Facing SpO2 and SaO2 discrepancies in ICU patients: is the perfusion index helpful?

Journal of Clinical Monitoring and Computing
Mark ThijssenNorbert Foudraine

Abstract

Peripheral oxygen saturation (SpO2) measured by pulse oximetry is an unreliable surrogate marker for arterial oxygenation (SaO2) in critically ill patients. We hypothesized that a higher perfusion index (PFI) would be associated with better accuracy of SpO2 measurement. We retrospectively collected SaO2, SpO2, and PFI data for each arterial blood gas (ABG) analysis in a cohort of intensive care unit patients. PFI was categorised as low (PFI < 1.0), intermediate (1.0 ≤ PFI  ≤ 2.5), or high (PFI > 2.5). The correlation between SpO2 and SaO2 was studied using Pearson's correlation. The Bland-Altman plot was used to analyse the agreement between SpO2 and SaO2. Furthermore, the correlation between the (SpO2-SaO2) difference and PFI was assessed. The level of (dis)agreement was calculated for the three PFI categories separately. Overall, 281 patients and 1281 data points were analysed. There was a significant correlation between SaO2 and SpO2 (r = 0.69, p < 0.01). The Bland-Altman analysis revealed a mean difference between SaO2 and SpO2 of 0.2% with limits of agreement of ± 6% (SD ± 2%). The correlation between the PFI and the (SpO2-SaO2) difference was low; the (SpO2-SaO2) difference improved only marginally with higher PFI values....Continue Reading

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Citations

Apr 14, 2021·ERJ Open Research·Thomas VoshaarDominic Dellweg
Oct 13, 2021·International Journal of Clinical Practice·Aslıhan Gürün KayaAkın Kaya

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