The accuracy of the biox 3700 pulse oximeter in patients receiving vasoactive therapy

Ibáñez, J.; Velasco, J.; Raurich, J. M.

doi:10.1007/bf01690773

Cited by 35 publications

(17 citation statements)

References 15 publications

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“…Different studies show a wide range (Ϫ0.02 to 3.39) of bias between the oxygen saturation assessed by pulse oximetry and arterial blood gas analysis (Table 4). [2][3][4][13][14][15][16] This may in part be due to the different clinical situations in which the studies were performed and the fact that the pulse oximeter interprets the ratio of oxyhemoglobin to total hemoglobin in the pulsatile arterial vessels. 17 Therefore, factors altering the detection of pulsatility of the arteries limit the accuracy of the S pO 2 values.…”

Section: What This Paper Contributes To Our Knowledgementioning

confidence: 99%

Pulse Oximetry Overestimates Oxygen Saturation in COPD

Amalakanti¹,

Pentakota

2015

Respir Care

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BACKGROUND: Measurement of oxygen saturation with a handheld pulse oximeter is widely practiced as a surrogate to invasive arterial blood gas analysis. Oxygen saturation is an important parameter in cases of COPD, but there are insufficient data on the role of pulse oximetry in patients with COPD, moreso in diseases across its spectrum, such as chronic bronchitis and emphysema. We assessed the performance of pulse oximetry in acute respiratory failure of patients with COPD. METHODS: This was a cross-sectional, observational study. We studied 50 subjects with COPD admitted to the Government General Hospital, a 1,000-bed tertiary referral center in Guntur, India, from June 2013 to July 2013. Simultaneous reading of S pO 2 by a handheld pulse oximeter and S aO 2 by an automated arterial blood gas analyzer were taken. RESULTS: Pulse oximetry was sufficiently sensitive (84.60%) to hypoxemia in respiratory failure to be used in clinical situations. The mean difference (bias) between S aO 2 and S pO 2 was ؊3.98 (95% CI ؊4.68 to 3.28). There was less sensitivity (82% vs 85%) and positive predictive value (69% vs 85%) of the pulse oximeter to respiratory failure in subjects with chronic bronchitis versus emphysema. CONCLUSIONS: Pulse oximetry performed poorly in comparison with the invasive arterial blood gas analysis. The variability of the readings was greater in the subjects with chronic bronchitis than in those with emphysema.

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Section: What This Paper Contributes To Our Knowledgementioning

confidence: 99%

Pulse Oximetry Overestimates Oxygen Saturation in COPD

Amalakanti¹,

Pentakota

2015

Respir Care

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“…Both the degree of inaccuracy, or bias, and its direction has been inconsistent [1-3,5,7-9]. In addition, while certain studies of critically ill patients have demonstrated that hypoxemia [1], anemia [10], requirement for vasoactive drugs [7], and acidosis [8] influence the accuracy of pulse oximetry, others have not [2,6]. Data on the effects of other physiologic derangements, such as hyperlactatemia and bacteremia, are absent.…”

Section: Introductionmentioning

confidence: 99%

“…This has also been demonstrated in animal models of severe sepsis [14,15]. The two existing studies examining the performance of pulse oximetry in humans with septic shock [7,9] were small, consisting of a combined 17 patients, and were undertaken in the intensive care unit (ICU), later in the course of disease. As the pathophysiology of sepsis evolves over time, with its distinct temporal changes to hemodynamic [16] and inflammatory [17] variables, there is an important paucity of data regarding pulse oximeter accuracy early in the course of severe sepsis.…”

Section: Introductionmentioning

confidence: 99%

The accuracy of pulse oximetry in emergency department patients with severe sepsis and septic shock: a retrospective cohort study

