Authors: Nicolas Nesseler JeanVincent Frénel Yoann Launey Jeff Morcet Yannick Mallédant Philippe Seguin
Publish Date: 2012/08/07
Volume: 38, Issue: 10, Pages: 1718-1722
Abstract
Pulse oximetry SpO2 measured at finger site via transmission mode may fail in situations of hypoperfusion Forehead sensors using reflectance technology might be useful in these circumstances We hypothesized that reflectance SpO2 would be more accurate than finger SpO2 in patients with severe shockA prospective observational study was conducted in an intensive care unit of a university hospital of patients in shock who were treated with high norepinephrine and/or epinephrine doses ≥01 μg kg−1 min−1 When blood gas determinations were requested forehead SpO2 and finger SpO2 values were simultaneous recorded Agreement between SpO2 measurements with arterial saturation SaO2 obtained by blood analysis with a cooximeter was assessed using the Bland–Altman method The number of outliers defined by the formula SaO2 − SpO2 ±3 indicated the proportion of measurements considered to be clinically unacceptableThirtytwo patients were enrolled in the study With the forehead sensor no reading failure occurred and 140 paired data sets forehead SpO2 vs SaO2 were obtained Bias and precision were +10 and +25 respectively and the limits of agreement ranged from −40 to 60 The finger sensor failed to give a value in four cases thus providing 136 paired data sets finger SpO2 vs SaO2 for analysis Bias and precision were +14 and +48 respectively and the limits of agreement ranged from −80 to 109 There were 21 15 outliers for the forehead sensor and 43 32 for the finger sensor P 0001The authors thank Véronique Sébille PhD Biostatistics Unit EA 4275 Pharmacy University of Nantes Nantes France for statistical support Financial support was obtained from institutional and/or departmental sources Devices forehead pulse oximetry sensors were donated by Covidien Tyco/Healthcare France
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