Forehead pulse oximetry compared with finger pulse oximetry and arterial blood gas measurement

Usual monitoring sites for pulse oximetry involve the fingers, toes, ear lobe, and nasal septum. This study examined the performance of a forehead sensor compared with a finger sensor for the pulse oximeter and arterial blood gas (ABG) analysis. Ten healthy adult volunteers and 22 ventilator-dependent patients were studied. The arterial oxygen saturation detected by forehead pulse oximetry (SpO2) correlated well with finger SpO2 and arterial oxygen saturation (SaO2) determined by arterial blood gas analysis in the healthy volunteers. Forehead SpO2 in mechanically ventilated patients correlated well with finger SpO2 and SaO2 when heart rate detected by pulse oximeter differed less than 10% from apical heart rate. Factors that caused a difference in oximeter-detected heart rate and apical heart rate were extensive tissue edema, head movement, and difficulty securing good tape placement. This suggests that when signal strength is weak, causing poor pulse rate detection, there will also be problems associated with accurate SpO2. The forehead pulse oximeter sensor works well on healthy, well-oxygenated volunteers. Difficulty was experienced when applying and using the sensor on critically ill patients. The reliability of the forehead pulse oximeter sensor has not been established at low saturations.