Comparison of Masimo O3 and INVOS 7100 cerebral oxygenation during immediate neonatal transition

This study aims to compare CrSO₂ measured simultaneously by Masimo O3 and INVOS during the first 15 min after birth in healthy term infants and to evaluate agreement and derived cerebral fractional tissue oxygen extraction (cFTOE). In this prospective observational study, 65 healthy term infants were monitored immediately after birth using Masimo O3 and INVOS 7100 applied simultaneously with randomized hemispheric placement. Pre-ductal oxygen saturation (SpO₂) was recorded continuously. Minute-specific values were derived from aggregated measurements during the final 30 s of each minute. Paired comparisons were performed using Wilcoxon signed-rank test. Agreement was assessed using Bland-Altman analysis with regression evaluation for proportional bias. Both devices demonstrated a similar temporal increase in CrSO₂ during the first 5 min, with relative stabilization thereafter. From minute 4 onward, Masimo O3 values were lower than INVOS, with significant differences at minutes 5 to 11 and min 14 (p < 0.05). Overall mean bias was - 2.8%, with 95% limits of agreement from + 18.0 to - 23.6%. Significant proportional bias was present (R² = 0.11, p < 0.001). When CrSO₂ was < 60%, mean bias was + 28.7% with wide limits of agreement. Masimo O3 derived cFTOE values were consistently higher at several time points. No significant hemispheric differences were detected.

Masimo O3 and INVOS show similar temporal patterns but an oxygenation-dependent proportional bias. CrSO₂ values are device-specific and not interchangeable, particularly at lower saturation levels during early transition.

• Cerebral oxygenation during neonatal transition increases rapidly after birth and can be monitored using near-infrared spectroscopy. • Absolute values differ between devices, limiting comparability across NIRS systems.

• This study provides a simultaneous head-to-head comparison of Masimo O3 and INVOS during immediate neonataltransition, demonstrating oxygenation-dependent proportional bias. • CrSO2 values are device-specific and and should not be directly translated between monitoring platforms.