title: Operational evaluation of pulse oximetry in NICU patients with arterial access.
abstract: 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.
authors.affiliation: Neonatology Department, Utah Valley Regional Medical Center, Provo, UT, USA.
authors.forename: Dale
authors.initials: D
authors.lastname: Gerstmann
authors.forename: Ryan
authors.initials: R
authors.lastname: Berg
authors.forename: Ron
authors.initials: R
authors.lastname: Haskell
authors.forename: Cathy
authors.initials: C
authors.lastname: Brower
authors.forename: Kari
authors.initials: K
authors.lastname: Wood
authors.forename: Brad
authors.initials: B
authors.lastname: Yoder
authors.forename: Loren
authors.initials: L
authors.lastname: Greenway
authors.forename: Gordon
authors.initials: G
authors.lastname: Lassen
authors.forename: Robert
authors.initials: R
authors.lastname: Ogden
authors.forename: Ronald
authors.initials: R
authors.lastname: Stoddard
authors.forename: Stephen
authors.initials: S
authors.lastname: Minton
mesh_terms: 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