2.50
Hdl Handle:
http://hdl.handle.net/10755/157091
Category:
Abstract
Type:
Presentation
Title:
Accuracy and Precision of Buccal Pulse Oximetry
Author(s):
De Jong, Marla; McKnight, Katherine; Bridges, Elizabeth; Bradshaw, Patricia; Schmelz, Joseph; Evers, Karen
Author Details:
Marla De Jong, Medical Research and Materiel Command, Fort Detrick, Maryland, USA, email: mdejong@aol.com; Katherine McKnight; Elizabeth Bridges; Patricia Bradshaw; Joseph Schmelz; Karen Evers
Abstract:
PURPOSE: The purpose of this study was to describe the accuracy and precision of buccal pulse oximetry (SbpO2) compared to arterial oxygen saturation (SaO2) obtained from a radial artery blood sample and pulse oximetry (SpO2) measured at the finger in healthy adults at normoxemia and under three hypoxemic conditions. BACKGROUND: Hypoxemia is a life-threatening complication common in wartime casualties. Continuous pulse oximetry monitoring can rapidly detect hypoxemia. Nurses may be unable to use traditional oximetry monitoring sites, such as the finger or earlobe, for casualties with amputations, severe burns, vasoconstriction, hypothermia, shock, or edema. Alternative monitoring sites such as the buccal pouch (cheek) have been used. Little is known, however, about the accuracy and precision of buccal oximetry. METHODS: Healthy, non-smoking adults without baseline hypoxemia, edema, dyshemoglobinemia, or fever participated in this prospective, within subjects experimental study. The SbpO2, SaO2, and SpO2 values were recorded at normoxemia and at three hypoxemic conditions (SpO2 = 90%, 80%, and 70%). Hypoxemia was induced using the Reduced Oxygen Breathing Device 2. The Bland-Altman method was used to assess accuracy and precision between SbpO2 and SaO2 and between SbpO2 and SpO2. The data were adjusted to account for a lag time between the buccal and finger sites. The standard by which precision of the buccal measure was judged clinically acceptable or interchangeable was set a priori at +/- 4% variability. RESULTS: Data were collected from 53 subjects (32 +/- 9 yrs; 37% male). Comparing SbpO2 and SaO2 values, mean differences (bias) of -1.8%, 0.3%, 2.4% and 2.6% were found at the normoxemia, 90%, 80%, and 70% levels, respectively. Comparing SbpO2 and SpO2 values, the mean difference was -1.4%, 0.11%, 3.3%, and 4.7% at the normoxemia, 90%, 80%, and 70% levels, respectively. SbpO2 and SaO2 values met precision criteria (1.6%, 95% CL = -4.9%, 1.3%) for normoxemia. SbpO2 and SpO2 values met precision criteria at normoxemia (1.5%, 95% CL = -4.4%, 1.5%) and 90% (1.9%, 95% CL = -3.6%, 3.8%) conditions. Precision exceeded a priori criteria at the five other test conditions. SpO2 lagged 21 +/- 11 sec behind SbpO2. CONCLUSIONS: Buccal oximetry is an inaccurate and imprecise method of assessing SpO2 when oxygen saturation is less than 90%. Increased divergence between SbpO2 and both SaO2 or SpO2 values was noted as hypoxemia worsened. The buccal method overestimated oxygen saturation in proportion to degree of hypoxemia. Such overestimations may falsely lead nurses to conclude that a patient's arterial oxygen saturation is acceptable when, in fact, further assessment or intervention is warranted.
