title: Evidence for the need of bedside accuracy of pulse oximetry in an intensive care unit.
abstract: OBJECTIVE
  To compare pulse oximetry saturation (Spo2 with arterial blood gas saturation (SaO2) obtained during clinical routine to determine the optimal lowest reliable value of SpO2 in ventilator-dependent patients before setting up a nurse-directed protocol of FIO2 titration.
  
  
  METHODS
  Prospective clinical study.
  
  
  METHODS
  Surgical intensive care unit in a university hospital.
  
  
  METHODS
  Thirty-three patients with a pulse oximeter probe in whom arterial blood gas was measured with a radial artery line.
  
  
  METHODS
  SPO2 was recorded by the nurses and compared with SaO2 obtained by blood gas analysis with a co-oximeter. Two sensors currently used in our surgical intensive care unit and connected to a monitor (HP OmniCare M1165/66A; Hewett Packard, Andover, MA) were tested. In group I, the Durensor DS 100A (Nellcor Puritan Bennett, Pleasanton, CA), a reusable sensor, was used. In group II, the Oxisensor D25L (Nellcor Puritan Bennett), a nonreusable sensor, was used.
  
  
  RESULTS
  In group 1, 64 data pairs were obtained. In this group, SaO2 ranged from 87 to 98% and SpO2 ranged from 92 to 100%. The bias was -1.90% and the limits of agreement ranged from -5.56 to 1.76%. In group 11, 47 data pairs were obtained. In this group, SaO2 ranged from 87 to 99% and SpO2 ranged from 92 to 100%. The bias was -2.49% and the limits of agreement ranged from -6.62 to 1.64%.
  
  
  CONCLUSIONS
  In the range of SaO2 tested, regardless of the sensor used, SpO2 overestimated SaO2. Large limits of agreement were found. Based on this result, the authors concluded that before defining a nurse-directed protocol of FIO2 titration with SpO2, the material used daily must be evaluated. A minimum threshold SpO2 value of 96% in both groups I and II is more reliable to ensure SaO2 > or = 90%.
authors.affiliation: Service de Réanimation Chirurgicale, CHRU de Pontchaillou, Rennes, France. yMalledant.rennes@invivo.edu
authors.forename: P
authors.initials: P
authors.lastname: Seguin
authors.forename: A
authors.initials: A
authors.lastname: Le Rouzo
authors.forename: M
authors.initials: M
authors.lastname: Tanguy
authors.forename: Y M
authors.initials: YM
authors.lastname: Guillou
authors.forename: A
authors.initials: A
authors.lastname: Feuillu
authors.forename: Y
authors.initials: Y
authors.lastname: Mallédant
mesh_terms: D001784:Blood Gas Analysis; D016001:Confidence Intervals; D003422:Critical Care; D006801:Humans; D000860:Hypoxia / Q000517:prevention & control; D007362:Intensive Care Units; D008875:Middle Aged; D010092:Oximetry / Q000379:methods* / Q000451:nursing; D019095:Point-of-Care Systems; D011446:Prospective Studies; D012121:Respiration, Artificial