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Reflectance Pulse Oximetry from Core Body in Neonates and Infants: Comparison to Arterial Blood Oxygen Saturation and to Transmission Pulse Oximetry

Journal of Perinatology volume 24, pages 366–371 (2004)Cite this article

Abstract

OBJECTIVE: To compare pulse oximetry oxygen saturation (SpO2) measured by a novel reflectance method from core body to arterial oxygen saturation (SaO2) in neonates and infants. Transmission pulse oximetry (TPO) was measured for comparison.

STUDY DESIGN: We monitored 18 infants by the two pulse oximeters simultaneously. The reflectance pulse oximetry (RPO) (PRO2, ConMed, Utica, NY) was measured on the upper back or chest, while the TPO (N395-Nellcor, Pleasanton, CA) was measured from the finger of the infant on the left hand or feet. Data from the two methods were compared to functional SaO2 derived from blood sample drawn from arterial line for patient care and measured by a Co-oximeter (Ilex, Instrument Lab. Lexington, MA). The potential advantage of the RPO is demonstrated in a case of a premature infant with hypovolemic shock, where SaO2 or TPO could not be obtained but oximetry was available from the RPO.

RESULTS: We used for analysis 56 RPO and 32 TPO measurements. SpO2 obtained from the RPO was 88.3±9.8%, from the TPO 84.2±10.1%, and functional SaO2 was 88.2±11.7%, with correlation coefficient of 0.93 and 0.88, respectively (p<0.0001). The mean difference (bias) and standard deviation of the differences (precision) between the RPO and the TPO compared to functional SaO2 were −0.09±4.5% and 1.26±5.9% and the absolute errors were 3.2±3.1%, and 4.4±4.0%, respectively. The accuracy of both RPO and TPO was diminished when SaO2 was <85%, but only the RPO remained correlated with the functional SaO2.

CONCLUSIONS: Reflectance pulse oximetry measured from core body of neonates and infants is accurate and reliable and is comparable to the transmission SpO2 when compared to functional SaO2. We speculate that the reflectance method might be advantageous in cases of poor peripheral perfusion in neonates and infants.

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Authors and Affiliations

  1. Department of Neonatology, Bnai Zion Medical Center, B Rappaport Faculty of Medicine, Technion-IIT, Haifa, Israel

    Amir Kugelman MD, Yoram Wasserman PhD, Frida Mor RN, BA, Leonid Goldinov BSc, Yoav Geller & David Bader MD

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  1. Amir Kugelman MD
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  2. Yoram Wasserman PhD
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  3. Frida Mor RN, BA
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  4. Leonid Goldinov BSc
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  5. Yoav Geller
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  6. David Bader MD
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Additional information

Data were presented in part as a poster at the Pediatric Academic Society meeting in Baltimore 2002 (“late breaker” session) and in the ATS meeting in Seattle 2003. This work was supported by ConMed Corporation, Utica, NY, USA.

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Kugelman, A., Wasserman, Y., Mor, F. et al. Reflectance Pulse Oximetry from Core Body in Neonates and Infants: Comparison to Arterial Blood Oxygen Saturation and to Transmission Pulse Oximetry. J Perinatol 24, 366–371 (2004). https://doi.org/10.1038/sj.jp.7211102

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