J Korean Crit Care Nurs.  2023 Feb;16(1):1-14. 10.34250/jkccn.2023.16.1.1.

Comparison of Arterial Oxygen Saturation Measured by Pulse Oximetry at Different Sensor Sites in Neurocritical Patients

• Jeon MJ
• Hwang SK

• KMID: 2539865
• DOI: http://doi.org/10.34250/jkccn.2023.16.1.1

Abstract

Purpose
: This study aimed to compare peripheral pulse oxygen saturation (SpO₂) values, measured at different monitoring sites, and arterial oxygen saturation (SaO₂) of neurocritical patients.
Methods
: The study included 110 patients admitted to the neurosurgical intensive care unit of a university hospital. The patients’ SpO₂ values were measured in their index fingers, both second toes, both earlobes, and foreheads, using the patient monitoring system. These values were compared with the standard value of SaO₂ measured using a blood gas analyzer. Data were analyzed using descriptive values, Pearson’s correlation coefficients, Lin’s concordance correlation coefficients (CCC), and Bland-Altman plots. Result : Regardless of the measuring site, SpO₂ was correlated with the paired measurements of SaO₂ (r=.40~.60, p＜.001, CCC range=.40~.58). No significant bias in paired measurements of SpO₂ and SaO₂ was observed at all sites (-0.06~0.19%, p＞.05). SpO₂ values at the left finger and right earlobe had the narrowest range, with a 95% limits of agreement (LOA) (left finger -3.04~2.93% and right earlobe -3.18~2.79%). SpO₂ at the index finger, on the side without an arterial catheter, had a narrower range of 95% LOA than that of the opposing finger (-3.00~2.97% vs. -3.73~3.26%).
Conclusion
: SpO₂ at the finger without an arterial catheter had the highest level of precision. This study suggests using the index finger, on the side without an arterial catheter, for pulse oximetry in neurocritical patients.

Keyword

Oximetry, Blood gas analysis, Nervous system diseases, Intensive care unit; 맥박 산소포화도, 동맥혈가스분석, 신경계질환, 중환자실