Accuracy of Pulse Oximetry in Mechanically Ventilated Adults (original) (raw)

A42. MONITORING IN THE ICU, 2009

Abstract

ABSTRACT Pusle oximetry is routinely used in the intensive care units (ICU) for continuous oxygenation assessment. In critically ill patients, however, when peripheral tissue is poorly perfused, the signal from the pulsatile blood flow is impaired leading to a less accurate estimate of SaO2. The purpose of this study is to examine the accuracy of pulse oximeter in ICU patients who are on mechanical ventilation in comparison to SaO2 obtained by simultaneous arterial blood gas (ABG). Secondary outcome is to examine the detrimental effect of vasopressors on the accuracy of pulse oximetry measurements. Design: Prospective observational study in tertiary care medical ICU. Measurements: pulse oximetry obtained simultaneously with ABG, vital signs, and use of vasopressors. Inclusion criteria: All adult patients aged 18 -89 yo who are admitted to intensive care unit and mechanically ventilated. Exclusion criteria: Age <18 yo, severe anemia (Hgb <8), pregnancy, Methemoglobulinemia, Carbon monoxide exposure or toxicity, and pigmented skin. SpO2 and O2 Sat from 91 mechanically ventilated patients were compared using Bland-Altman analysis. 21 patients (25%) had vasopressors during the data collection. Results: see table Results Mean Difference (%) 95%CI Upper limits of agreement (%) Lower limits of agreement (%) All (N=91) -1.9 2.3 -1.7,-2.1 2.8 -6.7 Vasopressors (N=24) -1.9 1.8 -1.5,-2.3 1.7 -5.5 No vasopressors (N=67)-1.9 2.4 -1.7, -2.1 2.9-6.7 Conclusion: Oxygen saturation can be accurately measured using pulse oximetry in mechanically ventilated patients. Vasopressors do not impair the accuracy of pulse oximetry measurements above 90%.

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