2004 OPEN FORUM Abstracts
A COMPARISON OF REFLECTIVE AND TRANSMISSION OXIMETRY IN PEDIATRIC PATIENTS WITH POOR PERFUSION
J. Marcum, MD; L. Auw, RRT; J. Judd, RRT;
C. Newth, MD. USC Keck School of Medicine, Children’s Hospital
Los Angeles, Departments of Anesthesia Critical Care Medicine and
Respiratory Care
Background: Pulse oximetry is
ubiquitous to intensive care prompting the term the 5th
vital sign. Pediatric patients often present challenges for
traditional digital transmission oximetry (DTO) because of
movement and poor digital signals. We compared the accuracy and
success of DTO to a new reflective forehead oximeter (RFO) in
pediatric patients in the PICU.
Methods: Informed
consent was obtained from the parents of 6 patients in the PICU. 6
patients were fitted with digital (Max-A) and forehead (Max Fast)
sensors connected to Nellcor N-595 oximeters. The forehead sensor
was placed above the eyebrow and secured with a headband. Digital
disposable sensors were placed on either hand. During routine care,
heart rate and saturations from the two monitors were recorded at the
time arterial blood oxygen saturation was determined using a
co-oximeter. Bland-Altman analysis was utilized to individually
compare HR data and oximetry data. All oximetry data was also
compared using a one-way ANOVA analysis.
Results: Patients
mean age was 5.8 years (1.0 years to 17.0 years) and mean weight was
18.9 kg (8.9 kg to 47.3 kg). During the study, DTO and RFO detected
a pulsatile signal in all 6 patients. Bland-Altman analysis of HR
revealed no significant difference between DTO and RFO (Bias –1.3,
95% limit –7.1 to 4.4). Bland-Altman analysis also revealed no
significant difference between RFO and co-oximetry (Bias –1.7,
95% limit –7.5 to 4.3). Furthermore, one-way ANOVA analysis of
RFO, DTO, and co-oximetry revealed no statistical difference between
RFO, DTO, and co-oximetry (p=0.1809).
Conclusions:
In this group of pediatric patients, reflective forehead oximetry
performs as well as digital transmission oximetry with regard to
obtaining a signal. There is no significant difference between HR
measurements obtained by RFO or DTO. Additionally, there is no
significant difference between oximetry measurements obtained by RFO,
DTO, and co-oximetry.