Mar 5.


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.

Publication types

  • Observational Study
  • Validation Study

MeSH terms

  • Bias
  • Female
  • Hemoglobinometry / instrumentation*
  • Hemoglobins / analysis*
  • Humans
  • Infant
  • Infant, Extremely Premature / blood*
  • Infant, Newborn
  • Infant, Very Low Birth Weight / blood*
  • Male
  • Oximetry / methods*
  • Prospective Studies
  • Regression Analysis


  • Hemoglobins