Reflectance pulse oximetry in fetal lambs: Subcutaneous vessels and vasoconstriction affect its reliability
Open accessAbstract
Objective Reflectance pulse oximetry (RPOX) has been introduced for intrapartum fetal surveillance. The purpose of this study was to describe two possible effects on the reliability of RPOX, namely the effect of the presence of a subcutaneous vein and the effect of vasoconstriction by adrenaline, both at fetal SaO2 levels.Methods In four anesthetized fetal lambs, a prototype 660/890 nm reflectance sensor (Nellcor Inc.) was placed on the fetal head, with the photodiode of the sensor precisely over a superficial subcutaneous vein. Measurements were made before and after coagulation of the vein. In five anesthetized fetal lambs, one or two reflectance sensors were placed on the fetal head and/or neck and adrenaline was administered in doses of 0.02 to 0.04 mg via a brachial artery. Pulse oximeter saturation readings (SpO2) were compared with continuous arterial oxygen saturation (SaO2) values obtained using a fiberoptic catheter (Opticath, Abbott) in the carotid artery.Results When the sensor was placed over the vein, the pulse oximeter read 18% to 24% too low at a SaO2 level of 20% to 50%. After coagulation of the vein, SpO2 readings were in agreement with fiberoptic SaO2 values. Administration of adrenaline resulted in a large overestimation of the SaO2 in 6 of the 7 measurements.Conclusions Subcutaneous veins and vasoconstriction can affect the reliability of reflectance pulse oximetry. As comparable situations may occur during labor, SpO2 readings should be interpreted with caution when this kind or comparable types of RPOX sensors are used at low SaO2 levels.
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Nijland et al. confirmed in fetal lambs that reflectance pulse oximetry SpO2 readings were significantly lower than fiberoptic SaO2 values, and when the vessel was coagulated, this difference became negligible.
“Nijland et al. also confirmed these results in fetal lambs, where reflectance pulse oximetry SpO2 readings were significantly lower than fiberoptic SaO2 values. However, when the vessel was coagulated, this difference became negligible [128].”
From Sources of inaccuracy in photoplethysmography for continuous cardiovascular monitoring (2021) · cites this paper as [128]
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Sources of inaccuracy in photoplethysmography for continuous cardiovascular monitoring
Fine, J., Branan, K. L., Rodriguez, A. J., Boonya-ananta, T., Ajmal, Ramella-Roman, J. C., McShane, M. J., & Coté, G. L. (2021) · Biosensors · doi:10.3390/bios11040126 · Cited by 348 · see citing works
- Authors
- Nijland, R., Jongsma, H. W., Verbruggen, I. M., & Nijhuis, J. G.
- Affiliations
- Radboud University Nijmegen (NL)
- ORCID
- Nijhuis, Jan G.
- Venue
- Journal of Clinical Monitoring
- Published
- 1996-05
- Volume
- 12
- Issue
- 3
- Pages
- 225-230
- ISSN
- 0748-1977 (ISSN-L)
- OpenAlex
- W1999181681
- Cited by
- 8
- References
- 21
- Citations by year
- 2021: 1
- FWCI
- 1.23
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- other-oa
- www.springer.com/tdm (tdm)
- Locations
- The Journal of Clinical Monitoring (publishedVersion)
- PubMed (publishedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion, other-oa)
- Topics
- Physical Sciences › Engineering › Biomedical Engineering › Non-Invasive Vital Sign Monitoring
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Optical Imaging and Spectroscopy Techniques
- Health Sciences › Medicine › Surgery › Hemodynamic Monitoring and Therapy
- Keywords
- reflectance pulse oximetry, fetal oxygen saturation, subcutaneous veins, vasoconstriction, epinephrine, intrapartum fetal monitoring, fetal sheep, arterial oxygen saturation, sensor reliability
- MeSH terms
- Animals, Epinephrine, Female, Fetal Blood, Fetal Monitoring, Oximetry, Pregnancy, Sheep, Vasoconstriction, Reproducibility of Results
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