Racial Disparities in Accuracy of Pulse Oximetry

项目摘要/摘要 我们建议评估动脉血氧饱和度(SaO2)和外周血氧之间的相关性 通过脉搏血氧饱和度(SpO2)差值和皮肤色素沉着测量饱和度。最近的数据表明 脉搏血氧仪高估了皮肤较黑的成年人的血氧饱和度。对新生儿来说，这一点还不太清楚。 然而，与低氧血症相关的医疗条件更多地发生在黑人婴儿和 与高氧血症相关的情况在黑人婴儿中发生的频率较低。因此，提出这样一个问题：如果 脉搏血氧仪高估了黑人婴儿的血氧饱和度，错误地将他们置于“安全”区域。我们会 在不同程度的皮肤色素沉着中同时测量SaO2和SpO2，同时考虑其他 生理变量，如胎龄、红细胞数量、胆红素和性别，以评估 皮肤色素沉着对SaO2-SpO2差异的影响。 我们团队的成员有与氧靶向疗法和脉搏相关的研究经验 新生儿血氧测定仪。此外，我们的团队成员有使用记录的脉搏血氧仪的经验 数据，并得到了领先的脉搏血氧仪设备公司的支持，以提供设备和 这项提议的传感器。 这项拟议的研究具有重要意义，因为它将回答脉搏血氧仪偏差是否因 皮肤颜色出现的程度具有临床意义，可能会对肤色较深的新生儿造成伤害。 这项研究的结果将为我们评估出生后年龄对脉搏的影响的更大试验提供参考 血氧计的准确性和多个血氧计，将影响脉搏血氧计如何用于不同皮肤的婴儿 色彩在常规护理，如CCHD筛查、SpO2靶向护理和未来的临床试验中。此外，这是 创新，因为它将使用现成的SpO2和SaO2测量，来自不同类型的婴儿 皮肤明暗程度评估脉搏血氧仪偏差和不精确度，并将使用非侵入性设备 测定黑色素指数，量化皮肤色素沉着。此外，它还将考虑其他 胎龄、低氧血症程度、性别和红细胞等对SpO2的生理学影响 输血。通过两个新生儿重症监护病房的合作，我们将建立 基础设施和必要的多学科关系，以后可以扩展到未来 多中心研究评估脉搏血氧饱和度的潜在差异及其与皮肤的相关性 色素沉着。

PROJECT SUMMARY/ABSTRACT We propose to assess the correlation between arterial oxygen saturation (SaO2) and peripheral oxygen saturation measured by pulse oximetry (SpO2) discrepancy and skin pigmentation. Recent data demonstrated that pulse oximetry devices overestimate SpO2 in darker skin adults. This is less understood in newborns. However, medical conditions associated with hypoxemia occur more commonly in black infants and the conditions associated with hyperoxemia occur less frequently in black infants. Thus, raising the question if pulse oximeters overestimate SpO2 in black infants and falsely putting them in the “safe” zone. We will measure simultaneous SaO2 and SpO2 among varying degrees of skin pigmentation while accounting for other physiologic variables such as gestational age, receipt of red blood cells, bilirubin, and sex, to assess the impact of skin pigmentation on the SaO2-SpO2 discrepancy. Members of our team have experience with research related to oxygen targeted therapies and pulse oximetry in newborns. Additionally, our team members have experience working with recorded pulse oximetry data and have received support from the leading pulse oximeter device company to supply equipment and sensors for this proposal. The proposed research is significant because it will answer the question if pulse oximetry bias due to skin color occurs to a degree that is clinically significant and could cause harm for newborns with darker skin. Results from this study will inform a larger trial in which we will assess the effect of postnatal age on pulse oximetry accuracy and multiple oximeters and will impact how pulse oximetry is used for infants of varying skin color in routine care such CCHD screening, SpO2 targeted care and future clinical trials. Additionally, this is innovative because it will use readily available SpO2 and SaO2 measurements from infants with varying degrees of light and dark skin to assess pulse oximeter bias and imprecision and will use a noninvasive device to measure melanin index to quantify skin pigmentation. Additionally, it will take into consideration other physiologic impacts on SpO2 such as gestational age, degree of hypoxemia, gender, and red blood cell transfusion. Through collaboration between two neonatal intensive care units, we will establish the infrastructure and necessary multidisciplinary relationships that can later be expanded to conduct future multicenter studies to evaluate the potential disparity from pulse oximeters and how it correlates with skin pigmentation.