Pulse Oximeter Performance during Rapid Desaturation

Abstract

The reliability of pulse oximetry is crucial, especially in cases of rapid changes in body oxygenation. In order to evaluate the performance of pulse oximeters during rapidly developing short periods of concurrent hypoxemia and hypercapnia, 13 healthy volunteers underwent 3 breathing phases during outdoor experiments (39 phases in total), monitored simultaneously by five different pulse oximeters. A significant incongruity in values displayed by the tested pulse oximeters was observed, even when the accuracy declared by the manufacturers were considered. In 28.2% of breathing phases, the five used devices did not show any congruent values. The longest uninterrupted congruent period formed 74.4% of total recorded time. Moreover, the congruent periods were rarely observed during the critical desaturation phase of the experiment. The time difference between the moments when the first and the last pulse oximeter showed the typical study endpoint values of SpO2 85% and 75% was 32.1 ± 23.6 s and 24.7 ± 19.3 s, respectively. These results suggest that SpO2 might not be a reliable parameter as a study endpoint, or more importantly as a safety limit in outdoor experiments. In the design of future studies, more parameters and continuous clinical assessment should be included.

Everything About Pulse Oximetry—Part 2: Clinical Applications, Portable/Wearable Pulse Oximeters, Remote Patient Monitoring, and Recent Advances

“…These findings suggest that SpO 2 might not be a reliable parameter as a study endpoint or safety limit in outdoor experiments. 4…”

“…The authors recommended using the forehead reflectance pulse oximeter in clinical situations where rapid changes in SpO 2 were expected. 3 Horakova et al 4 conducted a study to assess the performance of five different pulse oximeters during short periods of concurrent hypoxemia and hypercapnia. Thirteen healthy volunteers were involved in the study, and each underwent three breathing experiments monitored by the pulse oximeters.…”

“…These findings suggest that SpO 2 might not be a reliable parameter as a study endpoint or safety limit in outdoor experiments. 4 Du et al 5 conducted a meta-analysis to assess the diagnostic role of pulse oximetry for congenital heart disease (CHD), which is a leading cause of infant mortality. Early detection is critical for the successful management of CHD, as delayed diagnosis can lead to cardiovascular collapse, heart failure (HF), and death.…”