Accuracy of Pulse Oximetry in Detection of Oxygen Saturation in Patients Admitted to the Intensive Care Unit of Heart Surgery: Comparison of Finger, Toe, Forehead and Earlobe Probes

Overview

Journal BMC Nurs

Publisher Biomed Central

Specialty Medical Education

Date 2018 Apr 26

PMID 29692684

Citations 25

Authors

Sohila Seifi

Alireza Khatony

Gholamreza Moradi

Alireza Abdi

Farid Najafi

Affiliations

Soon will be listed here.

Abstract

Background: Heart surgery patients are more at risk of poor peripheral perfusion, and peripheral capillary oxygen saturation (SpO2) measurement is regular care for continuous analysis of blood oxygen saturation in these patients. With regard to controversial studies on accuracy of the current pulse oximetry probes and lack of data related to patients undergoing heart surgery, the present study was conducted to determine accuracy of pulse oximetry probes of finger, toe, forehead and earlobe in detection of oxygen saturation in patients admitted to intensive care units for coronary artery bypass surgery.

Methods: In this clinical trial, 67 patients were recruited based on convenience sampling method among those admitted to intensive care units for coronary artery bypass surgery. The SpO2 value was measured using finger, toe, forehead and earlobe probes and then compared with the standard value of arterial oxygen saturation (SaO2). Data were entered into STATA-11 software and analyzed using descriptive, inferential and Bland-Altman statistical analyses.

Results: Highest and lowest correlational mean values of SpO2 and SaO2 were related to finger and earlobe probes, respectively. The highest and lowest agreement of SpO2 and SaO2 were related to forehead and earlobe probes.

Conclusion: The SpO2 of earlobe probes due to lesser mean difference, more limited confidence level and higher agreement ration with SaO2 resulted by arterial blood gas (ABG) analysis had higher accuracy. Thus, it is suggested to use earlobe probes in patients admitted to the intensive care unit for coronary artery bypass surgery.

Trial Registration: Registration of this trial protocol has been approved in Iranian Registry of Clinical Trials at 2018-03-19 with reference IRCT20100913004736N22. "Retrospectively registered."

Citing Articles

Colliding Challenges Part 2: An Analysis of SARS-CoV-2 Infection in Patients with Extrapulmonary Tuberculosis Versus SARS-CoV-2 Infection Alone.

Mihuta C, Socaci A, Hogea P, Tudorache E, Mihuta M, Oancea C Medicina (Kaunas). 2025; 60(12.

PMID: 39768950 PMC: 11677740. DOI: 10.3390/medicina60122071.

Evaluation of the predictors and frequency of silent hypoxemia in COVID-19 patients and the gap between pulse oximeter and arterial blood gas levels: A cross-sectional study.

Fallahi M, Pezeshkian F, Ranjbar K, Javaheri R, Shahriarirad R Health Care Sci. 2024; 3(3):172-180.

PMID: 38947362 PMC: 11212329. DOI: 10.1002/hcs2.98.

Colliding Challenges: An Analysis of SARS-CoV-2 Infection in Patients with Pulmonary Tuberculosis versus SARS-CoV-2 Infection Alone.

Mihuta C, Socaci A, Hogea P, Tudorache E, Mihuta M, Oancea C Medicina (Kaunas). 2024; 60(5).

PMID: 38793006 PMC: 11123355. DOI: 10.3390/medicina60050823.

A risk stratification model for high-flow nasal cannula use in patients with coronavirus disease 2019 in Japan: A single-center retrospective observational cohort study.

Kurihara I, Sugawara H PLoS One. 2024; 19(2):e0290937.

PMID: 38394183 PMC: 10889628. DOI: 10.1371/journal.pone.0290937.

Quantifying tissue properties and absolute hemodynamics using coherent spatial imaging.

Crouzet C, Dunn C, Choi B J Biomed Opt. 2023; 28(12):127001.

PMID: 38116026 PMC: 10730023. DOI: 10.1117/1.JBO.28.12.127001.

