Effects of skin pigmentation on pulse oximeter accuracy at low saturation
Effects of skin pigmentation on pulse oximeter accuracy at low saturation
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DOI：
10.1097/00000542-200504000-00004
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发表时间：
2005-04-01
期刊：
影响因子：
8.8
通讯作者：
Severinghaus, JW
中科院分区：
文献类型：
--
作者：
Bickler, PE;Feiner, JR;Severinghaus, JW
背景：皮肤色素沉着在低HBO(2)饱和度下是否会影响脉搏血氧饱和度的准确性尚不确定。方法：对11例深色皮肤和10例浅色皮肤的受试者，在动脉血氧饱和度(SaO(2))在60%到100%之间的稳定平台水平下，评估手指脉搏血氧仪的准确性。测试的血氧仪是带有OxiMax-A探头的Nellcor N-595(Nellcor Inc.，加利福尼亚州普莱森顿)、Novametrix 513(Novametrix Inc.，康涅狄格州沃林福德)和Nning Onyx(Nning Inc.，普利茅斯，明尼苏达州)。半苏醒受试者通过口罩呼吸空气-氮气-二氧化碳混合物。计算机使用通过质谱仪测定的呼气末氧气和二氧化碳浓度来估算每一次呼吸的血氧饱和度(2)，操作员由此调整吸入气体以迅速达到2-3分钟的稳定脱饱和度平台。通过比较脉搏血氧饱和度(Spo(2))和血氧饱和度(SaO(2))(由辐射计OSM3测得的血氧饱和度)来确定饱和度、皮肤色素沉着和血氧仪偏差(Spo(2)-SaO(2))之间的相互关系。结果：在60-70%SaO(2)时，Spo(2)(三个血氧仪的平均值)高估SaO2(Bias+/-SD)3.56+/-2.45%(n=29)，轻度色素沉着组为0.37±3.20%(n=58)(P<；0.0001)。深色皮肤的标准偏差并不大于浅色皮肤。60-70%SaO(2)的暗色皮肤差异分别为2.35%(诺宁)、3.38%(Novametrix)和4.30%(Nellcor)。与皮肤色素相关的差异显著，诺宁低于70%SaO(2)，Novametrix低于90%，Nellcor在所有范围内。结论：三种脉搏血氧饱和度计在低氧时高估了深肤色个体的动脉血氧饱和度。
Background: It is uncertain whether skin pigmentation affects pulse oximeter accuracy at low HbO(2) saturation.Methods: The accuracy of finger pulse oximeters during stable, plateau levels of arterial oxygen saturation (Sao(2)) 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 Sao(2), 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 (Spo(2)) with Sao(2) (by Radiometer OSM3) were used in a multivariate model to determine the interrelation between saturation, skin pigmentation, and oximeter bias (Spo(2) - Sao(2)).Results: At 60-70% Sao(2) Spo(2) (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-fight skin differences at 60-70% Sao(2) were 2.35% (Nonin), 3.38% (Novametrix), and 4.30% (Nellcor). Skin pigment-related differences were significant with Nonin below 70% Sao(2), 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.