The Science Journal of the American Association for Respiratory Care

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.

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