Evaluation of Non-Invasive Hemoglobin Monitoring in Perioperative Patients: A Retrospective Study of the Rad-67<sup>TM</sup> (Masimo)
<b>Background</b>: Hemoglobin (Hb) is a crucial parameter in perioperative care due to its essential role for oxygen transport and tissue oxygenation. Accurate Hb monitoring allows for timely interventions to address perioperative anemia and, thus, prevent morbidity and mortality. Tradit...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2025-01-01
|
| Series: | Diagnostics |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2075-4418/15/2/128 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832588715020517376 |
|---|---|
| author | Philipp Helmer Andreas Steinisch Sebastian Hottenrott Tobias Schlesinger Michael Sammeth Patrick Meybohm Peter Kranke |
| author_facet | Philipp Helmer Andreas Steinisch Sebastian Hottenrott Tobias Schlesinger Michael Sammeth Patrick Meybohm Peter Kranke |
| author_sort | Philipp Helmer |
| collection | DOAJ |
| description | <b>Background</b>: Hemoglobin (Hb) is a crucial parameter in perioperative care due to its essential role for oxygen transport and tissue oxygenation. Accurate Hb monitoring allows for timely interventions to address perioperative anemia and, thus, prevent morbidity and mortality. Traditional Hb measurements rely on invasive blood sampling, which significantly contributes to iatrogenic anemia and poses discomfort and increased infection risks. The advent of non-invasive devices like Masimo’s Rad-67™, which measures Hb using pulse CO-oximetry (SpHb), offers a promising alternative. This study evaluates the accuracy of SpHb compared to clinical standard blood gas analysis (BGA) in perioperative patients. <b>Methods</b>: This retrospective study analyzed 335 paired Hb measurements with an interval <15 min between SpHb and BGA in the operating theater and post-anesthesia care unit of a university hospital. Patients experiencing hemodynamic instability, acute bleeding, or critical care were excluded. Statistical analysis included Bland–Altman plots and Pearson correlation coefficients (PCCs) to assess the agreement between SpHb and BGA. Potential confounders, e.g., patient age, skin temperature, sex, perfusion index (PI), and atrial fibrillation, were also analyzed. <b>Results</b>: The bias of the SpHb compared to BGA according to Bland–Altman was 0.00 g/dL, with limits of agreement ranging from −2.70 to 2.45 g/dL. A strong correlation was observed (<i>r</i> = 0.79). Overall, 57.6% of the paired measurements showed a deviation between the two methods of ≤±1 g/dL; however, this applied to only 33.3% of the anemic patients. Modified Clark’s Error Grid analysis showed 85.4% of values fell within clinically acceptable limits. Sex was found to have a statistically significant, but not clinically relevant, effect on accuracy (<i>p</i> = 0.02). <b>Conclusions</b>: The Rad-67<sup>TM</sup> demonstrates reasonable accuracy for non-invasive SpHb, but exhibits significant discrepancies in anemic patients with overestimating low values. While it offers potential for reducing iatrogenic blood loss, SpHb so far should not replace BGA in critical clinical decision-making. |
| format | Article |
| id | doaj-art-9eb1cc890e8e4710ac8c234f9264d720 |
| institution | Kabale University |
| issn | 2075-4418 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj-art-9eb1cc890e8e4710ac8c234f9264d7202025-01-24T13:28:50ZengMDPI AGDiagnostics2075-44182025-01-0115212810.3390/diagnostics15020128Evaluation of Non-Invasive Hemoglobin Monitoring in Perioperative Patients: A Retrospective Study of the Rad-67<sup>TM</sup> (Masimo)Philipp Helmer0Andreas Steinisch1Sebastian Hottenrott2Tobias Schlesinger3Michael Sammeth4Patrick Meybohm5Peter Kranke6Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080 Würzburg, GermanyDepartment of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080 Würzburg, GermanyDepartment of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080 Würzburg, GermanyDepartment of Anaesthesiology and Intensive Care, BG Murnau, Professor-Küntscher-Str. 8, 82418 Murnau, GermanyDepartment of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080 Würzburg, GermanyDepartment of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080 Würzburg, GermanyDepartment of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080 Würzburg, Germany<b>Background</b>: Hemoglobin (Hb) is a crucial parameter in perioperative care due to its essential