title: Comparison of a new forehead reflectance pulse oximeter sensor with a conventional digit sensor in pediatric patients.
abstract: BACKGROUND
  During conditions of poor perfusion, the accuracy of conventional extremity-based pulse oximeters may be limited. Limited evidence suggests that forehead perfusion may be better preserved during such periods, but pediatric experience with newer forehead reflectance sensors is limited. We prospectively compared the accuracy of a forehead reflectance sensor, the Max-Fast, with a new-generation digit sensor in pediatric patients.
  
  
  METHODS
  Pediatric patients > 10 kg and who had arterial catheters were eligible for enrollment. Blood oxygen saturation was simultaneously measured with forehead and digit sensors, and compared to corresponding CO-oximetry-measured arterial oxygen saturation values (S(aO2)) taken at the same times. We used Bland-Altman analysis to calculate the bias and precision of the forehead sensor and the digit sensor relative to the S(aO2) values.
  
  
  RESULTS
  We obtained 116 sample sets from 28 patients. The S(aO2) values ranged from 84.1% to 99.2%. The bias and precision of the forehead-to-S(aO2) difference were 0.6% and 2.7%, respectively, versus 1.4% and 2.6%, respectively, for the digit-to-S(aO2) difference (p < 0.05). Bias and precision were 0.7% and 2.6% versus 1.7% and 2.3% for the forehead and digit sensors, respectively, (p < 0.05) in patients who received vasoactive medications, compared with 0.5% and 2.8% versus 1.1% and 2.8% (p = not significant), respectively, in patients who did not receive vasoactive medications.
  
  
  CONCLUSIONS
  The Max-Fast sensor estimated S(aO2) as accurately as did a new-generation digit sensor in well-perfused pediatric patients.
authors.affiliation: Kosair Children's Hospital, University of Louisville, 571 S Floyd, Suite 332, Louisville, KY 40202, USA. john.berkenbosch@louisville.edu
authors.forename: John W
authors.initials: JW
authors.lastname: Berkenbosch
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Tobias
mesh_terms: D000293:Adolescent; D001785:Blood Gas Monitoring, Transcutaneous / Q000295:instrumentation* / Q000379:methods; D002648:Child; D002675:Child, Preschool; D004566:Electrodes; D005121:Extremities; D005260:Female; D005546:Forehead; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012044:Regression Analysis