The Science Journal of the American Association for Respiratory Care

2008 OPEN FORUM Abstracts

COMPARISON OF REFLECTIVE AND TRANSMISSION PULSE OXIMETRY WITH CO-OXIMETER MEASURED OXYGEN SATURATIONS IN SEVERELY BURNED CHILDREN

Ronald P. Mlcak1, Oscar E. Suman2,1, Marc G. Jeschke2,1, David N. Herndon2,1



Background: Pulse oximetry is considered a standard of care in intensive care units and is an important measurement that helps guide the care of critically ill patients. Oxygen saturation (SpO2) as measured by Pulse Reflectance Oximetry (PRO2) has been postulated to provide a more reliable index of arterial oxygenation than transmission oximetry. The purpose of this study was to compare reflectance oximetry and transmission type pulse oximetry with CO-Oximeter measured arterial oxygen saturation in severely burned children.

Methods:
Twenty pediatric patients with severe thermal injury were enrolled in this prospective study. Oxygen saturation was simultaneously measured with reflectance oximetry (ConMed PRO2) and transmission oximetry (Nellcor Puritan Bennet) and compared to corresponding CO-oximeter measured arterial oxygen saturation (SaO2) values. Study variables included SpO2, SaO2 and heart rates. Data are presented as mean ± SD. Statistical analysis was performed by using a Student's paired t-test and ANOVA were appropriate. Significance was accepted at p<0.05.

Results:
The mean age of the study patients was 9 ± 1 year. The mean % TBSA burn was 60 ± 5 % and the mean % 3rd degree burn of 53 ± 5 %.The mean SpO2 measured with the reflectance oximeter was not significantly different than the CO-oximeter measured arterial oxygen saturation (98.9 ± 1.0% versus 98.1 ± 1.0%). However the SpO2 measured with the transmission type oximeter was significantly different than the CO-oximeter measured saturations (99.5 ± 0.9% versus 98.1 ± 1.0%, p<0.05). Additionally, the mean heart rate showed no significant difference between oximeters (135 ± 20 bpm versus 136 ± 22 bpm, respectively).

Conclusions:
The results indicate no significant difference between the reflectance oximetry SpO2 readings and the CO-oximeter measured oxygen saturations. In contrast, there was a significant difference between the transmission oximeter and the CO-oximeter saturations. Due to the ability of the ConMed PRO2 reflectance oximeter to adequate reflect CO-oximeter measured saturations, this device may be a valuable tool in monitoring the oxygenation status in severely burned children.