2006 OPEN FORUM Abstracts
Pulse Reflectance Oximetry Compared to Traditional Oxygen Saturations in Pediatric Patients with Severe Thermal Injury
Ronald
P. Mlcak PhD, RRT, FAARC, David N. Herndon, MD. Shriners Hospital for Children, Galveston Burn
Hospital and The University of Texas Medical Branch, Galveston, Texas
Introduction:
Pulse oximetery is considered a standard of care in intensive care units
and is an important measurement that helps guide the care of critically ill
patients. A major limitation of most current devices is the inability to
adequately monitor peripheral sites in severely burned children. ConMed
Corporation (Utica, NY, USA) has recently introduced a pulse oximeter which
utilizes a flat, low profile sensor for use on the forehead or back, thus
avoiding problems associated with peripheral site monitoring. Oxygen saturation
(SaO2) as measured by Pulse Reflectance Oximetry (PRO2) has been postulated to
provide a reliable index of arterial oxygenation. The purpose of this study was
to assess the utility of the ConMed PRO2 pulse reflectance oximetry compared to
traditional pulse oximetery in pediatric patients with severe thermal injury.
Methods:
Ten pediatric patients with > 40% TBSA thermal injury were enrolled in this
study. The ConMed PRO2 pulse oximeter flat probe was placed on either the
forehead or back according to manufactures instruction. The Hewlett-Packard
pulse oximeter peripheral site probe was placed on the digit of the foot. Once
adequate signal strength was achieved the results were recorded. Study
variables included SpO2 and heart rates (HR). Statistical analysis was
performed by using a Student's paired t-test. Significance was accepted at
p<0.05.
Results:
The mean age of the study patients was 9 ± 1 years. The mean % TBSA burn was 65
± 5 % and the mean % 3rd
degree burn of 64 ± 5 %. Nine patients had bronchoscopic findings of inhalation
injury and 3 patients required mechanical ventilation. The mean O2 saturation
by the PRO2 flat sensor was 98 ± 1 vs. 99 ± 1 with traditional peripheral site
oximetry (p=0.3). Additionally, the mean HR with the PRO2 system was 128 ± 21
vs. 130 ± 23 with traditional peripheral oximetry (p=0.88). There was no
significant difference in SpO2's or HR's found between the two units.
Conclusion:
The results indicate that the PRO2 pulse reflectance oximeter with a flat
sensor worked equally well as compared to traditional peripheral site oximetry
in a group of severely burned children. The PRO2 system however has the added
advantage of monitoring over large flat surfaces with faster response times
thus avoiding problems with peripheral site monitoring.