Accuracy of Pulse Oximetry in Children

@article{Ross2014AccuracyOP,
  title={Accuracy of Pulse Oximetry in Children},
  author={Patrick A. Ross and Christopher J. L. Newth and Robinder G. Khemani},
  journal={Pediatrics},
  year={2014},
  volume={133},
  pages={22 - 29}
}
OBJECTIVE: For children with cyanotic congenital heart disease or acute hypoxemic respiratory failure, providers frequently make decisions based on pulse oximetry, in the absence of an arterial blood gas. The study objective was to measure the accuracy of pulse oximetry in the saturations from pulse oximetry (SpO2) range of 65% to 97%. METHODS: This institutional review board–approved prospective, multicenter observational study in 5 PICUs included 225 mechanically ventilated children with an… 
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64 Citations
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Methods Citations
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64 Citations

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Citation Type

The Accuracy of Noninvasive Peripheral Pulse Oximetry After Palliative Cardiac Surgery in Patients With Cyanotic Congenital Heart Disease
TLDR
Concerns are raised 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.
Accuracy of Pulse Oximetry in the Presence of Fetal Hemoglobin—A Systematic Review
TLDR
A systematic qualitative review of human studies in the English language from inception to January 2021 found that an increase in HbF changes the relation of partial oxygen pressure to SpO2, which is physiologically explained by the leftward shift in oxygen dissociation curve.
Accuracy of pulse oximetry versus arterial blood gas in screening cyanotic heart
TLDR
The pulse oximeter detected oxygen saturation comparable to arterial oxygen saturation in all the patients with cyanotic heart diseases, even though most of them did not present with clinically significant cyanosis.
Pulse Oximetry Overestimates Oxyhemoglobin in Neonates with Critical Congenital Heart Disease
TLDR
Improvements in pulse oximetry accuracy and precision in the neonate would benefit both screening and clinical care in the NICU, and reinforce the concern that present pulse oximeter technology may overestimate measured oxyhemoglobin values.
Accuracy of the Masimo SET® LNCS neo peripheral pulse oximeter in cyanotic congenital heart disease
TLDR
The performance of the Masimo SET® LNCS Neo pulse oximeter is poor when arterial oxyhaemoglobin saturations are below 75%.
Accuracy of a portable pulse oximeter in monitoring hypoxemic infants with cyanotic heart disease
TLDR
The study device is at least as accurate as the hospital device and offers the advantage of being more portable with Bluetooth technology that allows reliable, efficient data transmission and both devices tended to overestimate oxygen saturation in this patient population when compared to the gold standard, co-oximetry.
Accuracy of Pulse Oximeters Intended for Hypoxemic Pediatric Patients
TLDR
The Masimo Blue sensor has improved accuracy at saturations 75–85% versus the Nellcor and Masimo Standard sensors, and pulse oximetry alone should not be relied on in making clinical decisions.
ASSESSMENT OF ACCURACY OF PULSE OXIMETRY IN PEDIATRIC AGE GROUPS AND FACTORS AFFECTING IT
TLDR
In condition with oxygen saturation (SpO­2<80%) and in critical status, SpO2 is not sufficiently accurate to replace SaO2 measured by arterial blood gases analyzer.
A comparison of manual versus automated saturation of peripheral oxygenation in the neonatal intensive care unit
  • Anirudha Das, M. Mhanna, +4 authors M. Collin
  • Medicine
    The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
  • 2016
TLDR
The difference between manually and automatically recorded SpO2 is large in lower SpO1 ranges and small in higher SpO3 ranges, and Automated oxygen administering systems should be considered to reduce potential errors.
Hypoxemic and hyperoxemic likelihood in pulse oximetry ranges: NICU observational study
TLDR
The likelihood of a PaO2 >99 mm Hg is marked in term infants with SpO2 above 95% and above 98% in preterm infants, andSpO2 levels between 90% and 95% are appropriate targets for term and preterm babies.
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References

SHOWING 1-10 OF 27 REFERENCES
Pulse Oximetry in Children with Congenital Heart Disease: Effects of Cardiopulmonary Bypass and Cyanosis
TLDR
The Nellcor N-395 pulse oximeter failed more often immediately after cardiopulmonary bypass than did the Masimo SET Radical pulse oximeters, and SpO2 measured with both oximeters overestimated SaO2 in the presence of persistent hypoxemia.
Effect of fetal haemoglobin on the accuracy of pulse oximetry in preterm infants
TLDR
The accuracy of pulse oximetry in 22 preterm infants between 1 h and 73 days of age is reported and it is concluded that the Nellcor N‐200 pulse oximeter gives reliable oxygen saturation measurements unaffected by the HbF level in pre term infants.
Pulse oximeter accuracy and precision at five different sensor locations in infants and children with cyanotic heart disease
TLDR
Pulse oximetry readings are used clinically as an indirect estimation of arterial oxygen saturation (SaO2) as well as reliability and precision in congenital heart disease patients in the immediate post-corrective stage.
Pulse oximeter accuracy and precision affected by sensor location in cyanotic children
TLDR
The Philips M1020A pulse oximeter and Nellcor MAX-N sensors were less accurate and precise when used on the sole of the foot or palm of the hand of a child with an Sao2 <90%.
Effects of Fetal Hemoglobin on Accurate Measurements of Oxygen Saturation in Neonates
  • S. P. Shiao
  • Medicine, Biology
    The Journal of perinatal & neonatal nursing
  • 2005
TLDR
The left-shifted oxyhemoglobin curves warrant the importance of accurate measurements of oxygenation status for neonates, and Fetel hemoglobin determination is essential for accurate SO2 measurements and the assessment of proper oxygenation Status in neonates.
Comparison of SpO2 to PaO2 based markers of lung disease severity for children with acute lung injury*
TLDR
Lung injury severity markers, which use Spo2, are adequate surrogate markers for those that use PaO2 in children with respiratory failure for SpO2 between 80% and 97%.
Dark Skin Decreases the Accuracy of Pulse Oximeters at Low Oxygen Saturation: The Effects of Oximeter Probe Type and Gender
TLDR
Multivariate analysis indicated that Sao2 level, sensor type, skin color, and gender were predictive of errors in Spo2 estimates at low Sao2 levels, suggesting that clinically important bias should be considered when monitoring patients with saturations below 80%, especially those with darkly pigmented skin.
Effects of Skin Pigmentation on Pulse Oximeter Accuracy at Low Saturation
TLDR
The three tested pulse oximeters overestimated arterial oxygen saturation during hypoxia in dark-skinned individuals, and skin pigment-related differences were significant with Nonin below 70% Sao2, with Novametrix below 90%, and with Nellcor at all ranges.
Oxygen saturation and outcomes in preterm infants.
TLDR
Targeting an oxygen saturation below 90% with the use of current oximeters in extremely preterm infants was associated with an increased risk of death.
Maximizing the Laboratory Setting for Testing Devices and Understanding Statistical Output in Pulse Oximetry
TLDR
The next steps in the advancement of regulatory validation testing would be to develop standards that include an expanded analysis of pulse oximeter performance by assessment of pop-ups, dropouts, frozen readings, and periods of no reading through assessment of sensitivity/specificity and possibly a “Performance Index” similar to the approach taken by Barker.
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