Systematic Review and Meta-Analysis of Method Comparison Studies of Masimo Pulse Co-Oximeters (Radical-7 ™ or Pronto-7 ™ ) and HemoCue® Absorption Spectrometers (B-Hemoglobin or 201+) with Laboratory Haemoglobin Estimation

• Published in: Anaesthesia and intensive care Vol. 43; no. 3; pp. 341 - 350
• Main Authors: Hiscock, R., Kumar, D., Simmons, S. W.
• Format: Journal Article
• Language: English
• Published: United States 01.05.2015
• Subjects: Hemoglobinometry - instrumentation; Hemoglobinometry - methods; Hemoglobinometry - statistics & numerical data; Hemoglobins; Humans; Oximetry - instrumentation; Oximetry - methods; Oximetry - statistics & numerical data; Point-of-Care Systems - statistics & numerical data; Spectrum Analysis - instrumentation; Spectrum Analysis - methods; Spectrum Analysis - statistics & numerical data; oximetry; haemoglobin
• ISSN: 0310-057X; 1448-0271
• DOI: 10.1177/0310057X1504300310

We assessed agreement in haemoglobin measurement between Masimo pulse co-oximeters (Rad-7 ™ and Pronto-7 ™ ) and HemoCue ® photometers (201+ or B-Hemoglobin) with laboratory-based determination and identified 39 relevant studies (2915 patients in Masimo group and 3084 patients in HemoCue group). In the Masimo group, the overall mean difference was -0.03 g/dl (95% prediction interval -0.30 to 0.23) and 95% limits of agreement -3.0 to 2.9 g/dl compared to 0.08 g/dl (95% prediction interval -0.04 to 0.20) and 95% limits of agreement -1.3 to 1.4 g/dl in the HemoCue group. Only B-Hemoglobin exhibited bias (0.53, 95% prediction interval 0.27 to 0.78). The overall standard deviation of difference was larger (1.42 g/dl versus 0.64 g/dl) for Masimo pulse co-oximeters compared to HemoCue photometers. Masimo devices and HemoCue 201+ both provide an unbiased, pooled estimate of laboratory haemoglobin. However, Masimo devices have lower precision and wider 95% limits of agreement than HemoCue devices. Clinicians should carefully consider these limits of agreement before basing transfusion or other clinical decisions on these point-of-care measurements alone.