RETROSPECTIVE COHORT STUDY SKIN
14, 15 Positive Sp o 2 device bias was noted in patients with deeply pigmented skin at Sa o 2 concentrations less than 80%, but this discrepancy did not persist at Sa o 2 concentrations greater than 80%.Īfter receiving Institutional Review Board approval from the Icahn School of Medicine at Mount Sinai (New York, New York), data were extracted from our departmental data warehouse for all adult patients (older than 18 yr) who received an anesthetic that included at least one arterial blood gas (ABG) sample between January 2008 and December 2019. 8–13 More recent studies evaluating modern pulse oximeters have evaluated Sp o 2 device bias in hypoxic patients with and without dark skin pigmentation. Overestimation of Sp o 2 (positive device bias) in patients with dark skin pigmentation has been shown to be as high as 5%, although some studies have demonstrated no evidence of Sp o 2 device bias. 5–7 Skin pigmentation is another potential source of inaccuracy, and studies have demonstrated conflicting data regarding the impact of skin pigmentation on the difference between Sa o 2 concentrations and Sp o 2 values ( i.e., Sp o 2 device bias). 5 These include inadequate waveform capture from hypotension motion artifact or hypoperfusion falsely elevated values due to ambient light or carboxyhemoglobin or falsely low values from severe anemia, nail polish, or vital dyes. While the measurement of oxygen saturation by pulse oximetry (Sp o 2) is generally a reliable noninvasive measure of a patient’s true arterial oxygen saturation (Sa o 2), several factors may interfere with the accuracy of pulse oximetry measurement.
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