Respiratory failure & ventilation
Low Perfusion and Missed Diagnosis of Hypoxemia by Pulse Oximetry in Darkly Pigmented Skin: A Prospective Study
Authors' conclusion
Low peripheral perfusion combined with darker skin pigmentation leads to clinically significant high-reading pulse oximeter errors and missed diagnoses of hypoxemia.
Study context
- Population
- Healthy subjects during stable hypoxemia (SaO2 68%-100%), 2 pulse oximeters (Nellcor N-595, Masimo Radical 7)9,763 matched readings
- Participants
- 146 subjects
- Exposure
- Light vs Medium vs Dark
- Lightn = 25reference
- Mediumn = 78
- Darkn = 43
- Outcome
- Pulse oximeter bias (difference between SaO2 and SpO2) by skin pigment category, in a multivariable mixed-effects model incorporating repeated measures, SaO2 levels and perfusion
Methodological detailslaboratory setting, multivariable mixed-effects model
- Laboratory setting
- Multivariable mixed-effects model
Main finding
As reported in the abstract
Pulse oximeter bias
- Perfusion index (PI) 1.0% to 1.5%, 0.5% to 1.0% and <0.5%: relationship to mean bias or median absolute bias
- P<.00001
Observational data: associations, not effects.
Further findings
Missed diagnosis of hypoxemia (SpO2 92%-96% when SaO2 <88%) in low perfusion (PI < 1%) · combined frequency, both oximeters
Original publication
Low Perfusion and Missed Diagnosis of Hypoxemia by Pulse Oximetry in Darkly Pigmented Skin: A Prospective Study. Anesth Analg. Published 18 December 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →