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Paper Information

Journal:   JOURNAL OF ISFAHAN MEDICAL SCHOOL (I.U.M.S)   Fall-Winter 2003 , Volume 20 , Number 67; Page(s) 9 To 12.


Author(s):  SARYAZDI H.*
* Medical School of I.U.M.S

Introduction: The use of pulse oximetry to monitor arterial oxygen saturation (Sa02) is considered accurate and reliable and decrease the number of arterial blood gays (ABG) analysis by 50% . However differing reports exist about the accuracy in chronic hypoxemia. Because in some stages of angiography, surgery, and anesthesia of cyanotic congenital heart disease (CHD) the knowledge of exact Sa02 or Pa02 is vital therefore accuracy of pulse oximetry in cyanotic CHD was compared with ABG analyzer.
The influence of high hematocrit values in the accuracy at low saturation was also investigated.
Methods: In 33 children with cyanotic CHD the pulse oximetry reading (SP02) way compared with Sa02 obtained by ABG analyzer. All oxygen saturation was measured at steady state. Results: Pulse oximetry consistently overstimated Sa02 (76 ± 15% vs 72 ± 15%) The result indicate that at low saturation <80% pulse oximetry is not accurate ay at higher steady state.
Discussion: Prior studies suggested that pulse oximetry overstimate oxygen saturation at low levels.
Because patients with cyanotic CHD generally have severe chronic hypoxemia this overstimation has clinical significance, for example Sp02 of 80% would predict Sa02 of 73 - 79%. The lower of this range may suggests, the need for clinical intervention whereas the upper would be considered adequate. We recommend measurement of Pa02 or Sa02 for important clinical decisions. High hematocrit levels have not been responsible for impaired accuracy of pulse oximetry at saturation value below 80%.

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