Journal of Anesthesia

, Volume 33, Issue 3, pp 441–453 | Cite as

Comparison of invasive and noninvasive blood hemoglobin measurement in the operating room: a systematic review and meta-analysis

  • Hosein Shabaninejad
  • Nashmil GhadimiEmail author
  • Kourosh Sayehmiri
  • Hossein Hosseinifard
  • Rasoul Azarfarin
  • Hasan Abolghasem Gorji
Review Article


Noninvasive hemoglobin (Hb)-monitoring devices are new inventions in pulse oximeter systems that show hemoglobin levels continuously. The aim of this systematic review and meta-analysis was to evaluate the accuracy and precision of noninvasive versus standard central laboratory Hb measurements in the operating room. We systematically searched multiple databases. Then, for the quality assessment of studies, we modified QUADAS-2 in the Revman 5.3 software. The GRADE approach was used to measure the quality of evidence (Grading of Recommendations Assessment, Development, and Evaluation). Data were analyzed using the meta-analysis method (random effect model) using STATA 11 software. A total of 28 studies on 2000 participants were included in the meta-analysis. Meta-analysis results of mean differences between noninvasive and the central laboratory Hb measurements in overall pooled random effects were − 0.27 (95% LoA (0.44, − 0.10); P value < 0.05). According to this meta-analysis, noninvasive hemoglobin measurement has acceptable accuracy in comparison with the standard invasive method.


Measurement Pulse oximeter Noninvasive Hemoglobin Monitoring 



This article is part of the dissertation entitled "Health technology assessment of Comparison of Invasive and Noninvasive Blood Hemoglobin Measurement in surgery" at the Master’s Degree in Health Technology Assessment supported by Iran University of Medical Sciences (code: iums/shmis-1395/9311592004).

Supplementary material

540_2019_2629_MOESM1_ESM.docx (3.2 mb)
Supplementary material 1 (DOCX 3301 KB)


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Copyright information

© Japanese Society of Anesthesiologists 2019

Authors and Affiliations

  • Hosein Shabaninejad
    • 1
  • Nashmil Ghadimi
    • 2
    Email author
  • Kourosh Sayehmiri
    • 3
  • Hossein Hosseinifard
    • 4
  • Rasoul Azarfarin
    • 5
  • Hasan Abolghasem Gorji
    • 1
  1. 1.Department of Health Services Management, School of Health Management and Information SciencesIran University of Medical SciencesTehranIran
  2. 2.Health Technology Assessment, School of Health Management and Information ScienceIran University of Medical sciencesTehranIran
  3. 3.Prevention Center of Social-Mental InjuriesIlam University of Medical SciencesIlamIran
  4. 4.Biostatistics, Research Center for Evidence Based Medicine (RCEBM)Tabriz University of Medical SciencesTabrizIran
  5. 5.Echocardioghraphy Research Center, Rajaie Cardiovascular Medical and Research CenterIran University of Medical SciencesTehranIran

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