Evaluating enhanced pulse oximetry auditory displays for neonatal oxygen targeting: A randomized laboratory trial...

Standard pulse oximeter auditory tones do not clearly indicate departures from the target range of oxygen saturation (SpO₂) of 90%-95% in preterm neonates. We tested whether acoustically enhanced tones would improve participants' ability to identify SpO₂ range. Twenty-one clinicians and 23 non-clinicians used (1) standard pulse oximetry variable-pitch tones plus alarms; (2) beacon-enhanced tones without alarms in which reference tones were inserted before standard pulse tones when SpO₂ was outside target range; and (3) tremolo-enhanced tones without alarms in which pulse tones were modified with tremolo when SpO₂ was outside target range. For clinicians, range identification accuracies (mean (SD)) in the standard, beacon, and tremolo conditions were 52% (16%), 73% (14%) and 76% (13%) respectively, and for non-clinicians 49% (16%), 76% (13%) and 72% (14%) respectively, with enhanced conditions always significantly more accurate than standard. Acoustic enhancements to pulse oximetry clearly indicate departures from preterm neonates' target SpO₂ range.