Effect of measurement error on calculated variables of oxygen transport

The effect of measurement error in pH, PCO2, and PO2 on mathematically derived variables of oxygen transport in patients was delineated by comparing calculated oxygen saturations from a blood-gas machine with measured saturations from a CO-oximeter and further by modeling the error in a computer simulation. Twenty-one critically ill patients aged 30-84 yr were studied. A total of 80 arterial and 80 mixed venous blood gas samples were collected. The intraclass correlation results between measured and calculated arterial (SaO2) and mixed venous (Sv-O2) oxygen saturations were 0.59 and 0.68, respectively. The product-moment correlation for SaO2 was 0.75 and for Sv-O2 was 0.77. The percent error in calculating and measuring oxygen saturation was found to be greater at low PO2 values, whereas percent error of calculating oxygen consumption increased as the PO2 increased. Measurement repeatability at high PO2 is better than at low PO2 for both measured and calculated methods. We conclude from this comparison that measured and calculated SaO2 and Sv-O2 values are not interchangeable. Each can introduce substantial error in calculating oxygen consumption through error propagation and error amplification.