Operational evaluation of pulse oximetry in NICU patients with arterial access.
OBJECTIVE
To investigate pulse oximetry in neonates who require arterial access as represented by the clinical data recorded to manage their care.


METHODS
Analysis of simultaneous SpO(2) and SaO(2) from: 7-year historical NICU data (N=31905); 4-month prospective NICU data (N=566); verification data using two hemoximeters (N=52); and NICU data from two collaborating centers (N=95 and 168). The bias function (SpO(2)-SaO(2)) was regressed against the measured "gold" standard, SaO(2).


RESULTS
A significant negative correlation was found for each of the data sets between the bias function and SaO(2). This bias was similar for devices from several manufacturers (Datex-Ohmeda, Masimo, Nellcor, and Spacelabs). Maximum operational performance occurred with peaks between 92 and 97% SaO(2), but declined markedly above and below this narrow range. In all, 71 to 95% of patients exhibited data with significant bias(.)


CONCLUSIONS
These operational data suggest that with the methodology and devices currently in use, SpO(2) values in most all neonates who require arterial lines inaccurately correlate with measured arterial saturation.
Gerstmann
Dale
D
Neonatology Department, Utah Valley Regional Medical Center, Provo, UT, USA.
Berg
Ryan
R
Haskell
Ron
R
Brower
Cathy
C
Wood
Kari
K
Yoder
Brad
B
Greenway
Loren
L
Lassen
Gordon
G
Ogden
Robert
R
Stoddard
Ronald
R
Minton
Stephen
S
D015331:Cohort Studies; D005260:Female; D006801:Humans; D000860:Hypoxia / Q000175:diagnosis; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods; D010092:Oximetry / Q000379:methods*; D010101:Oxygen Consumption / Q000502:physiology*; D011446:Prospective Studies; D011659:Pulmonary Gas Exchange; D012680:Sensitivity and Specificity