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Accuracy of pulse oximetry during exercise stress testing
L H Norton1, B Squires, N P Craig
1John Hunter Hospital, Newcastle, Australia.
International Journal of Sports Medicine
|October 1, 1992
Summary
Pulse oximetry underestimates oxygen saturation during severe exercise. Accuracy decreases with higher exercise intensity, and it fails to detect changes in oxygen levels when breathing enriched air. Use pulse oximetry cautiously during intense exercise.
Area of Science:
- Sports Medicine
- Clinical Physiology
- Exercise Science
Background:
- Pulse oximetry is widely used in clinical and sports medicine for exercise stress testing.
- Limited validation studies exist for pulse oximetry accuracy under compromised peripheral blood flow during exercise.
Purpose of the Study:
- To evaluate the accuracy of pulse oximetry in estimating arterial oxygen saturation (%SaO2) during severe exercise stress.
- To determine if exercise intensity impacts pulse oximetry accuracy.
Main Methods:
- Ten athletes performed three exhaustive exercise bouts: maximal oxygen uptake (VO2max), 115% of VO2max (Smax), and Smax with an inspired oxygen fraction (FIO2) of 0.30.
- Peripheral oxygen saturation was measured using pulse oximetry and compared against arterial blood gas analysis.
Main Results:
- Pulse oximetry significantly underestimated %SaO2 compared to arterial blood gas analysis during severe exercise.
- The underestimation worsened with increasing exercise intensity, from 2.9% at VO2max to 4.6% at Smax.
- Pulse oximetry failed to detect the reversal of exercise-induced hypoxemia when athletes breathed a higher FIO2.
Conclusions:
- Pulse oximetry measurements of oxygen saturation during severe exercise should be interpreted with caution due to potential inaccuracies.
- The accuracy of pulse oximetry is compromised under conditions of high exercise intensity and altered inspired oxygen levels.
- Further research is needed to understand the limitations of pulse oximetry in exercise physiology.