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Related Experiment Videos

Errors in 14 pulse oximeters during profound hypoxia.

J W Severinghaus1, K H Naifeh, S O Koh

  • 1Department of Anesthesia, University of California, San Francisco 94143-0542.

Journal of Clinical Monitoring
|April 1, 1989
PubMed
Summary

Pulse oximeter accuracy varies significantly between manufacturers, especially at low oxygen saturation levels. Many devices underestimate oxygen levels and show reduced precision, impacting patient monitoring.

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Area of Science:

  • Biomedical Engineering
  • Medical Device Technology
  • Clinical Monitoring

Background:

  • Pulse oximetry is a critical, non-invasive method for monitoring oxygen saturation.
  • Variability in pulse oximeter performance can affect clinical decision-making.
  • Previous studies have indicated potential inaccuracies in pulse oximeter readings.

Purpose of the Study:

  • To evaluate and compare the accuracy of pulse oximeters from multiple manufacturers.
  • To identify performance differences, particularly under hypoxic conditions.
  • To quantify the bias and precision of various devices.

Main Methods:

  • Tested 14 manufacturers' pulse oximeters on 125 subject sets during induced hypoxic plateaus.
  • Collected data at varying oxyhemoglobin (O2Hb) levels, including profound hypoxia (40-70%) and specific regression points (approx. 50-86%).
  • Defined an "ambiguity" index (bias and precision) to quantify error, comparing SpO2 to arterial O2Hb analyzed by a reference oximeter.

Main Results:

  • Significant differences in bias and precision were observed among the 14 manufacturers.
  • Common issues included underestimation of oxygen saturation and decreased precision at lower saturation levels.
  • Ambiguity values varied widely, with some devices showing substantial errors (e.g., Ohmeda, Radiometer, Nellcor).

Conclusions:

  • Substantial performance variations exist between pulse oximeter brands, especially during hypoxia.
  • Underestimation of saturation and loss of precision are key problems at low O2Hb levels.
  • Clinical use requires careful consideration of device-specific accuracy limitations.

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