Dark Skin Decreases the Accuracy of Pulse Oximeters at Low Oxygen Saturation: The Effects of Oximeter Probe Type and Gender
Dark Skin Decreases the Accuracy of Pulse Oximeters at Low Oxygen Saturation: The Effects of Oximeter Probe Type and Gender
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DOI：
10.1213/01.ane.0000285988.35174.d9
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发表时间：
2007-12-01
影响因子：
5.7
通讯作者：
Bickler, Philip E.
中科院分区：
文献类型：
--
作者：
Feiner, John R.;Severinghaus, John W.;Bickler, Philip E.
简介：脉搏血氧饱和度可能会高估动脉血氧饱和度（Sao（2））在低Sao（2）水平的个人与深色皮肤，但其他因素，如性别和血氧计探头类型，仍然较少studyed.METHODS：我们研究了皮肤色素和血氧计的准确性之间的关系在36名受试者（19名男性，17名女性）的肤色范围。研究了Masimo Radical、Nellcor N-595和Nonin 9700的夹式传感器和粘合剂/一次性手指探针。半卧位受试者通过吸嘴呼吸空气-氮气-CO（2）混合物，以快速达到2- 3分钟的稳定Sao（2）平台期。脉搏血氧仪（Spo（2））测量的Sao（2）与Sao（2）的比较（由辐射计OSM-3）被用于多变量模型中以评估误差的来源。对于配备夹式传感器的Masimo Radical，70%-80%饱和度范围的平均偏倚（Spo（2）- Sao（2））为2.61%，配备一次性传感器的Radical为-1.58%，Nellcor成形夹为2.59%，Nellcor一次性使用成形夹为3.6%，Nonin成形夹为-0.60%，Nonin一次性使用成形夹为2.43%。深色皮肤增加了低Sao时的偏倚（2）;与夹式传感器相比，使用粘合剂/一次性传感器观察到更大的偏倚。在低Sao（2）水平下，不同仪器对深肤色受试者的饱和度估计值差异高达10%。结论：多变量分析表明，Sao（2）水平、传感器类型、肤色和性别可预测低Sao（2）水平下Spo（2）估计值的错误。数据表明，当监测饱和度低于80%的患者时，应考虑临床重要偏倚，尤其是深色皮肤患者;但需要进一步研究来证实相关人群中的这些观察结果。
INTRODUCTION: Pulse oximetry may overestimate arterial oxyhemoglobin saturation (Sao(2)) at low Sao(2) levels in individuals with darkly pigmented skin, but other factors, such as gender and oximeter probe type, remain less studied.METHODS: We studied the relationship between skin pigment and oximeter accuracy in 36 subjects (19 males, 17 females) of a range of skin tones. Clip-on type sensors and adhesive/disposable finger probes for the Masimo Radical, Nellcor N-595, and Nonin 9700 were studied. Semisupine subjects breathed air-nitrogen-CO(2) mixtures via a mouthpiece to rapidly achieve 2- to 3-min stable plateaus of Sao(2). Comparisons of Sao(2) measured by pulse oximetry (Spo(2)) with Sao(2) (by Radiometer OSM-3) were used in a multivariate model to assess the source of errors.RESULTS: The mean bias (Spo(2) - Sao(2)) for the 70%-80% saturation range was 2.61% for the Masimo Radical with clip-on sensor, -1.58% for the Radical with disposable sensor, 2.59% for the Nellcor clip, 3.6% for the Nellcor disposable, -0.60% for the Nonin clip, and 2.43% for the Nonin disposable. Dark skin increased bias at low Sao(2); greater bias was seen with adhesive/disposable sensors than with the clip-on types. Up to 10% differences in saturation estimates were found among different instruments in dark-skinned subjects at low Sao(2).CONCLUSIONS: Multivariate analysis indicated that Sao(2) level, sensor type, skin color, and gender were predictive of errors in Spo(2) estimates at low Sao(2) levels. The data suggest that clinically important bias should be considered when monitoring patients with saturations below 80%, especially those with darkly pigmented skin; but further study is needed to confirm these observations in the relevant populations.