Reflectance Pulse Oximetry from Core Body in Neonates and Infants: Comparison to Arterial Blood Oxygen Saturation and to Transmission Pulse Oximetry

Abstract

OBJECTIVE:To compare pulse oximetry oxygen saturation (SpO 2 ) measured by a novel reflectance method from core body to arterial oxygen saturation (SaO 2 ) in neonates and infants. Transmission pulse oximetry (TPO) was measured for comparison. STUDY DESIGN:We monitored 18 infants by the two pulse oximeters simultaneously. The reflectance pulse oximetry (RPO) (PRO2, ConMed, Utica, NY) was measured on the upper back or chest, while the TPO (N395-Nellcor, Pleasanton, CA) was measured from the finger of the infant on the left hand or feet. Data from the two methods were compared to functional SaO 2 derived from blood sample drawn from arterial line for patient care and measured by a Co-oximeter (Ilex, Instrument Lab. Lexington, MA). The potential advantage of the RPO is demonstrated in a case of a premature infant with hypovolemic shock, where SaO 2 or TPO could not be obtained but oximetry was available from the RPO. RESULTS:We used for analysis 56 RPO and 32 TPO measurements. SpO 2 obtained from the RPO was 88.3±9.8%, from the TPO 84.2±10.1%, and functional SaO 2 was 88.2±11.7%, with correlation coefficient of 0.93 and 0.88, respectively (p<0.0001). The mean difference (bias) and standard deviation of the differences (precision) between the RPO and the TPO compared to functional SaO 2 were À0.09±4.5% and 1.26±5.9% and the absolute errors were 3.2±3.1%, and 4.4±4.0%, respectively. The accuracy of both RPO and TPO was diminished when SaO 2 was <85%, but only the RPO remained correlated with the functional SaO 2 .CONCLUSIONS: Reflectance pulse oximetry measured from core body of neonates and infants is accurate and reliable and is comparable to the transmission SpO 2 when compared to functional SaO 2 . We speculate that the reflectance method might be advantageous in cases of poor peripheral perfusion in neonates and infants.

Acidosis, lactate, electrolytes, muscle enzymes, and other factors in the blood of Sus scrofa following repeated TASER® exposures

“…The extremely low values of SpO 2 may have been artificially low due to inherent measurement properties of pulse oximetry. The accuracy of this technique can be diminished when saturation is less than 85% [29] and in situations of low tissue blood perfusion [30]. In addition, Yamaya et al [31] reported that, in conditions of hypoxia and severe reductions of pH, further decrements in measured O 2 saturation may occur even in the absence of any true changes in pO 2 .…”

Pilot investigation of anterior fontanelle photoplethysmographic signals and their suitability in estimating arterial oxygen saturation

“…With no obstruction offered by any bony material, it is theorised that the AF can be used as an optical window where both red and infrared light can be used to make PPG measurements at a point below the scalp to directly monitor saturation. Other studies into SpO 2 readings from the core of the neonate would also support this [6].…”

Pulse Oximetry in Comparison to Arterial Blood Oxygen Saturation in Patients with Respiratory Distress in Neonatal Intensive Care Unit (NICU)

“…7 The fifth vital sign for assessing every newborn is the Pulse oximeter oxygen saturation (SpO 2 ). 8 Normally the saturation of oxygen is 93% in healthy newborns in room air and differs according to post-natal age. 9 The adequacy of oxygenation and ventilation are assessed by the Arterial blood gas analysis which is the gold standard.…”