Abstract
Pulse oximetry is universally used for monitoring patients in the critical care setting. This article updates the review on pulse oximetry that was published in 1999 in Critical Care. A summary of the recently developed multiwavelength pulse oximeters and their ability in detecting dyshemoglobins is provided. The impact of the latest signal processing techniques and reflectance technology on improving the performance of pulse oximeters during motion artifact and low perfusion conditions is critically examined. Finally, data regarding the effect of pulse oximetry on patient outcome are discussed.
Highlights
Pulse oximetry is ubiquitously used for monitoring oxygenation in the critical care setting
In the largest randomized trial involving more than 20,000 perioperative patients, rates of incidence of hypoxemia (SpO2 of less than 90 %) were 7.9 % in patients who were monitored with pulse oximetry and only 0.4 % in patients without an oximeter [43]
Pulse oximetry is universally used for monitoring respiratory status of patients in the intensive care unit (ICU)
Summary
Pulse oximetry is ubiquitously used for monitoring oxygenation in the critical care setting. The conventional pulse oximeters use transmission sensors in which the light emitter and detector are on opposing surfaces of the tissue bed. These sensors are suitable for use on the finger, toe, or earlobe; when tested under conditions of low perfusion, finger probes performed better than other probes [9]. In critically ill patients with low perfusion, the bias and precision between SpO2 and SaO2 were lower for the forehead reflectance probe than for the finger probe [11,12]. A recent study compared the response time of the conventional finger probe with the reflectance forehead probe in patients undergoing general anesthesia [16] (Fig. 4). The forehead probe monitors O2 saturation from the supraorbital artery in which blood flow is abundant and is less likely to be affected by vasoconstriction than is a peripheral artery [17]
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