Document Detail

Decreased accuracy of pulse oximetry measurements during low perfusion caused by sepsis: Is the perfusion index of any value?
MedLine Citation:
PMID:  16810522     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To evaluate the effects of deteriorating perfusion caused by sepsis on the accuracy of pulse oximetry measurements using two more recently available techniques (Nellcor N-395 and Masimo Radical) and to evaluate the perfusion index as a marker of impaired peripheral perfusion to indicate that accuracy of pulse oximetry readings may be affected. DESIGN AND SETTING: Interventional cohort study in a university animal research facility. SUBJECTS: Thirty-seven adult anesthetized, ventilated rabbits. INTERVENTIONS: Pneumonia/sepsis was induced by tracheal instillation of Escherichia coli. MEASUREMENTS AND RESULTS: Oxygen saturation and perfusion index as a marker of peripheral perfusion were measured by pulse oximetry (SpO2) and recorded continuously for 8 h. Arterial oxygen saturation (SaO2) was measured every 30 min by CO oximetry, and bias (SpO2 - SaO2) was calculated at each time point for each device to assess time-dependent changes in bias. Bias increased significantly across time for both devices tested comparing the first with the second half of the experimental period. Bias measurements during the second half of the experimental time were beyond the +/-3% error limit in 21.4% of cases with Nellcor and in 22.6% with Masimo. A lower perfusion index was associated with increased bias, but sensitivity, specificity, and positive and negative predictive values of this marker for increased bias was very limited. CONCLUSIONS: We conclude that accuracy of pulse oximetry measurements was considerably affected with both devices with progressively deteriorating hemodynamics in this animal model of severe sepsis. Perfusion index as a marker for increased risk of bias was not a useful tool.
Helmut D Hummler; Anja Engelmann; Frank Pohlandt; Josef Högel; Axel R Franz
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2006-06-30
Journal Detail:
Title:  Intensive care medicine     Volume:  32     ISSN:  0342-4642     ISO Abbreviation:  Intensive Care Med     Publication Date:  2006 Sep 
Date Detail:
Created Date:  2006-08-22     Completed Date:  2007-02-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1428-31     Citation Subset:  IM    
Division of Neonatology and Pediatric Critical Care, Department of Pediatrics, Children's Hospital, University of Ulm, 89070 Ulm, Germany.
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MeSH Terms
Blood Circulation
Chi-Square Distribution
Disease Models, Animal
Monitoring, Physiologic / methods*
Predictive Value of Tests
Regional Blood Flow
Sensitivity and Specificity
Sepsis / physiopathology*
Statistics, Nonparametric
Comment In:
Intensive Care Med. 2006 Sep;32(9):1287-9   [PMID:  16810521 ]

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