title: The Accuracy of Noninvasive Peripheral Pulse Oximetry After Palliative Cardiac Surgery in Patients With Cyanotic Congenital Heart Disease.
abstract: Children with cyanotic congenital heart disease (CCHD) live with oxyhemoglobin saturations that are typically expressed as percentages in the range of 70s and 80s. Peripheral pulse oximetry (measurement of SpO2) performs poorly in this range and yet is widely used to inform clinical decisions in these patients. The reference standard is co-oximetry of arterial samples (SaO2).
  
  
  
  In this study, 515 paired measurements of SpO2and SaO2were taken from 19 children who had undergone palliative cardiac surgery.
  
  
  
  SpO2(Masimo SET LNCS Neo pulse oximeter) overestimated oxyhemoglobin saturation in 82% of measurements (mean 4.6% ± 6.6%). There was a strong negative correlation between mean bias and SaO2( r = -.96, P = .002, 95% confidence interval: -0.99 to -0.68).
  
  
  
  The results raise a concern that critical hypoxemia may go undetected and untreated if pulse oximetry is relied upon as the primary means of assessing oxyhemoglobin saturation in children with CCHD. Strong preference must be given to co-oximetry of arterial samples.
authors.affiliation: 1 University of Southampton, Department of Medicine, Southampton, United Kingdom.
authors.forename: Gemma E
authors.initials: GE
authors.lastname: Scrimgeour
authors.affiliation: 2 Paediatric Intensive Care Unit, Southampton Children's Hospital, Southampton, United Kingdom.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Griksaitis
authors.affiliation: 2 Paediatric Intensive Care Unit, Southampton Children's Hospital, Southampton, United Kingdom.
authors.forename: John V
authors.initials: JV
authors.lastname: Pappachan
authors.affiliation: 2 Paediatric Intensive Care Unit, Southampton Children's Hospital, Southampton, United Kingdom.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Baldock
mesh_terms: D006348:Cardiac Surgical Procedures / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006330:Heart Defects, Congenital / Q000097:blood* / Q000601:surgery; D006801:Humans; D007223:Infant; D008297:Male; D010092:Oximetry / Q000379:methods*; D010100:Oxygen / Q000097:blood*; D011184:Postoperative Period; D015203:Reproducibility of Results
chemical_list: D010100:Oxygen
keywords: PaO2; oxygen saturation