Principles of Pulse Oximetry: Theoretical and Practical Considerations

Continuous monitoring of arterial oxygen saturation with a pulse oximeter is rapidly becoming a standard of anesthesiology practice (1). Because of the tremendous potential market, more than 20 manufacturers now produce pulse oximeters. As one might expect, there have been many unsubstantiated claims and couterclaims regarding those features and capabilities that distinguish one oximeter from another. The purpose of this communication is threefold: (a) to review the underlying principles of pulse oximetry and the limitations they impose, (b) to provide a basis for assessing pulse oximeters to be used in a particular application, and (c) to make available the results of a comparative evaluation of nine widely marketed pulse oximeters (Table 1).

[1]  D C Hoaglin,et al.  The Effect of Nail Polish on Pulse Oximetry , 1988, Anesthesia and analgesia.

[2]  Richard F. Davis,et al.  EFFECT OF FLUORESCEIN, INDOCYANINE GREEN, AND METHYLENE BLUE ON THE MEASUREMENT OF OXYGEN SATURATION BY PULSE OXIMETRY , 1986 .

[3]  D. Paulus,et al.  Infrared heat lamps interfere with pulse oximeters. , 1984, Anesthesiology.

[4]  M. Kelner,et al.  Effects of intravenously administered dyes on pulse oximetry readings. , 1986, Anesthesiology.

[5]  K. Tremper,et al.  A clinical comparison of transcutaneous PO2 and pulse oximetry in the operating room. , 1986, Anesthesia and analgesia.

[6]  M. Scheller,et al.  More on dyes and pulse oximeters. , 1987, Anesthesiology.

[7]  J. Eisenkraft,et al.  Pulse oximeter desaturation due to methemoglobinemia. , 1988, Anesthesiology.

[8]  A. P. Shepherd,et al.  Role of Light Scatterng in Whole Blood Oximetry , 1986, IEEE Transactions on Biomedical Engineering.

[9]  P. Poppers,et al.  Spurious pulse oximeter desaturation with methylene blue injection. , 1986, Anesthesiology.

[10]  D. A. Davis,et al.  Falsely normal saturation reading with the pulse oximeter. , 1987, Anesthesiology.

[11]  V. Rich.  Personal communication , 1989, Nature.

[12]  J. Gross,et al.  Evaluation of the Ohmeda 3700 pulse oximeter: steady-state and transient response characteristics. , 1987, Anesthesiology.

[13]  I. Norley.  Erroneous actuation of the pulse oximeter , 1987, Anaesthesia.

[14]  J. Severinghaus,et al.  Accuracy of Response of Six Pulse Oximeters to Profound Hypoxia , 1987, Anesthesiology.

[15]  J. Cooper,et al.  Standards for patient monitoring during anesthesia at Harvard Medical School. , 1986, JAMA.