title: Reliability of pulse oximetry during cardiopulmonary resuscitation in a piglet model of neonatal cardiac arrest.
abstract: BACKGROUND
  Pulse oximetry is widely used in intensive care and emergency conditions to monitor arterial oxygenation and to guide oxygen therapy.
  
  
  OBJECTIVE
  To study the reliability of pulse oximetry in comparison with CO-oximetry in newborn piglets during cardiopulmonary resuscitation (CPR).
  
  
  METHODS
  In a prospective cohort study in 30 healthy newborn piglets, cardiac arrest was induced, and thereafter each piglet received CPR for 20 min. Arterial oxygen saturation was monitored continuously by pulse oximetry (SpO2). Arterial blood was analyzed for functional oxygenation (SaO2) every 2 min. SpO2 was compared with coinciding SaO2 values and bias considered whenever the difference (SpO2 - SaO2) was beyond ±5%.
  
  
  RESULTS
  Bias values were decreased at the baseline measurements (mean: 2.5 ± 4.6%) with higher precision and accuracy compared with values across the experiment. Two minutes after cardiac arrest, there was a marked decrease in precision and accuracy as well as an increase in bias up to 13 ± 34%, reaching a maximum of 45.6 ± 28.3% after 10 min over a mean SaO2 range of 29-58%.
  
  
  CONCLUSIONS
  Pulse oximetry showed increased bias and decreased accuracy and precision during CPR in a model of neonatal cardiac arrest. We recommend further studies to clarify the exact mechanisms of these false readings to improve reliability of pulse oximetry during the marked desaturation and hypoperfusion found during CPR.
authors.affiliation: Division of Neonatology and Pediatric Critical Care, Department of Pediatrics and Adolescent Medicine, Ulm University, Ulm, Germany.
authors.forename: Mohammad Ahmad
authors.initials: MA
authors.lastname: Hassan
authors.forename: Marc
authors.initials: M
authors.lastname: Mendler
authors.forename: Miriam
authors.initials: M
authors.lastname: Maurer
authors.forename: Markus
authors.initials: M
authors.lastname: Waitz
authors.forename: Li
authors.initials: L
authors.lastname: Huang
authors.forename: Helmut D
authors.initials: HD
authors.lastname: Hummler
mesh_terms: D000818:Animals; D000831:Animals, Newborn; D016887:Cardiopulmonary Resuscitation; D004195:Disease Models, Animal; D006323:Heart Arrest / Q000097:blood*; D008991:Monitoring, Physiologic; D010092:Oximetry / Q000379:methods*; D010100:Oxygen / Q000032:analysis*; D011446:Prospective Studies; D015203:Reproducibility of Results; D013552:Swine
chemical_list: D010100:Oxygen