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Peer-reviewed veterinary case report

The precision and accuracy of Nellcor and Masimo oximeters at low oxygen saturations (70%) in newborn lambs.

Journal:
Archives of disease in childhood. Fetal and neonatal edition
Year:
2014
Authors:
Dawson, J A et al.

Abstract

BACKGROUND: Administration of oxygen in the delivery room is informed by oxygen saturation (SpO&#x2082;). An oxygen saturation range of 60%-70% is the threshold for administering oxygen in the first minutes after birth. The accuracy of newer generation oximeters to measure SpO&#x2082; has not been compared against the 'gold standard', direct arterial blood oxygen saturation (SaO&#x2082;) when SaO&#x2082; is low. The aim of this study was to determine the accuracy and precision of Nellcor and Masimo oximeters to measure SpO&#x2082; when SaO&#x2082; <70%. METHOD: Prospective observational study in ventilated anaesthetised newborn lambs with an indwelling carotid artery catheter. Ventilation was adjusted to achieve hypoxaemia. Nellcor (Oxi-Max 600 with Max-N sensor) and Masimo (Rad 4 with low noise optical probe (LNOP) sensor) sensors were applied to the right forelimb (preductal). An arterial blood sample was collected at 1-5 min intervals when the animal was hypoxic. The displayed SpO&#x2082; was recorded. We used Bland-Altman analysis to determine precision and accuracy of each oximeter when SaO&#x2082; <70%. RESULTS: 17 lambs were studied, 165 measurements were obtained, 123 were SaO&#x2082; <70%. The mean difference (&#xb1;1.96 SD) Nellcor SpO&#x2082;-SaO&#x2082; when SaO&#x2082; <70% was 17% (-12% to 46%). The mean difference (&#xb1;1.96 SD) Masimo SpO&#x2082;-SaO&#x2082; when SaO2 <70% was 13% (-19% to 45%). CONCLUSIONS: At SaO&#x2082;<70%, both monitors overestimated oxygen saturation (SpO&#x2082;) compared with the gold standard. Both oximeters were equally inaccurate when SaO&#x2082; was low.

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Original publication: https://pubmed.ncbi.nlm.nih.gov/24596406/