The accuracy of pulse oximetry in the emergency department

Lee, Wally W.; Mayberry, Kurt; Crapo, Robert O.; Jensen, Robert L.

doi:10.1053/ajem.2000.7330

Cited by 86 publications

(77 citation statements)

References 24 publications

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“…Most of these studies have been done in hospitalised patients, generally in intensive care units, or in healthy individuals who are exposed to various conditions of hypoxia. Very few studies have examined the agreement between Sa,O 2 and Sp,O 2 in the setting of outpatient monitoring [8][9][10], an area in which this information can be highly relevant. With the development of long-term home oxygen therapy and home mechanical ventilation, clinicians attend an increasingly greater number of patients with end-stage lung disease in whom the decisions regarding these and other therapies are often based on pulse oximetry findings [11][12][13][14].…”

mentioning

confidence: 99%

Accuracy and reliability of pulse oximetry at different arterial carbon dioxide pressure levels

Muñoz¹,

Sampol²,

Ríos³

et al. 2008

European Respiratory Journal

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The present study aimed to assess whether arterial carbon dioxide pressure (Pa,CO 2 ) has an impact on agreement between oxygen saturation measured with pulse oximetry (Sp,O 2 ) or arterial blood gas co-oximetry (Sa,O 2 ).Sa,O 2 and Sp,O 2 determinations were obtained simultaneously from 846 patients under assessment for long-term home oxygen therapy in a specialised outpatient clinic. Both measurements were taken with patients seated and breathing room air.Agreement between Sa,O 2 and Sp,O 2 results was analysed by the Bland-Altman method and the Lin concordance coefficient. In addition, potential interactions of arterial oxygen tension (Pa,O 2 ) or Pa,CO 2 on agreement were analysed by adjusted multivariate analysis.Upon comparison of Sa,O 2 and Sp,O 2 results, the Bland-Altman technique yielded a bias (95% confidence interval (CI)) of -1.24 (-6.86-4.38) and -1.32 (-7.78-5.15) when Pa,CO 2 .48 mmHg (6.39 kPa) or Pa,O 2 ,54 mmHg (7.20 kPa), respectively. Estimate by Lin's coefficient (95% CI) in these cases was 0.88 (0.85-0.90) and 0.81 (0.77-0.85). Adjusted multivariate analysis, performed to assess the impact of pH, Pa,O 2 , Pa,CO 2 and bicarbonate on bias, showed that Pa,O 2 , Pa,CO 2 and their interaction terms were the most important predictors of the bias (standardised estimates of -0.54, -0.94, and 0.85, respectively). The effect of pH, although statistically significant, was small, and bicarbonate had no significant effect.Arterial carbon dioxide pressure status can contribute to impaired agreement between arterial oxygen saturation and arterial oxygen saturation measured with pulse oximetry, particularly in patients with hypercapnia.

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confidence: 99%

Accuracy and reliability of pulse oximetry at different arterial carbon dioxide pressure levels

Muñoz¹,

Sampol²,

Ríos³

et al. 2008

European Respiratory Journal

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“…Essentially, only pH, pO 2 (partial pressure of oxygen), and pCO 2 are measured values in a blood gas analysis, whereas all other indices such as bicarbonate and oxygen saturation in a blood gas analysis are derived from these former values. Earlier studies have shown good correlation and agreement between oxygen saturation measured by the pulse oximetry and that measured on the arterial blood gas (20,21). Given a small arteriovenous pH difference, demonstration of minimal arteriovenous pCO 2 difference variability would have suggested that arterial blood gas measurements would be rarely indicated.…”

Section: Discussionmentioning

confidence: 99%

Point-of-Care Bedside Gas Analyzer: Limited Use of Venous pCO2 in Emergency Patients

Ibrahim

Ooi

Huak

et al. 2011

The Journal of Emergency Medicine

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“…It has been recommended that patients at risk for hypoxic conditions be monitored using pulse oximetry. 12,14,[33][34][35][36][37] Hypoxia is commonly found in the elderly 38 and those at risk for coronary vascular disease, 39 coronary artery disease, 39 sleep disordered breathing, 39 disorders of balance, hypertension, 39 chronic migraines, and anxiety and mood disorders, 39 all of which can be present within a population of chiropractic patients. See Table 1 for a complete list of clinical signs and symptoms indicating use of pulse oximetry.…”

Section: Conceptual Model Of Pulse Oximetry In a Chiropractic Settingmentioning

confidence: 99%

“…1 For most devices, accuracy to within 2% has become an acceptable standard; and most are considered sufficiently accurate and reliable for many clinical purposes. 14,16,[58][59][60] Interpreting results…”

Section: How It Workmentioning

confidence: 99%

“…1 Hypoxemia often leads to hypoxia (ie, reduced tissue oxygenation 13 ), which results in oxidative stress, a condition associated with a wide variety of degenerative processes. 14 Doctors of chiropractic (DCs) are trained to assess vital signs and the clinical signs of oxidative stress, such as cyanosis, pallor, fatigue, and mental confusion. However, previous studies have found that clinicians using these signs alone failed to detect hypoxemia/ hypoxia in emergency department patients.…”

Section: Introductionmentioning

confidence: 99%

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The role of pulse oximetry in chiropractic practice: a rationale for its use

Hall

Jensen

2012

Journal of Chiropractic Medicine

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Objective: Pulse oximetry is used regularly to assess oxygen saturation levels. The objective of this commentary is to discuss a rationale for using pulse oximetry in chiropractic practice. Discussion: Pulse oximetry may offer doctors of chiropractic a way to monitor patients' oxygen saturation levels. Quantification of saturation values with heart rate may give clinical aid to the management of chiropractic patients. Markedly reduced saturation levels may necessitate medical referral, whereas mildly reduced levels could lead to changes in chiropractic management. Conclusions: Pulse oximetry has the potential to be an integral part of chiropractic practice.

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The accuracy of pulse oximetry in the emergency department

Cited by 86 publications

References 24 publications

Accuracy and reliability of pulse oximetry at different arterial carbon dioxide pressure levels

Accuracy and reliability of pulse oximetry at different arterial carbon dioxide pressure levels

Point-of-Care Bedside Gas Analyzer: Limited Use of Venous pCO2 in Emergency Patients

The role of pulse oximetry in chiropractic practice: a rationale for its use

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