et al. 2010

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BackgroundPulse oximetry is routinely used to continuously and noninvasively monitor arterial oxygen saturation (SaO2) in critically ill patients. Although pulse oximeter oxygen saturation (SpO2) has been studied in several patient populations, including the critically ill, its accuracy has never been studied in emergency department (ED) patients with severe sepsis and septic shock. Sepsis results in characteristic microcirculatory derangements that could theoretically affect pulse oximeter accuracy. The purposes of the present study were twofold: 1) to determine the accuracy of pulse oximetry relative to SaO2 obtained from ABG in ED patients with severe sepsis and septic shock, and 2) to assess the impact of specific physiologic factors on this accuracy.MethodsThis analysis consisted of a retrospective cohort of 88 consecutive ED patients with severe sepsis who had a simultaneous arterial blood gas and an SpO2 value recorded. Adult ICU patients that were admitted from any Calgary Health Region adult ED with a pre-specified, sepsis-related admission diagnosis between October 1, 2005 and September 30, 2006, were identified. Accuracy (SpO2 - SaO2) was analyzed by the method of Bland and Altman. The effects of hypoxemia, acidosis, hyperlactatemia, anemia, and the use of vasoactive drugs on bias were determined.ResultsThe cohort consisted of 88 subjects, with a mean age of 57 years (19 - 89). The mean difference (SpO2 - SaO2) was 2.75% and the standard deviation of the differences was 3.1%. Subgroup analysis demonstrated that hypoxemia (SaO2 < 90) significantly affected pulse oximeter accuracy. The mean difference was 4.9% in hypoxemic patients and 1.89% in non-hypoxemic patients (p < 0.004). In 50% (11/22) of cases in which SpO2 was in the 90-93% range the SaO2 was <90%. Though pulse oximeter accuracy was not affected by acidoisis, hyperlactatementa, anemia or vasoactive drugs, these factors worsened precision.ConclusionsPulse oximetry overestimates ABG-determined SaO2 by a mean of 2.75% in emergency department patients with severe sepsis and septic shock. This overestimation is exacerbated by the presence of hypoxemia. When SaO2 needs to be determined with a high degree of accuracy arterial blood gases are recommended.

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“…The reliability of pulse oximetry during hypoxemia has been studied during breathing of hypoxic gas mixtures by healthy volunteers and in children with cyanotic congenital heart disease [3,4]. The effect of low perfusion on pulse oximetry has been studied using vasoconstrictive therapy, during hemorrhagic hypotension and in sepsis-associated hypoperfusion [5,6,7]. …”

Section: Introductionmentioning

confidence: 99%

Reliability of Pulse Oximetry during Progressive Hypoxia, Cardiopulmonary Resuscitation, and Recovery in a Piglet Model of Neonatal Hypoxic Cardiac Arrest

et al. 2017

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Background: Pulse oximetry is widely used in intensive care and emergency conditions to monitor arterial oxygenation and to guide oxygen therapy. Objective: To study the reliability of pulse oximetry in comparison with CO-oximetry in newborn piglets during progressive hypoxia, cardiac arrest, cardiopulmonary resuscitation (CPR), and after return of spontaneous circulation (ROSC). Methods: Thirty-three newborn piglets were exposed to hypoxia until asystole occurred and then resuscitated until ROSC. Arterial oxygen saturation was monitored continuously by pulse oximetry (SpO₂) with one sensor applied to the wrist of the right forelimb (FL) and another to the thigh of the left hind limb (HL). Arterial functional oxygen saturation (SaO₂) was measured at baseline and at predefined intervals during each phase of the experiment. SpO₂ was compared with coinciding SaO₂ values and bias considered whenever the difference (SpO₂ - SaO₂) was beyond ±5%. Results: Bias values were lower at the baseline measurements (-3.7 ± 2.3% in FL and -4.1 ± 3.4% in HL) as well as after ROSC (1.5 ± 4.2% in FL and 0.2 ± 4.6% in HL) with higher precision and accuracy than during other experiment phases. During hypoxia induction, cardiac arrest, and CPR, there was a marked decrease in precision and accuracy as well as an increase in bias up to 43 ± 26 and 56 ± 27% in FL and HL, respectively, over a range of SaO₂ from 13 to 51%. Conclusion: Pulse oximetry showed increased bias and decreased accuracy and precision during marked hypoxemia in a model of neonatal hypoxic cardiac arrest.

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The accuracy of the biox 3700 pulse oximeter in patients receiving vasoactive therapy

Cited by 35 publications

References 15 publications

Pulse Oximetry Overestimates Oxygen Saturation in COPD

Pulse Oximetry Overestimates Oxygen Saturation in COPD

The accuracy of pulse oximetry in emergency department patients with severe sepsis and septic shock: a retrospective cohort study

Reliability of Pulse Oximetry during Progressive Hypoxia, Cardiopulmonary Resuscitation, and Recovery in a Piglet Model of Neonatal Hypoxic Cardiac Arrest

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