role for oxygen transport and tissue oxygenation. Accurate Hb monitoring allows for timely interventions to address perioperative anemia and, thus, prevent morbidity and mortality. Traditional Hb measurements rely on invasive blood sampling, which significantly contributes to iatrogenic anemia and poses discomfort and increased infection risks. The advent of non-invasive devices like Masimo’s Rad-67™, which measures Hb using pulse CO-oximetry (SpHb), offers a promising alternative. This study evaluates the accuracy of SpHb compared to clinical standard blood gas analysis (BGA) in perioperative patients. <b>Methods</b>: This retrospective study analyzed 335 paired Hb measurements with an interval <15 min between SpHb and BGA in the operating theater and post-anesthesia care unit of a university hospital. Patients experiencing hemodynamic instability, acute bleeding, or critical care were excluded. Statistical analysis included Bland–Altman plots and Pearson correlation coefficients (PCCs) to assess the agreement between SpHb and BGA. Potential confounders, e.g., patient age, skin temperature, sex, perfusion index (PI), and atrial fibrillation, were also analyzed. <b>Results</b>: The bias of the SpHb compared to BGA according to Bland–Altman was 0.00 g/dL, with limits of agreement ranging from −2.70 to 2.45 g/dL. A strong correlation was observed (<i>r</i> = 0.79). Overall, 57.6% of the paired measurements showed a deviation between the two methods of ≤±1 g/dL; however, this applied to only 33.3% of the anemic patients. Modified Clark’s Error Grid analysis showed 85.4% of values fell within clinically acceptable limits. Sex was found to have a statistically significant, but not clinically relevant, effect on accuracy (<i>p</i> = 0.02). <b>Conclusions</b>: The Rad-67<sup>TM</sup> demonstrates reasonable accuracy for non-invasive SpHb, but exhibits significant discrepancies in anemic patients with overestimating low values. While it offers potential for reducing iatrogenic blood loss, SpHb so far should not replace BGA in critical clinical decision-making.https://www.mdpi.com/2075-4418/15/2/128co-oximetrySpHbpoint-of-careanemiahemoglobinaccuracy |
| spellingShingle | Philipp Helmer Andreas Steinisch Sebastian Hottenrott Tobias Schlesinger Michael Sammeth Patrick Meybohm Peter Kranke Evaluation of Non-Invasive Hemoglobin Monitoring in Perioperative Patients: A Retrospective Study of the Rad-67<sup>TM</sup> (Masimo) Diagnostics co-oximetry SpHb point-of-care anemia hemoglobin accuracy |
| title | Evaluation of Non-Invasive Hemoglobin Monitoring in Perioperative Patients: A Retrospective Study of the Rad-67<sup>TM</sup> (Masimo) |
| title_full | Evaluation of Non-Invasive Hemoglobin Monitoring in Perioperative Patients: A Retrospective Study of the Rad-67<sup>TM</sup> (Masimo) |
| title_fullStr | Evaluation of Non-Invasive Hemoglobin Monitoring in Perioperative Patients: A Retrospective Study of the Rad-67<sup>TM</sup> (Masimo) |
| title_full_unstemmed | Evaluation of Non-Invasive Hemoglobin Monitoring in Perioperative Patients: A Retrospective Study of the Rad-67<sup>TM</sup> (Masimo) |
| title_short | Evaluation of Non-Invasive Hemoglobin Monitoring in Perioperative Patients: A Retrospective Study of the Rad-67<sup>TM</sup> (Masimo) |
| title_sort | evaluation of non invasive hemoglobin monitoring in perioperative patients a retrospective study of the rad 67 sup tm sup masimo |
| topic | co-oximetry SpHb point-of-care anemia hemoglobin accuracy |
| url | https://www.mdpi.com/2075-4418/15/2/128 |
| work_keys_str_mv | AT philipphelmer evaluationofnoninvasivehemoglobinmonitoringinperioperativepatientsaretrospectivestudyoftherad67suptmsupmasimo AT andreassteinisch evaluationofnoninvasivehemoglobinmonitoringinperioperativepatientsaretrospectivestudyoftherad67suptmsupmasimo AT sebastianhottenrott evaluationofnoninvasivehemoglobinmonitoringinperioperativepatientsaretrospectivestudyoftherad67suptmsupmasimo AT tobiasschlesinger evaluationofnoninvasivehemoglobinmonitoringinperioperativepatientsaretrospectivestudyoftherad67suptmsupmasimo AT michaelsammeth evaluationofnoninvasivehemoglobinmonitoringinperioperativepatientsaretrospectivestudyoftherad67suptmsupmasimo AT patrickmeybohm evaluationofnoninvasivehemoglobinmonitoringinperioperativepatientsaretrospectivestudyoftherad67suptmsupmasimo AT peterkranke evaluationofnoninvasivehemoglobinmonitoringinperioperativepatientsaretrospectivestudyoftherad67suptmsupmasimo |