2001 OPEN FORUM Abstracts
PERFORMANCE OF PULSE OXIMETER TECHNOLOGIESIN A PEDIATRIC SLEEP LAB SETTING.
Christine D. McGregor RRT, JacintheLavergne RRT, Sylvia Ladan RRT, Andra Leimanis B.Sc., Gillian M. Nixon M.B.Ch.B.,Robert T. Brouillette MD. Montreal ChildrenÕs Hospital, McGill University, Montreal,Canada.
Background: Newer pulse oximetershave been developed to be motion resistant. However, they have not yet beenevaluated in a pediatric sleep laboratory, a setting where manual scoring forsuspect pulse oximetry values is routine.
Methods: While evaluatingnew pulse oximeter technology, we obtained simultaneous data from two versionsof Masimo pulse oximeters (Quartz Q-400 and Masimo Radical) and from a Nellcordevice (N-200). Events were randomly selected for analysis, an ÒeventÓ beinga desaturation of ³ 4% registered by either oximeter. In series 1, comparisonswere made in 24 patients between a Quartz in 4 second averaging time and theN-200 set in their shortest, 3 to 5 second averaging (Mode 2). In series 2,22 patients were studied comparing a Radical with 2 second averaging to theN-200, again in Mode 2.
Results: Interobserver agreementfor event classification was 93%. Series 1: 88% of 220 wakeful events and 38%of 194 sleep events were classified as motion artifact on the N-200. Neitherthe Q-400 nor transcutaneous oxygen confirmed a drop in the majority of thesecases. During sleep, there were 119 events detected by either or both the N-200and Q-400: 113 (95%) by the N-200 versus 82 (69%) by the Q-400. For these 119events, the extent of desaturation was slightly less for both Q-400 than theN-200 oximeter, 4.5 ± 2.4% versus 5.5 ± 2.5%, respectively. Series 2: The extentof desaturation was slightly larger for the Radical. The Radical detected morenon-artifactual desaturation events occurring during sleep than the N-200, 90%versus 76% (C2 = 9.9, p<0.01).
Conclusions: Both Masimo pulseoximeters register many fewer false desaturations due to motion artifact. Using4 second averaging, a Q-400 detected significantly fewer SaO2 dips than theN-200 but using 2 second averaging, the Radical detected more SaO2 dips thanthe N-200. These findings suggest that in a pediatric sleep laboratory, useof the Radical pulse oximeter with short averaging times could significantlyreduce workload and improve reliability of detecting desaturations.