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    Pulse Oximetry

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    Ade Yonata
    Pulse oximetry allows noninvasive measurement of arterial hemoglobin saturation without the risks of arterial puncture. It has become the standard method for continuously monitoring oxygen saturation, now considered the "fifth vital sign". However, practitioners should be aware of potential limitations. Pulse oximetry measures oxygen saturation by detecting differences in light absorption of arterial blood pulsations using two wavelengths, building on principles from the Beer-Lambert law. While greatly improving on previous methods, early devices still had issues with interference from venous and capillary blood. Modern pulse oximetry preferentially measures arterial saturation by quantifying light signal pulsations.

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    Pulse Oximetry

    Uploaded by

    Ade Yonata
    158 views2 pages
    Pulse oximetry allows noninvasive measurement of arterial hemoglobin saturation without the risks of arterial puncture. It has become the standard method for continuously monitoring oxygen saturation, now considered the "fifth vital sign". However, practitioners should be aware of potential limitations. Pulse oximetry measures oxygen saturation by detecting differences in light absorption of arterial blood pulsations using two wavelengths, building on principles from the Beer-Lambert law. While greatly improving on previous methods, early devices still had issues with interference from venous and capillary blood. Modern pulse oximetry preferentially measures arterial saturation by quantifying light signal pulsations.

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    Pulse oximetry allows noninvasive measurement of arterial hemoglobin saturation without the risks of arterial puncture. It has become the standard method for continuously monitoring oxygen saturation, now considered the "fifth vital sign". However, practitioners should be aware of potential limitations. Pulse oximetry measures oxygen saturation by detecting differences in light absorption of arterial blood pulsations using two wavelengths, building on principles from the Beer-Lambert law. While greatly improving on previous methods, early devices still had issues with interference from venous and capillary blood. Modern pulse oximetry preferentially measures arterial saturation by quantifying light signal pulsations.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    158 views2 pages

    Pulse Oximetry

    Uploaded by

    Ade Yonata
    Pulse oximetry allows noninvasive measurement of arterial hemoglobin saturation without the risks of arterial puncture. It has become the standard method for continuously monitoring oxygen saturation, now considered the "fifth vital sign". However, practitioners should be aware of potential limitations. Pulse oximetry measures oxygen saturation by detecting differences in light absorption of arterial blood pulsations using two wavelengths, building on principles from the Beer-Lambert law. While greatly improving on previous methods, early devices still had issues with interference from venous and capillary blood. Modern pulse oximetry preferentially measures arterial saturation by quantifying light signal pulsations.

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    © All Rights Reserved
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    Pulse oximetry

    Pulse oximetry
    Author
    C Crawford Mechem, MD, FACEP
    Section Editor
    Polly E Parsons, MD
    Deputy Editor
    Helen Hollingsworth, MD
    Disclosures
    All topics are updated as new evidence becomes available and our peer review process is
    complete.
    Literature review current through: Oct 2012. | This topic last updated: Apr 23, 2012.
    INTRODUCTION Hypoxemia is an important and potentially avoidable cause of morbidity
    and mortality in many hospital settings, including the intensive care unit (ICU), emergency
    department, procedure suite, and operating room. Rapid, accurate detection of hypoxemia is
    critical to prevent serious complications; however, oxygenation is difficult to assess on the basis
    of physical examination alone. Frank cyanosis does not develop until the level of
    deoxyhemoglobin reaches 5 g/dL, which corresponds to an arterial oxygen saturation (SaO
    2
    ) of
    around 67 percent [1]. Furthermore, the threshold at which cyanosis becomes apparent is
    affected by multiple variables including peripheral perfusion, skin pigmentation, and hemoglobin
    concentration [2].
    Blood gas analysis was for many years the only available method of detecting hypoxemia in
    critically ill patients, but this technique is painful, has potential complications, and does not
    provide immediate or continuous data [3]. (See "Arterial blood gases" and "Arterial
    catheterization techniques for invasive monitoring".)
    Pulse oximetry allows noninvasive measurement of arterial hemoglobin saturation, without the
    risks associated with arterial puncture. Over the past 30 years, pulse oximetry has become the
    standard for continuous and/or noninvasive assessment of arterial oxygen saturation [4]. Arterial
    oxygen saturation determination with pulse oximetry is now in such ubiquitous use that it has
    been called the "fifth vital sign" [5].
    Despite the widespread use of pulse oximetry in clinical monitoring, many practitioners are
    unaware of the potential limitations of this technology. Theoretical and clinical aspects of pulse
    oximetry will be reviewed here. The interpretation of arterial oxygen tension is discussed
    separately. (See "Oxygenation and mechanisms of hypoxemia".)
    HISTORY Carl Matthes invented the first noninvasive oximeter employing an ear probe in
    1935 [6]. The device used two wavelengths of light to compensate for variations in tissue
    thickness and blood content, but did not account for pulsatile flow. The development of oximetry
    intensified during World War II, when a method was sought to monitor oxygenation in pilots
    flying at high altitudes in pressurized cockpits [3,6,7]. These early nonpulsatile devices did not
    measure true arterial saturation because of interference from capillary and venous blood, and
    they were unwieldy to use and transport [8].
    In 1970, scientists at Hewlett-Packard developed the first widely used, commercial ear oximeter
    that preferentially measured arterial saturation by heating the tissue to 41C to increase local
    cutaneous blood flow [7]. In 1974, Takuo Aoyagi found that arterial oxygen saturation could be
    measured by quantifying pulsations in the light signals coming through tissue. This eliminated
    the need for heating the tissue, and his device is the ancestor of the current generation of pulse
    oximeters [9].
    PRINCIPLES The theoretical basis for pulse oximetry derives from the Beer-Lambert law.
    This law states that the absorption of light of a given wavelength passing through a non-
    absorbing solvent, which contains an absorbing solute, is proportional to the product of the solute
    concentration, the light path length, and an extinction coefficient. The Beer-Lambert law can
    readily be applied to co-oximeters used for blood gas analysis, in which a sample of arterial
    blood can be placed within a cuvette, and factors such as light path length and solute
    concentration can be controlled [10].

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