Effects of Skin Pigmentation on Pulse Oximeter Accuracy at Low Saturation

2005 ◽  
Vol 102 (4) ◽  
pp. 715-719 ◽  
Author(s):  
Philip E. Bickler ◽  
John R. Feiner ◽  
John W. Severinghaus
Keyword(s):  
Carbon Dioxide ◽  
Oxygen Saturation ◽  
Pulse Oximeter ◽  
Arterial Oxygen Saturation ◽  
Skin Pigmentation ◽  
Arterial Oxygen ◽  
Dark Light ◽  
Light Skin ◽  
End Tidal ◽  
Pulse Oximeters

Background It is uncertain whether skin pigmentation affects pulse oximeter accuracy at low HbO2 saturation. Methods The accuracy of finger pulse oximeters during stable, plateau levels of arterial oxygen saturation (Sao2) between 60 and 100% were evaluated in 11 subjects with darkly pigmented skin and in 10 with light skin pigmentation. Oximeters tested were the Nellcor N-595 with the OxiMax-A probe (Nellcor Inc., Pleasanton, CA), the Novametrix 513 (Novametrix Inc., Wallingford, CT), and the Nonin Onyx (Nonin Inc., Plymouth, MN). Semisupine subjects breathed air-nitrogen-carbon dioxide mixtures through a mouthpiece. A computer used end-tidal oxygen and carbon dioxide concentrations determined by mass spectrometry to estimate breath-by-breath Sao2, from which an operator adjusted inspired gas to rapidly achieve 2- to 3-min stable plateaus of desaturation. Comparisons of oxygen saturation measured by pulse oximetry (Spo2) with Sao2 (by Radiometer OSM3) were used in a multivariate model to determine the interrelation between saturation, skin pigmentation, and oximeter bias (Spo2 - Sao2). Results At 60-70% Sao2, Spo2 (mean of three oximeters) overestimated Sao2 (bias +/- SD) by 3.56 +/- 2.45% (n = 29) in darkly pigmented subjects, compared with 0.37 +/- 3.20% (n = 58) in lightly pigmented subjects (P < 0.0001). The SD of bias was not greater with dark than light skin. The dark-light skin differences at 60-70% Sao2 were 2.35% (Nonin), 3.38% (Novametrix), and 4.30% (Nellcor). Skin pigment-related differences were significant with Nonin below 70% Sao2, with Novametrix below 90%, and with Nellcor at all ranges. Pigment-related bias increased approximately in proportion to desaturation. Conclusions The three tested pulse oximeters overestimated arterial oxygen saturation during hypoxia in dark-skinned individuals.

scholarly journals First Evaluation of a Newly Constructed Underwater Pulse Oximeter for Use in Breath-Holding Activities

2021 ◽  
Vol 12 ◽  
Author(s):  
Eric Mulder ◽  
Erika Schagatay ◽  
Arne Sieber
Keyword(s):  
Oxygen Saturation ◽  
Pulse Oximeter ◽  
Arterial Oxygen Saturation ◽  
Dropout Rate ◽  
Arterial Oxygen ◽  
Breath Holding ◽  
Signal Loss ◽  
Physiological Variables ◽  
Dry Conditions ◽  
Pulse Oximeters

Studying risk factors in freediving, such as hypoxic blackout, requires development of new methods to enable remote underwater monitoring of physiological variables. We aimed to construct and evaluate a new water- and pressure proof pulse oximeter for use in freediving research. The study consisted of three parts: (I) A submersible pulse oximeter (SUB) was developed on a ruggedized platform for recording of physiological parameters in challenging environments. Two MAX30102 sensors were used to record plethysmograms, and included red and infra-red emitters, diode drivers, photodiode, photodiode amplifier, analog to digital converter, and controller. (II) We equipped 20 volunteers with two transmission pulse oximeters (TPULS) and SUB to the fingers. Arterial oxygen saturation (SpO2) and heart rate (HR) were recorded, while breathing room air (21% O2) and subsequently a hypoxic gas (10.7% O2) at rest in dry conditions. Bland-Altman analysis was used to evaluate bias and precision of SUB relative to SpO2 values from TPULS. (III) Six freedivers were monitored with one TPULS and SUB placed at the forehead, during a maximal effort immersed static apnea. For dry baseline measurements (n = 20), SpO2 bias ranged between −0.8 and −0.6%, precision between 1.0 and 1.5%; HR bias ranged between 1.1 and 1.0 bpm, precision between 1.4 and 1.9 bpm. For the hypoxic episode, SpO2 bias ranged between −2.5 and −3.6%, precision between 3.6 and 3.7%; HR bias ranged between 1.4 and 1.9 bpm, precision between 2.0 and 2.1 bpm. Freedivers (n = 6) performed an apnea of 184 ± 53 s. Desaturation- and resaturation response time of SpO2 was approximately 15 and 12 s shorter in SUB compared to TPULS, respectively. Lowest SpO2 values were 76 ± 10% for TPULS and 74 ± 13% for SUB. HR traces for both pulse oximeters showed similar patterns. For static apneas, dropout rate was larger for SUB (18%) than for TPULS (<1%). SUB produced similar SpO2 and HR values as TPULS, both during normoxic and hypoxic breathing (n = 20), and submersed static apneas (n = 6). SUB responds more quickly to changes in oxygen saturation when sensors were placed at the forehead. Further development of SUB is needed to limit signal loss, and its function should be tested at greater depth and lower saturation.

