Respiratory failure & ventilation
Accuracy of Pulse Oximetry and Risk Factors Associated With Discrepancy From Arterial Oxygenation in Asian Patients in the ICU: An Observational Study
Authors' conclusion
Our results show that dissociation between Spo2 and Sao2 in Asian patients in the ICU was small; however, overestimation and underestimation were associated with increased mortality risk, particularly among patients with chronic hemodialysis or impaired peripheral perfusion.
Study context
- Population
- Adult patients admitted to an ICU at a tertiary care hospital in Japan, October 2013 through September 2021
- Participants
- 10,698 patients
- Outcome
- Agreement between SpO2 and SaO2 (bias)
Methodological detailssingle-center, observational
- Single-center
- Observational
Main finding
As reported in the abstract
Mean bias between SpO2 and SaO2
Mean bias between SpO2 and SaO2
−1.2%
Largest discrepancies after ICU admission (hours)
24.7
Observational data: associations, not effects.
Further findings
Hidden hypoxemia
- Hidden hypoxemia (SaO2 < 88%, SpO2 ≥ 88%)
- 0.8%
- Serious hidden hypoxemia (SpO2 ≥ 92%)
- 0.6%
Factors associated with SpO2-SaO2 differences
- Overestimation of SaO2 associated with high creatinine, particularly with chronic hemodialysis; underestimation associated with sepsis, mechanical ventilation and signs of impaired systemic perfusion
Mortality
- U-shaped relation between SpO2-SaO2 differences and mortality (nonlinear association)
Original publication
Accuracy of Pulse Oximetry and Risk Factors Associated With Discrepancy From Arterial Oxygenation in Asian Patients in the ICU: An Observational Study. Chest. Published 18 March 2025. doi:10.
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