A prospective study of intraoperative pulse oximetry failure

Journal of Clinical Monitoring and Computing - Tập 7 - Trang 253-258 - 1991
Peter R. Freund1,2,3, Patrick T. Overand1, Jeremy Cooper1, Lawrence Jacobson1, Stan Bosse1, Brad Walker1, Karen L. Posner1, Frederick W. Cheney1
1From the Department of Anesthesiology, University of Washington School of Medicine, Seattle
2From the Department of Physiology and Biophysics, University of Washington School of Medicine, Seattle
3Anesthesiology and OR Services (112A), VA Medical Center, Seattle

Tóm tắt

Since pulse oximetry is now an ASA standard for intraoperative monitoring, we sought to determine the intraoperative failure rate for this device. We prospectively evaluated the intraoperative failure rate of our pulse oximeters at the four University of Washington Hospitals (University of Washington Medical Center, Veterans Affairs Medical Center [VAMC], Children's Hospital and Medical Center, and Harborview Medical Center [HMC]) recorded from April 1989 to August 1989. We defined failure as the inability to obtain any oximetry reading for a cumulative period of more than 30 minutes during any anesthetic procedure after all equipment malfunctions had been eliminated. Our pulse oximeters failed in 124 of 11,046 cases studied; this is a failure rate of 1.12%, which ranged from 0.56% at HMC to 4.24% at VAMC. The failure rate at VAMC (4.24%) was significantly higher than the other hospitals (p<0.001). Those cases associated with the pulse oximeter failure had the following characteristics: (1) an ASA status of 3 or higher, (2) lengthy operations, and (3) elderly patients. When the device did fail in a patient, it did not function for 32% of the mean anesthesia time. We conclude that the intraoperative use of the pulse oximetry can provide information about blood oxygen saturation in most patients. However, in approximately 1% of the patients we studied in the operating room, mechanically functioning pulse oximeters failed to provide readings of blood oxygen saturations during routine operative use.

Tài liệu tham khảo

Yelderman M, New W. Evaluation of pulse oximetry. Anesthesiology 1983;59:349–352 Severinghaus JW, Naifeh KH, Koh SO. Errors in pulse oximeters during profound hypoxia. J Clin Monit 1989;5(2):72–81 Tremper K, Barker S. Pulse oximetry. Anesthesiology 1989;70:98–108 Wukitsch M, Petterson M, Tobler D, Pologe J. Pulse oximetry: analysis of theory technology and practice. J Clin Monit 1988;4:290–301 Bashein G. A comprehensive computer system for anesthesis record retrieval. Anesth Analg 1985;64:425–431 Fleiss JL. Statistical methods for rates and proportions. New York: Wiley, 1981. Snedecor GW, Cochran WG. Statistical methods. Ames: Iowa State University Press, 1980 Cecil W, Thorpe K, Fibuch E, Touhy G: A clinical evaluation of the accuracy of the Nellcor N-100 and Ohmeda 3201 pulse oximeters. J Clin Monit 1988;4:31–36 Skeehan TM, Hensley FA Jr: Axillary artery compression and the prone position. Anesth Analg 1986;65:518–519 Cote CJ, Goldstein EA, Cote MA, et al. A single blind study of pulse oximetry in children. Anesthesiology 1988;68:184–188 Morris RW, Buxchman A, Warren DL, et al. The prevalence of hypoxemia detected by pulse oximetry during recovery from anesthesia. J Clin Monit 1988;4:16–20 Tyler IL, Tantisira B, Winter PM, Motoyama EK. Continuous monitoring of arterial oxygenation saturation with pulse oximeter during transfer to the recovery room. Anesth Analg 1985;64:1108–1112 Tremper KK, Hufstedler S, Barker SJ, Adams AL. Accuracy of pulse oximeter in the critically ill adult: effect of temperature and haemodynamics. Anesthesiology 1985;63:A175 Brown DL. Anesthesia risk: a historical perspective. In: Brown DL. Risk and outcome in anesthesia. Philadelphia: Lippincott, 1988:19