Repository Posting Date:
26-Oct-2011
Date of Publication:
26-Oct-2011
Citation:
2009 National Teaching Institute Research Abstracts. American Journal of Critical Care, 18(3), e1-e17.
Conference Date:
2009
Conference Name:
National Teaching Institute and Critical Care Exposition
Conference Host:
American Association of Critical-Care Nurses
Conference Location:
New Orleans, Louisiana, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titleAccuracy and Precision of Buccal Pulse Oximetryen_GB
dc.contributor.authorDe Jong, Marlaen_GB
dc.contributor.authorMcKnight, Katherineen_GB
dc.contributor.authorBridges, Elizabethen_GB
dc.contributor.authorBradshaw, Patriciaen_GB
dc.contributor.authorSchmelz, Josephen_GB
dc.contributor.authorEvers, Karenen_GB
dc.author.detailsMarla De Jong, Medical Research and Materiel Command, Fort Detrick, Maryland, USA, email: mdejong@aol.com; Katherine McKnight; Elizabeth Bridges; Patricia Bradshaw; Joseph Schmelz; Karen Eversen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157091-
dc.description.abstractPURPOSE: The purpose of this study was to describe the accuracy and precision of buccal pulse oximetry (SbpO2) compared to arterial oxygen saturation (SaO2) obtained from a radial artery blood sample and pulse oximetry (SpO2) measured at the finger in healthy adults at normoxemia and under three hypoxemic conditions. BACKGROUND: Hypoxemia is a life-threatening complication common in wartime casualties. Continuous pulse oximetry monitoring can rapidly detect hypoxemia. Nurses may be unable to use traditional oximetry monitoring sites, such as the finger or earlobe, for casualties with amputations, severe burns, vasoconstriction, hypothermia, shock, or edema. Alternative monitoring sites such as the buccal pouch (cheek) have been used. Little is known, however, about the accuracy and precision of buccal oximetry. METHODS: Healthy, non-smoking adults without baseline hypoxemia, edema, dyshemoglobinemia, or fever participated in this prospective, within subjects experimental study. The SbpO2, SaO2, and SpO2 values were recorded at normoxemia and at three hypoxemic conditions (SpO2 = 90%, 80%, and 70%). Hypoxemia was induced using the Reduced Oxygen Breathing Device 2. The Bland-Altman method was used to assess accuracy and precision between SbpO2 and SaO2 and between SbpO2 and SpO2. The data were adjusted to account for a lag time between the buccal and finger sites. The standard by which precision of the buccal measure was judged clinically acceptable or interchangeable was set a priori at +/- 4% variability. RESULTS: Data were collected from 53 subjects (32 +/- 9 yrs; 37% male). Comparing SbpO2 and SaO2 values, mean differences (bias) of -1.8%, 0.3%, 2.4% and 2.6% were found at the normoxemia, 90%, 80%, and 70% levels, respectively. Comparing SbpO2 and SpO2 values, the mean difference was -1.4%, 0.11%, 3.3%, and 4.7% at the normoxemia, 90%, 80%, and 70% levels, respectively. SbpO2 and SaO2 values met precision criteria (1.6%, 95% CL = -4.9%, 1.3%) for normoxemia. SbpO2 and SpO2 values met precision criteria at normoxemia (1.5%, 95% CL = -4.4%, 1.5%) and 90% (1.9%, 95% CL = -3.6%, 3.8%) conditions. Precision exceeded a priori criteria at the five other test conditions. SpO2 lagged 21 +/- 11 sec behind SbpO2. CONCLUSIONS: Buccal oximetry is an inaccurate and imprecise method of assessing SpO2 when oxygen saturation is less than 90%. Increased divergence between SbpO2 and both SaO2 or SpO2 values was noted as hypoxemia worsened. The buccal method overestimated oxygen saturation in proportion to degree of hypoxemia. Such overestimations may falsely lead nurses to conclude that a patient's arterial oxygen saturation is acceptable when, in fact, further assessment or intervention is warranted.en_GB
dc.date.available2011-10-26T19:24:48Z-
dc.date.issued2011-10-26en_GB
dc.date.accessioned2011-10-26T19:24:48Z-
dc.identifier.citation2009 National Teaching Institute Research Abstracts. American Journal of Critical Care, 18(3), e1-e17.en_GB
dc.conference.date2009en_GB
dc.conference.nameNational Teaching Institute and Critical Care Expositionen_GB
dc.conference.hostAmerican Association of Critical-Care Nursesen_GB
dc.conference.locationNew Orleans, Louisiana, USAen_GB
dc.identifier.citation2009 National Teaching Institute Research Abstracts. American Journal of Critical Care, 18(3), e1-e17.en_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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