Accuracy of pulse oximetry in the intensive care unit

Andry Van De Louw, C. Cracco, C. Cerf, A. Harf, P. Duvaldestin, F. Lemaire, L. Brochard

Research output: Contribution to journalArticle

157 Citations (Scopus)

Abstract

Objective: Pulse oximetry (SpO2) is a standard monitoring device in intensive care units (ICUs), currently used to guide therapeutic interventions. Few studies have evaluated the accuracy of SpO2 in critically ill patients. Our objective was to compare pulse oximetry with arterial oxygen saturation (SaO2) in such patients, and to examine the effect of several factors on this relationship. Design: Observational prospective study. Setting: A 26-bed medical ICU in a university hospital. Patients: One hundred two consecutive patients admitted to the ICU in whom one or serial arterial blood gas analyses (ABGs) were performed and a reliable pulse oximeter signal was present. Interventions: For each ABG, we collected SaO2, SpO2, the type of pulse oximeter, the mode of ventilation and requirement for vasoactive drugs. Measurements and results: Three hundred twenty-three data points were collected. The mean difference between SpO2 and SaO2 was -0.02% and standard deviation of the differences was 2.1%. From one sample to another, the fluctuations in SpO2 to arterial saturation difference indicated that SaO2 could not be reliably predicted from SpO2 after a single ABG. Subgroup analysis showed that the accuracy of SpO2 appeared to be influenced by the type of oximeter, the presence of hypoxemia and the requirement for vasoactive drugs. Finally, high SpO2 thresholds were necessary to detect significant hypoxemia with good sensitivity. Conclusion: Large SpO2 to SaO2 differences may occur in critically ill patients with poor reproducibility of SpO2. A SpO2 above 94% appears necessary to ensure a SaO2 of 90%.

Original languageEnglish (US)
Pages (from-to)1606-1613
Number of pages8
JournalIntensive Care Medicine
Volume27
Issue number10
DOIs
StatePublished - Nov 13 2001

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Oximetry
Intensive Care Units
Critical Illness
Pulse
faropenem medoxomil
Blood Gas Analysis
Pharmaceutical Preparations
Observational Studies
Ventilation
Prospective Studies
Oxygen
Equipment and Supplies

All Science Journal Classification (ASJC) codes

  • Critical Care and Intensive Care Medicine

Cite this

Van De Louw, A., Cracco, C., Cerf, C., Harf, A., Duvaldestin, P., Lemaire, F., & Brochard, L. (2001). Accuracy of pulse oximetry in the intensive care unit. Intensive Care Medicine, 27(10), 1606-1613. https://doi.org/10.1007/s001340101064
Van De Louw, Andry ; Cracco, C. ; Cerf, C. ; Harf, A. ; Duvaldestin, P. ; Lemaire, F. ; Brochard, L. / Accuracy of pulse oximetry in the intensive care unit. In: Intensive Care Medicine. 2001 ; Vol. 27, No. 10. pp. 1606-1613.
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abstract = "Objective: Pulse oximetry (SpO2) is a standard monitoring device in intensive care units (ICUs), currently used to guide therapeutic interventions. Few studies have evaluated the accuracy of SpO2 in critically ill patients. Our objective was to compare pulse oximetry with arterial oxygen saturation (SaO2) in such patients, and to examine the effect of several factors on this relationship. Design: Observational prospective study. Setting: A 26-bed medical ICU in a university hospital. Patients: One hundred two consecutive patients admitted to the ICU in whom one or serial arterial blood gas analyses (ABGs) were performed and a reliable pulse oximeter signal was present. Interventions: For each ABG, we collected SaO2, SpO2, the type of pulse oximeter, the mode of ventilation and requirement for vasoactive drugs. Measurements and results: Three hundred twenty-three data points were collected. The mean difference between SpO2 and SaO2 was -0.02{\%} and standard deviation of the differences was 2.1{\%}. From one sample to another, the fluctuations in SpO2 to arterial saturation difference indicated that SaO2 could not be reliably predicted from SpO2 after a single ABG. Subgroup analysis showed that the accuracy of SpO2 appeared to be influenced by the type of oximeter, the presence of hypoxemia and the requirement for vasoactive drugs. Finally, high SpO2 thresholds were necessary to detect significant hypoxemia with good sensitivity. Conclusion: Large SpO2 to SaO2 differences may occur in critically ill patients with poor reproducibility of SpO2. A SpO2 above 94{\%} appears necessary to ensure a SaO2 of 90{\%}.",
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Van De Louw, A, Cracco, C, Cerf, C, Harf, A, Duvaldestin, P, Lemaire, F & Brochard, L 2001, 'Accuracy of pulse oximetry in the intensive care unit', Intensive Care Medicine, vol. 27, no. 10, pp. 1606-1613. https://doi.org/10.1007/s001340101064

Accuracy of pulse oximetry in the intensive care unit. / Van De Louw, Andry; Cracco, C.; Cerf, C.; Harf, A.; Duvaldestin, P.; Lemaire, F.; Brochard, L.

In: Intensive Care Medicine, Vol. 27, No. 10, 13.11.2001, p. 1606-1613.

Research output: Contribution to journalArticle

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T1 - Accuracy of pulse oximetry in the intensive care unit

AU - Van De Louw, Andry

AU - Cracco, C.

AU - Cerf, C.

AU - Harf, A.

AU - Duvaldestin, P.

AU - Lemaire, F.

AU - Brochard, L.

PY - 2001/11/13

Y1 - 2001/11/13

N2 - Objective: Pulse oximetry (SpO2) is a standard monitoring device in intensive care units (ICUs), currently used to guide therapeutic interventions. Few studies have evaluated the accuracy of SpO2 in critically ill patients. Our objective was to compare pulse oximetry with arterial oxygen saturation (SaO2) in such patients, and to examine the effect of several factors on this relationship. Design: Observational prospective study. Setting: A 26-bed medical ICU in a university hospital. Patients: One hundred two consecutive patients admitted to the ICU in whom one or serial arterial blood gas analyses (ABGs) were performed and a reliable pulse oximeter signal was present. Interventions: For each ABG, we collected SaO2, SpO2, the type of pulse oximeter, the mode of ventilation and requirement for vasoactive drugs. Measurements and results: Three hundred twenty-three data points were collected. The mean difference between SpO2 and SaO2 was -0.02% and standard deviation of the differences was 2.1%. From one sample to another, the fluctuations in SpO2 to arterial saturation difference indicated that SaO2 could not be reliably predicted from SpO2 after a single ABG. Subgroup analysis showed that the accuracy of SpO2 appeared to be influenced by the type of oximeter, the presence of hypoxemia and the requirement for vasoactive drugs. Finally, high SpO2 thresholds were necessary to detect significant hypoxemia with good sensitivity. Conclusion: Large SpO2 to SaO2 differences may occur in critically ill patients with poor reproducibility of SpO2. A SpO2 above 94% appears necessary to ensure a SaO2 of 90%.

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Van De Louw A, Cracco C, Cerf C, Harf A, Duvaldestin P, Lemaire F et al. Accuracy of pulse oximetry in the intensive care unit. Intensive Care Medicine. 2001 Nov 13;27(10):1606-1613. https://doi.org/10.1007/s001340101064