UMEM Educational Pearls

Category: Critical Care

Title: Pulse Oximetry

Keywords: pulse oximetry (PubMed Search)

Posted: 1/22/2008 by Mike Winters, MD (Updated: 12/4/2023)
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Pitfalls in pulse oximetry in the critically ill

  • Pulse oximeters are calibrated by manufacturers using data collected from healthy volunteers
  • In general, pulse oximeters are accurate  within +/- 2% for sats > 70%
  • In the critically ill, however, the accuracy of pulse oximetry diminishes when sats drop below 90%
  • Also, there may be a significant lag time between a hypoxic event and the actual display of the event - most commonly seen in low flow states, hypotension, mild hypothermia, and when using vasoactive medications
  • Prolonged lag times are more common with finger probes
  • Pitfall - pulse oximetry does not provide any assessment regarding ventilation (PaCO2) or acid-base status (pH) - it is simply an estimate of arterial oxgyen saturation
  • Pearl: anemia does not affect the accuracy of pulse oximetry