Pulse oximetry

Amal Jubran, Amal Jubran

Abstract

Pulse oximetry is universally used for monitoring patients in the critical care setting. This article updates the review on pulse oximetry that was published in 1999 in Critical Care. A summary of the recently developed multiwavelength pulse oximeters and their ability in detecting dyshemoglobins is provided. The impact of the latest signal processing techniques and reflectance technology on improving the performance of pulse oximeters during motion artifact and low perfusion conditions is critically examined. Finally, data regarding the effect of pulse oximetry on patient outcome are discussed.

Figures

Fig. 1
Fig. 1
Transmitted light absorbance spectra of four hemoglobin species: oxyhemoglobin, reduced hemoglobin, carboxyhemoglobin, and methemoglobin
Fig. 2
Fig. 2
Common pulsatile signals on a pulse oximeter. (Top panel) Normal signal showing the sharp waveform with a clear dicrotic notch. (Second panel) Pulsatile signal during low perfusion showing a typical sine wave. (Third panel) Pulsatile signal with superimposed noise artifact giving a jagged appearance. (Bottom panel) Pulsatile signal during motion artifact showing an erratic waveform. Reprinted with permission from BioMed Central Ltd [1]
Fig. 3
Fig. 3
Changes in oxygen saturation measured by pulse oximetry (SpO2) compared with arterial oxygen saturation measured by a CO-oximeter (SaO2) in critically ill patients. The pulse oximeter consistently overestimated the actual changes of SaO2. Reprinted with permission from BioMed Central Ltd [8]
Fig. 4
Fig. 4
Oxygen saturation measured with pulse oximetry (SpO2) using transmittance finger probe (diamond) and reflectance forehead probe (squares) during apnea and mask ventilation with 100% O2. The reflectance probe showed faster responses than the transmission probe at every measurement point. *P < 0.05 between the two groups. Reprinted with permission from Wiley [16]
Fig. 5
Fig. 5
Bias of O2 saturation pulse oximetry (SpO2) and arterial O2 saturation (SaO2) of various nail polish colors in critically ill patients. Thick horizontal lines represent mean bias, the whiskers represent maximum and minimum bias; the bottom and top of the boxes represent the first and third quartiles. *P < 0.05 ,**P < 0.01 when compared with arterial oxygen saturation. Reprinted with permission from Elsevier Inc. [29]

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