{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T19:12:17Z","timestamp":1791486737939,"version":"4.3.4"},"reference-count":38,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2025,1,8]],"date-time":"2025-01-08T00:00:00Z","timestamp":1736294400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009379","name":"University of Wuerzburg","doi-asserted-by":"publisher","award":["CSP-19"],"award-info":[{"award-number":["CSP-19"]}],"id":[{"id":"10.13039\/501100009379","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: 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\u2019s Rad-67\u2122, 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. Methods: This retrospective study analyzed 335 paired Hb measurements with an interval &lt;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\u2013Altman 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. Results: The bias of the SpHb compared to BGA according to Bland\u2013Altman was 0.00 g\/dL, with limits of agreement ranging from \u22122.70 to 2.45 g\/dL. A strong correlation was observed (r = 0.79). Overall, 57.6% of the paired measurements showed a deviation between the two methods of \u2264\u00b11 g\/dL; however, this applied to only 33.3% of the anemic patients. Modified Clark\u2019s 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 (p = 0.02). Conclusions: The Rad-67TM 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.<\/jats:p>","DOI":"10.3390\/diagnostics15020128","type":"journal-article","created":{"date-parts":[[2025,1,8]],"date-time":"2025-01-08T04:54:08Z","timestamp":1736312048000},"page":"128","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Evaluation of Non-Invasive Hemoglobin Monitoring in Perioperative Patients: A Retrospective Study of the Rad-67TM (Masimo)"],"prefix":"10.3390","volume":"15","author":[{"given":"Philipp","family":"Helmer","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University Hospital W\u00fcrzburg, Oberd\u00fcrrbacher Str. 6, 97080 W\u00fcrzburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1993-8571","authenticated-orcid":false,"given":"Andreas","family":"Steinisch","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University Hospital W\u00fcrzburg, Oberd\u00fcrrbacher Str. 6, 97080 W\u00fcrzburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9426-7560","authenticated-orcid":false,"given":"Sebastian","family":"Hottenrott","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University Hospital W\u00fcrzburg, Oberd\u00fcrrbacher Str. 6, 97080 W\u00fcrzburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Schlesinger","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care, BG Murnau, Professor-K\u00fcntscher-Str. 8, 82418 Murnau, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6528-9883","authenticated-orcid":false,"given":"Michael","family":"Sammeth","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University Hospital W\u00fcrzburg, Oberd\u00fcrrbacher Str. 6, 97080 W\u00fcrzburg, Germany"},{"name":"Department of Applied Sciences and Health, Coburg University of Applied Sciences and Art, Friedrich-Streib-Str. 2, 96450 Coburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2666-8696","authenticated-orcid":false,"given":"Patrick","family":"Meybohm","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University Hospital W\u00fcrzburg, Oberd\u00fcrrbacher Str. 6, 97080 W\u00fcrzburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5324-981X","authenticated-orcid":false,"given":"Peter","family":"Kranke","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University Hospital W\u00fcrzburg, Oberd\u00fcrrbacher Str. 6, 97080 W\u00fcrzburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1097\/ALN.0000000000000463","article-title":"Practice guidelines for perioperative blood management: An updated report by the American Society of Anesthesiologists Task Force on Perioperative Blood Management","volume":"122","author":"Null","year":"2015","journal-title":"Anesthesiology"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Rumpf, F., Hof, L., Old, O., Friederich, P., Friedrich, J., Thoma, J., Wittmann, M., Zacharowski, K., Choorapoikayil, S., and Meybohm, P. 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