A multicentre prospective observational study comparing arterial blood gas values to those obtained by pulse oximeters used in adult patients attending Australian and New Zealand hospitals

Abstract

Background: Pulse oximetry is widely used in the clinical setting. The purpose of this validation study was to investigate the level of agreement between oxygen saturations measured by pulse oximeter (SpO 2) and arterial blood gas (SaO 2) in a range of oximeters in clinical use in Australia and New Zealand. Methods: Paired SpO 2 and SaO 2 measurements were collected from 400 patients in one Australian and two New Zealand hospitals. The ages of the patients ranged from 18 to 95 years. Bias and limits of agreement were estimated. Sensitivity and specificity for detecting hypoxaemia, defined as SaO 2 < 90%, were also estimated. Results: The majority of participants were recruited from the Outpatient, Ward or High Dependency Unit setting. Bias, oximeter-measured minus arterial blood gas-measured oxygen saturation, was − 1.2%, with limits of agreement − 4.4 to 2.0%. SpO 2 was at least 4% lower than SaO 2 for 10 (2.5%) of the participants and SpO 2 was at least 4% higher than the SaO 2 in 3 (0.8%) of the participants. None of the participants with a SpO 2 ≥ 92% were hypoxaemic, defined as SaO 2 < 90%. There were no clinically significant differences in oximetry accuracy in relation to clinical characteristics or oximeter brand. Conclusions: In the majority of the participants, pulse oximetry was an accurate method to assess SaO 2 and had good performance in detecting hypoxaemia. However, in a small proportion of participants, differences between SaO 2 and SpO 2 could have clinical relevance in terms of patient monitoring and management. A SpO 2 ≥ 92% indicates that hypoxaemia, defined as a SaO 2 < 90%, is not present. Trial registration: Australian and New Zealand Clinical Trials Registry (ACTRN12614001257651). Date of registration: 2/12/2014.

Novel Use of Home Pulse Oximetry Monitoring in COVID‐19 Patients Discharged From the Emergency Department Identifies Need for Hospitalization

“…A recent multicenter, prospective study found SpO 2 < 92% had 95% sensitivity and 90% specificity for detecting PaO 2 < 60 mm Hg. 3 PaO 2 < 60 mm Hg defines hypoxemic respiratory failure. 4 On the oxygen-dissociation curve, there is a steep drop in SpO 2 as PaO 2 approaches 60 mm Hg known as the "slippery slope."…”

“…Additionally, while it is generally known that patients with advanced age, comorbidities, or certain laboratory findings are at increased risk for worse clinical outcomes, specific predictors for who will require hospitalization are not known at this time. 2,3 Goal of Investigation Our objective was to evaluate patient-reported oxygen saturation (SpO 2 ) using pulse oximetry as a home monitoring tool for patients with initially nonsevere COVID-19 to identify need for hospitalization.…”

Establishment of&nbsp;a&nbsp;Highly Predictive&nbsp;Survival Nomogram For Patients With Sepsis: A Retrospective Cohort Study

“…The predictions made using the nomogram regarding whether a patient has MC are also related to the immune system, and the inclusion of albumin in the nomogram re ects the tendency of older patients to have a worse nutritional status than their younger counterparts. XXX [26][27] The haemodynamic performance of patients with septic shock is exceptionally complicated. In sepsis, endothelial cell dysfunction, the interaction of leukocytes/platelets and endothelial cells, coagulation activation, in ammation, abnormal haemorheology, and functional shunting together lead to microcirculatory disorders, insu cient tissue perfusion, and hypoxia, ultimately leading to multiple-organ dysfunction or even septic shock [28][29] .…”

“…Sepsis, which is de ned as an infection with organ failure characterized by a dysregulation of the host's response to the infection, including in ammation and non-immune responses involving multiple systems according to the International Consensus on the De nition of Sepsis and Septic Shock Version III in 2016,is common in intensive care units (ICUs) worldwide and has a high morbidity and mortality [1][2] . There are more than 19 million sepsis cases in the world annually 1 , and the fatality rate is reportedly as high as 26.10-42.86% 2 .…”

An emergency system for monitoring pulse oximetry, peak expiratory flow and body temperature of patients with COVID-19 at home: Development and preliminary application

“…This provides a graphical description of these readings against time(Figure 3), allowing the user to detect trends toward normality or abnormal changes in the mentioned parameters by visual analysis.The program allows the user to select the minimum SpO2 value considered appropriate. Previous studies used a minimum normal SpO2 of 92%[22,23], while others report that these values are between 93% and 94%[10]. The program automatically searches for the minimum SpO2 values presented by this patient and compared with the selected value.…”