Masimo announced the CE marking and commercial launch in Europe of the single-patient-use adhesive rainbow SuperSensor, compatible for use with both Masimo and third-party monitors with Masimo rainbow® technology inside. In an industry first, the comprehensive, convenient, and multi-purpose SuperSensor uses 12 LEDs to simultaneously offer 12 blood constituent parameters noninvasively and continuously: SET® oxygen saturation (SpO2), total hemoglobin, SpHb®, carboxyhemoglobin (SpCO®), methemoglobin (SpMet®), oxygen reserve index (ORi™), PVi®, RPVi™, pulse rate (PR), respiration rate (RRp®), perfusion index (Pi), fractional oxygen saturation (SpfO2™), and oxygen content (SpOC™)—all on the same single-patient-use adhesive sensor. By allowing clinicians to noninvasively and continuously monitor so many different physiologic indicators simultaneously, the SuperSensor offers the ability to assess the patient’s status continuously. At the core of the SuperSensor is Masimo SET® pulse oximetry, which has been clinically proven to help care teams enhance patient safety and improve patient outcomes; in fact, more than 100 independent and objective studies have shown that Masimo SET® outperforms other pulse oximetry technologies in clinical settings and motion and low perfusion conditions, providing clinicians with increased sensitivity and specificity to make critical care decisions.1 SET® has also been shown to help clinicians reduce severe retinopathy of prematurity in neonates,2 improve CCHD screening in newborns,3 and, when used for continuous monitoring with Masimo Patient SafetyNet™ in post-surgical wards, reduce deaths due to opioid overdose, while also reducing rapid response team activations, ICU transfers, and the cost of care. Continuous hemoglobin monitoring with SpHb as part of patient blood management programs has been found to help clinicians improve outcomes in both high- and low- blood loss surgeries, such as reducing the percentage of patients receiving transfusions,8 reducing the units of red blood cells transfused per patient,9-10 reducing the time to transfusion,11 and reducing costs.12 The utility of PVi, a measure of the dynamic changes in perfusion index that occur during the respiratory cycle, as an indicator of fluid responsiveness, has been demonstrated in more than 100 independent studies.13 Use of SpHb and PVi together, as part of an integrated goal-directed therapy protocol for fluid management and blood administration, has even been shown to help clinicians reduce mortality 30 and 90 days after surgery, by 33% and 29%, respectively. ORi is a noninvasive and continuous trending index that extends oxygen monitoring of patients receiving supplemental oxygen. By monitoring oxygenation beyond the upper limits of conventional pulse oximetry, ORi offers the potential for advanced warning of hypoxemia, during preoxygenation and intubation procedures, and of hyperoxia, in patients receiving greater concentrations of supplemental oxygen than clinically required. For example, in a study of pediatric patients undergoing general anaesthesia with orotracheal intubation, researchers found that ORi detected impending desaturation in a median of 31.5 seconds before noticeable changes in SpO2 occurred.15 A study evaluating the ability of ORi to predict mild hypoxemia during endotracheal intubation found that the time between decrease in ORi and subsequent decrease in SpO2 “may allow preventive action,” and that a higher ORi value during preoxygenation was “independently protective against hypoxemia.”16 In another study, researchers found that monitoring adult ICU patients with ORi significantly reduced the time these critically ill patients spent with moderate hyperoxia, compared to monitoring with oxygen saturation (SpO2) alone. SpMet helps clinicians noninvasively and continuously monitor methemoglobin levels in the blood.18 Elevated methemoglobin levels can be caused by many drugs given in hospitals, including inhaled nitric oxide (iNO) therapy,19-20 which has been used as a potential treatment for lung complications associated with COVID-19. SpMet may be an important monitoring tool during iNO therapy. By making SpMet,SpCO, and SpfO2 available on the same sensor, the SuperSensor provides a more complete picture of oxygenation in the presence of potential dyshemoglobin interference. Fractional oxygen saturation (FO2Hb) provides a measure of the fraction of total hemoglobin that is currently oxygenated, as opposed to SpO2, functional oxygen saturation, which measures the fraction of hemoglobin that is oxygenated based on an estimation of the effective hemoglobin available (hemoglobin capable of being oxygenated). In healthy individuals, FO2Hb is often similar to SpO2, but when dyshemoglobin levels are elevated, FO2Hb may be more representative of the total oxygen-carrying capacity of hemoglobin than SpO2. In the presence of dyshemoglobins, SpO2 may appear “normal,” but SpfO2—a noninvasive, continuous measurement of FO2Hb—may provide more insight into a possible oxygenation impairment. Combined with the ability to monitor SpCO and SpMet on the same sensor, clinicians now have additional information to help determine if a dyshemoglobin species is responsible, and intervene appropriately.