Accuracy of Pulse Oximetry in Children with Congenital Heart Disease.

Abstract

Background: Detection of arterial oxygen saturation in pediatric patients with congenital heart disease (CHD) can be helpful for their management. Methods: We compared oxygen saturation and heart rate detected by pulse oximeter with the data of cardiac catheterization in order to determine the reliability and pitfalls of pulse oximetry (PO) in pediatric patients with CHD. 110 patients with different cyanotic and acyanotic CHD who were referred for right and left sided cardiac catheterization were enrolled in this study PO from left index finger and simultaneous oxygen saturations and pressures from cardiac catheterization were recorded. Results: There was a statistically significant correlation (r= 0.68, p<0.0001) between measured oxygen saturation by PO and aortic oxygen saturation and between heart rate in elctrocardiography (ECG) and heart rate recorded by PO (r=0.94, p<0.0001) respectively. This study also showed that presence of cyanosis (p=0.01), digital clubbing (p=0.001), low oxygen saturation in supra-vena cava and right atrium (p=0.002, P= 0.01) can decrease accuracy of PO for detection of arterial oxygen saturation. High mean right atrial pressure can affect the accuracy of PO for detection of heart rate (P=0.034). PO had maximum sensitivity and specificity for detecting saturation of 88% and heart rate of 99 beat/min. Conclusion: Pulse oximetry, within the above limits of accuracy, is a useful tool for estimation of arterial oxygen saturation and heart rate in children with CHD.