DESIGN OF A RING-TYPE REFLECTION PULSE OXIMETER WITH A PARABOLIC REFLECTOR

2015 ◽  
Vol 27 (01) ◽  
pp. 1550007 ◽  
Author(s):  
Chun-Hao Lu ◽  
Jiun-Hung Lin ◽  
Han-Ming Huang ◽  
Cheng-Yang Huang ◽  
Cheng-Chi Tai
Keyword(s):  
Oxygen Saturation ◽  
Pulse Oximeter ◽  
Clinical Medicine ◽  
Arterial Oxygen Saturation ◽  
Arterial Oxygen ◽  
Parabolic Reflector ◽  
Ring Type ◽  
Reflected Light ◽  
Pulse Oximeters

A pulse oximeter is a noninvasive instrument used in clinical medicine to monitor arterial oxygen saturation. Fingertip-type pulse oximeters are popular, but their inconvenience for long-term monitoring in daily life means that other types of wearable pulse oximeters, such as a ring-type reflection pulse oximeter, needs to be developed. However, designing a ring-type pulse oximeter for measuring the oxygen saturation is difficult due to the complex tissue architecture of the finger base. This study used human tissue simulations to evaluate the practicability of a ring-type reflection pulse oximeter design. Moreover, given that the collection of diffusely reflected light can be enhanced by using a parabolic reflector, the efficacy of a ring-type reflection pulse oximeter with a parabolic reflector was also evaluated.

Re: “Positional Changes in Arterial Oxygen Saturation and End-Tidal Carbon Dioxide at High Altitude: Medex 2015” by Kuenzel et al.

2020 ◽  
Vol 21 (3) ◽  
pp. 305-306
Author(s):  
Ulrich Limper ◽  
Vera Fiala ◽  
Eva M. Elmenhorst ◽  
Jens Tank ◽  
Gereon Schaelte ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Oxygen Saturation ◽  
High Altitude ◽  
Arterial Oxygen Saturation ◽  
Arterial Oxygen ◽  
End Tidal Carbon Dioxide ◽  
End Tidal

scholarly journals Is pulse oximeter a reliable tool for non-critically ill patients with COVID-19?

2021 ◽  
Author(s):  
Aslıhan Gürün Kaya ◽  
Miraç Öz ◽  
İREM AKDEMİR KALKAN ◽  
Ezgi Gülten ◽  
güle AYDIN ◽  
...  
Keyword(s):  
Oxygen Saturation ◽  
Pulse Oximeter ◽  
Lymphocyte Count ◽  
Arterial Oxygen Saturation ◽  
Arterial Oxygen ◽  
Arterial Blood Gas ◽  
Reactive Protein ◽  
Arterial Blood ◽  
The Difference ◽  
Clinical Conditions

Introduction: Guidelines recommend using a pulse oximeter rather than arterial blood gas (ABG) for COVID-19 patients. However, significant differences can be observed between oxygen saturation measured by pulse oximetry (SpO2) and arterial oxygen saturation (SaO2) in some clinical conditions. We aimed to assess the reliability of pulse oximeter in patients with COVID-19 Methods: We retrospectively reviewed ABG analyses and SpO2 levels measured simultaneously with ABG in patients hospitalized in COVID-19 wards. Results: We categorized total 117 patients into two groups; in whom the difference between SpO2 and SaO2 was 4% (acceptable difference) and >4% (large difference). Large difference group exhibited higher neutrophil count, C-reactive protein, ferritin, fibrinogen, D-dimer and lower lymphocyte count. Multivariate analyses revealed that increased fibrinogen, increased ferritin and decreased lymphocyte count were independent risk factors for large difference between SpO2 and SaO2. The total study group demonstrated the negative bias of 4.02% with the limits of agreement of −9.22% to 1.17%. The bias became significantly higher in patients with higher ferritin, fibrinogen levels and lower lymphocyte count. Conclusion: Pulse oximeters may not be sufficient to assess actual oxygen saturation especially in COVID-19 patients with high ferritin and fibrinogen levels and low lymphocyte count low SpO2 measurements.

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