References

Akin Korhan E, Hakverdioglu Yont G, Khorshid L . Comparison of oxygen saturation values obtained from fingers on physically restrained or unrestrained sides of the body. Clin Nurse Spec. 2011; 25(2):71-4. DOI: 10.1097/NUR.0b013e31820aeff2. View

Bilan N, Behbahan A, Abdinia B, Mahallei M . Validity of pulse oximetry in detection of hypoxaemia in children: comparison of ear, thumb and toe probe placements. East Mediterr Health J. 2010; 16(2):218-22. View

Hakverdioglu Yont G, Akin Korhan E, Khorshid L . Comparison of oxygen saturation values and measurement times by pulse oximetry in various parts of the body. Appl Nurs Res. 2011; 24(4):e39-43. DOI: 10.1016/j.apnr.2010.03.002. View

Lindholm P, Blogg S, Gennser M . Pulse oximetry to detect hypoxemia during apnea: comparison of finger and ear probes. Aviat Space Environ Med. 2007; 78(8):770-3. View

Wilson B, Cowan H, Lord J, Zuege D, Zygun D . The accuracy of pulse oximetry in emergency department patients with severe sepsis and septic shock: a retrospective cohort study. BMC Emerg Med. 2010; 10:9. PMC: 2876142. DOI: 10.1186/1471-227X-10-9. View

Jensen L, Onyskiw J, Prasad N . Meta-analysis of arterial oxygen saturation monitoring by pulse oximetry in adults. Heart Lung. 1998; 27(6):387-408. DOI: 10.1016/s0147-9563(98)90086-3. View

Hodgson C, Tuxen D, Holland A, Keating J . Comparison of forehead Max-Fast pulse oximetry sensor with finger sensor at high positive end-expiratory pressure in adult patients with acute respiratory distress syndrome. Anaesth Intensive Care. 2009; 37(6):953-60. DOI: 10.1177/0310057X0903700620. View

Pluddemann A, Thompson M, Heneghan C, Price C . Pulse oximetry in primary care: primary care diagnostic technology update. Br J Gen Pract. 2011; 61(586):358-9. PMC: 3080222. DOI: 10.3399/bjgp11X572553. View

Cheng E, Hopwood M, Kay J . Forehead pulse oximetry compared with finger pulse oximetry and arterial blood gas measurement. J Clin Monit. 1988; 4(3):223-6. DOI: 10.1007/BF01621821. View

10.

Fernandez M, Burns K, Calhoun B, George S, Martin B, Weaver C . Evaluation of a new pulse oximeter sensor. Am J Crit Care. 2007; 16(2):146-52. View

11.

Viera A, Garrett J . Understanding interobserver agreement: the kappa statistic. Fam Med. 2005; 37(5):360-3. View

12.

Eberhard P, Gisiger P, Gardaz J, Spahn D . Combining transcutaneous blood gas measurement and pulse oximetry. Anesth Analg. 2002; 94(1 Suppl):S76-80. View

13.

Wax D, Rubin P, Neustein S . A comparison of transmittance and reflectance pulse oximetry during vascular surgery. Anesth Analg. 2009; 109(6):1847-9. DOI: 10.1213/ANE.0b013e3181bbc446. View

14.

Berkenbosch J, Tobias J . Comparison of a new forehead reflectance pulse oximeter sensor with a conventional digit sensor in pediatric patients. Respir Care. 2006; 51(7):726-31. View

15.

Schallom L, Sona C, McSweeney M, Mazuski J . Comparison of forehead and digit oximetry in surgical/trauma patients at risk for decreased peripheral perfusion. Heart Lung. 2007; 36(3):188-94. DOI: 10.1016/j.hrtlng.2006.07.007. View

16.

Nesseler N, Frenel J, Launey Y, Morcet J, Malledant Y, Seguin P . Pulse oximetry and high-dose vasopressors: a comparison between forehead reflectance and finger transmission sensors. Intensive Care Med. 2012; 38(10):1718-22. DOI: 10.1007/s00134-012-2659-0. View

17.

Blaylock V, Brinkman M, Carver S, McLain P, Matteson S, Newland P . Comparison of finger and forehead oximetry sensors in postanesthesia care patients. J Perianesth Nurs. 2008; 23(6):379-86. DOI: 10.1016/j.jopan.2008.07.009. View

18.

Durbin Jr C, Rostow S . More reliable oximetry reduces the frequency of arterial blood gas analyses and hastens oxygen weaning after cardiac surgery: a prospective, randomized trial of the clinical impact of a new technology. Crit Care Med. 2002; 30(8):1735-40. DOI: 10.1097/00003246-200208000-00010. View

19.

Sugino S, Kanaya N, Mizuuchi M, Nakayama M, Namiki A . Forehead is as sensitive as finger pulse oximetry during general anesthesia. Can J Anaesth. 2004; 51(5):432-6. DOI: 10.1007/BF03018304. View

20.

Ibanez J, Velasco J, Raurich J . The accuracy of the Biox 3700 pulse oximeter in patients receiving vasoactive therapy. Intensive Care Med. 1991; 17(8):484-6. DOI: 10.1007/BF01690773. View