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Oxygen saturation measurement in cyanotic heart disease with the Apple watch
Angelika Weis1, Martin Leroy1, Christian Jux1
1Department of Pediatric Cardiology, Intensive Care Medicine and Congenital Heart Disease, Justus Liebig University, Gießen, HE, 35390, Germany.
Insights
An Apple Watch can measure transcutaneous oxygen saturation in children with cyanotic heart disease, but is only reliable for mild cases with readings above 85%. It is not recommended for moderate or severe cyanosis.
Area of Science:
- Cardiology
- Biomedical Engineering
- Pediatrics
Background:
- Accurate transcutaneous oxygen saturation measurement is critical for assessing cyanosis in congenital heart disease (CHD).
- Evaluating supplementary devices for monitoring oxygen saturation in pediatric patients with CHD is essential.
Purpose of the Study:
- To assess the utility of an Apple Watch Series 7 for supplementary transcutaneous oxygen saturation measurements in children with cyanotic heart disease.
- To compare Apple Watch measurements with a standard oximeter during a six-minute walk test.
Main Methods:
- Simultaneous transcutaneous oxygen saturation measurements were taken using an Oximeter and an Apple Watch Series 7 in 36 children with cyanotic heart disease.
- Measurements were conducted before and after a six-minute walk test.
Main Results:
- Apple Watch measurements were successful in 35/36 children before and 34/36 after the walk test.
- Measurements were not possible in children with transcutaneous oxygen saturation < 85% on the oximeter.
- The Apple Watch tended to show higher readings than the oximeter, particularly in mild cyanosis.
Conclusions:
- Apple Watch measurements are only valid for mild cyanosis (transcutaneous oxygen saturation > 85%) and tend to overestimate values.
- The device is not reliable for monitoring oxygen saturation in children with moderate to severe cyanosis.
- Home monitoring of oxygen saturation using an Apple Watch in children with cyanotic heart disease is not recommended due to reliability issues.
Background:
Accurate measurement of transcutaneous oxygen saturation is important for the assessment of cyanosis in CHD. Aim of this study was the evaluation of a supplementary transcutaneous oxygen saturation measurement with an Apple watch® in children with cyanotic heart disease.
Material And Methods:
During a six-minute walk test, measurement of transcutaneous oxygen saturation was performed simultaneously with an Oximeter (Nellcor, Medtronic, USA) and an Apple watch® Series 7 (Apple inc, USA) in 36 children with cyanotic heart disease.
Results:
Median age was 9.2 (IQR 5.7-13.8) years. Transcutaneous oxygen saturation measurement with the Apple watch® was possible in 35/36 and 34/36 subjects before and after six-minute walk test. Children, in whom Apple watch® measurement was not possible, had a transcutaneous oxygen saturation < 85% on oximeter. Before six-minute walk test, median transcutaneous oxygen saturation was 93 (IQR 91-97) % measured by oximeter and 95 (IQR 93-96) % by the Apple watch®. After a median walking distance of 437 (IQR 360-487) m, transcutaneous oxygen saturation dropped to 92 (IQR 88-95, p < 0.001) % by oximeter and to 94 (IQR 90-96, p = 0.013) % measured with the Apple watch®.
Conclusion:
In children with mild cyanosis measurement of transcutaneous oxygen saturation with an Apple watch® showed only valid results if transcutaneous oxygen saturation was > 85%, with higher values being measured with the smart watch. In children with moderate or severe cyanosis transcutaneous oxygen saturation, measurement with the Apple watch® was not reliable and cannot be recommended to monitor oxygen saturation at home.
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