title: Reliability of Pulse Oximetry during Progressive Hypoxia, Cardiopulmonary Resuscitation, and Recovery in a Piglet Model of Neonatal Hypoxic 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 progressive hypoxia, cardiac arrest, cardiopulmonary resuscitation (CPR), and after return of spontaneous circulation (ROSC).
  
  
  METHODS
  Thirty-three newborn piglets were exposed to hypoxia until asystole occurred and then resuscitated until ROSC. Arterial oxygen saturation was monitored continuously by pulse oximetry (SpO2) with one sensor applied to the wrist of the right forelimb (FL) and another to the thigh of the left hind limb (HL). Arterial functional oxygen saturation (SaO2) was measured at baseline and at predefined intervals during each phase of the experiment. SpO2 was compared with coinciding SaO2 values and bias considered whenever the difference (SpO2 - SaO2) was beyond ±5%.
  
  
  RESULTS
  Bias values were lower at the baseline measurements (-3.7 ± 2.3% in FL and -4.1 ± 3.4% in HL) as well as after ROSC (1.5 ± 4.2% in FL and 0.2 ± 4.6% in HL) with higher precision and accuracy than during other experiment phases. During hypoxia induction, cardiac arrest, and CPR, there was a marked decrease in precision and accuracy as well as an increase in bias up to 43 ± 26 and 56 ± 27% in FL and HL, respectively, over a range of SaO2 from 13 to 51%.
  
  
  CONCLUSIONS
  Pulse oximetry showed increased bias and decreased accuracy and precision during marked hypoxemia in a model of neonatal hypoxic cardiac arrest.
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Sohag University, Sohag, Egypt.
authors.forename: Mohammad Ahmad
authors.initials: MA
authors.lastname: Hassan
authors.forename: Claudia
authors.initials: C
authors.lastname: Weber
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
authors.forename: Marc Robin
authors.initials: MR
authors.lastname: Mendler
mesh_terms: D000818:Animals; D000831:Animals, Newborn; D015415:Biomarkers / Q000097:blood; D016887:Cardiopulmonary Resuscitation; D004195:Disease Models, Animal; D005552:Forelimb / Q000098:blood supply*; D006323:Heart Arrest / Q000097:blood / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D006614:Hindlimb / Q000098:blood supply*; D000860:Hypoxia / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D010092:Oximetry; D010100:Oxygen / Q000097:blood*; D011237:Predictive Value of Tests; D012039:Regional Blood Flow; D015203:Reproducibility of Results; D034421:Sus scrofa; D013997:Time Factors
chemical_list: D015415:Biomarkers; D010100:Oxygen
keywords: Cardiopulmonary resuscitation; Hypoxia; Pulse oximetry