Impact of Skin Color on Spo2 Detection of Hypoxemia

Abstract

In one study, investigators found differences between fingertip/clip oximeters and adhesive/disposable sensors in patients with darker skin pigmentation.1 The differences varied by manufacturer.The best way is to correlate the Spo2 results with physical examination findings. “Normal” Spo2 readings in spite of clinical findings indicating otherwise should always be of concern in any patient. If clinical findings that indicate possible hypoxemia are present (eg, tachypnea, dyspnea, altered mentation, chest pain), especially when the measured Spo2 is in the lower range (eg, < 92%), arterial blood gas values should be obtained and treatment (oxygen) should be instituted.I anticipate that there will be more inclusion of diverse populations in testing of technology. The Food and Drug Administration has recommended that device manufacturers submit a plan outlining the inclusion of diverse populations in the evaluation of equipment they develop moving forward. The Food and Drug Administration held a hearing on November 1, 2022, related to this subject. The executive summary is available at https://www.fda.gov/media/162709/download.I suspect that technology advances will improve pulse oximetry monitoring. Currently, several manufacturers have been able to show accuracy with their products in patients with darker skin pigmentation. Also, several engineers are working on this issue.2