Document Detail

Comparison of oxygen saturation by pulse oximetry and co-oximetry during exercise testing in patients with COPD.
MedLine Citation:
PMID:  8625659     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: Measurement of oxygen saturation by pulse oximetry (SpO2) is frequently performed during exercise testing of patients with COPD to monitor for hypoxemia. The purpose of this study was to assess the accuracy and precision of pulse oximetry during exercise. We hypothesized that the SpO2 would more closely reflect oxygen saturation as measured by co-oximetry (SaO2) when it was corrected for carboxyhemoglobin (COHb). We also hypothesized that SpO2 would more closely reflect SaO2 when the pulse rate by oximeter was equivalent to the heart rate by ECG. Finally, we hypothesized that SpO2 would be a better measure of SaO2 at maximal workloads than at rest or submaximal workloads. METHODS: Eight white men with severe COPD (mean +/- SD FEV1, 0.91 +/- 0.37) underwent progressive, symptom-limited exercise testing by cycle ergometry. SaO2 was measured from arterial blood at each workload using a co-oximeter. SpO2 and pulse rate were obtained by a pulse oximeter (Ohmeda 3700). Heart rate was continuously monitored by ECG. RESULTS: Reliable oximetric values as determined by a dicrotic notch in each waveform and adequate signal intensity were obtained in all eight patients. SpO2 was a moderately accurate measure of SaO2 (bias, 1.7%; precision, 2.9). The bias actually increased (4.1%) when SpO2 was corrected for COHb. Accuracy of SpO2 was not improved when pulse rate by oximetry and heart rate by ECG were equivalent, nor was the accuracy improved at maximal workloads relative to submaximal workloads during the exercise test. CONCLUSION: Oxygen saturation as measured by pulse oximetry (SpO2) in patients with COPD undergoing exercise testing is not sufficiently accurate to replace SaO2 as the gold standard for oxygen saturation.
J P McGovern; S A Sasse; D W Stansbury; L A Causing; R W Light
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Chest     Volume:  109     ISSN:  0012-3692     ISO Abbreviation:  Chest     Publication Date:  1996 May 
Date Detail:
Created Date:  1996-06-27     Completed Date:  1996-06-27     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1151-5     Citation Subset:  AIM; IM    
Department of Medicine, Veteran's Administration Medical Center, Long Beach, Calif 90822, USA.
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MeSH Terms
Carboxyhemoglobin / analysis
Exercise Test*
Forced Expiratory Volume
Lung Diseases, Obstructive / blood*,  physiopathology
Middle Aged
Oximetry / methods*
Oxygen / blood
Vital Capacity
Reg. No./Substance:
7782-44-7/Oxygen; 9061-29-4/Carboxyhemoglobin

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