Accuracy of pulse oximetry in patients with low systemic vascular resistance

• Published in: Anaesthesia Vol. 52; no. 2; pp. 127 - 130
• Main Authors: Secker, C., Spiers, P.
• Format: Journal Article
• Language: English
• Published: Oxford Blackwell Science Ltd 01-02-1997; Blackwell
• Subjects: Adult; Aged; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Cardiac Catheterization; Critical Care - methods; Emergency and intensive care: infection, septic shock; Female; Humans; Intensive care medicine; Male; Measurement techniques; Medical sciences; Middle Aged; Monitoring, Physiologic - methods; Oximetry - methods; Oxygen - blood; Partial Pressure; pulse oximetry. Complications; septic shock; Shock, Septic - blood; Vascular Resistance - physiology; Shock; Human; Infection; Blood gas; Pulse oxymetry; Vascular resistance; Gas saturation; Cardiovascular disease; Monitoring
• ISSN: 0003-2409; 1365-2044
• DOI: 10.1111/j.1365-2044.1997.32-az0062.x

In order to assess the accuracy of pulse oximeters in patients with septic shock, we compared 80 paired readings of oxygen saturations taken from pulse oximeters and oxygen saturations obtained from co‐oximetry in patients receiving intensive therapy with indwelling pulmonary artery flotation catheters. Comparison between groups with low or normal systemic vascular resistance indices showed a small (1.4%) but significant (p < 0.001) underreading of the saturation from the pulse oximeter in the presence of a low systemic vascular resistance. With normal or high systemic vascular resistance pulse oximeter readings correlated well with co‐oximetry. We hypothesise that the main cause of this underreading is because the pulse oximeter is sensing pulsatile venous flow due to the opening of arteriovenous channels in the skin in septic states.