Comparison of nasal and forehead oximetry accuracy and pressure injury in critically ill patients
Abstract
Background In critically ill patients, clinicians can have difficulty obtaining accurate oximetry measurements.Objective To compare the accuracy of nasal alar and forehead sensor measurements and incidence of pressure injury.Methods 43 patients had forehead and nasal alar sensors applied. Arterial samples were obtained at 0, 24, and 120 hours. Oxygen saturations measured by co-oximetry were compared to sensor values. Skin was assessed every 8 hours.Results Oxygen saturations ranged from 69.8%-97.8%, with 18% of measures < 90%. Measurements were within 3% of co-oximetry values for 54% of nasal alar compared to 35% of forehead measurements. Measurement failures occurred in 6% for nasal alar and 22% for forehead. Three patients developed a pressure injury with the nasal alar sensor and 13 patients developed a pressure injury with the forehead sensor (χ2 = 7.68; p = .006).Conclusions In this group of patients with decreased perfusion, nasal alar sensors provided a potential alternative for continuous monitoring of oxygen saturation.
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When measurement bias and precision are considered jointly in Arms, pulse oximetry measurements for all the subgroups appear acceptably accurate, with Arms below the internationally recommended threshold of 4% or the more conservative US FDA threshold of 3%.
“Nevertheless, when the extents of measurement bias and precision are considered jointly in Arms, pulse oximetry measurements for all the subgroups appear acceptably accurate (with Arms < the internationally recommended threshold of 4% [10, 55], or even the more conservative threshold of 3% in the US FDA guidance) [56].”
From The effects of skin pigmentation on the accuracy of pulse oximetry in measuring oxygen saturation: a systematic review and meta-analysis (2022) · cites this paper as [56]
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References 21 · Cited by 30
- Authors
- Schallom, M., Prentice, D., Sona, C., Arroyo, C., & Mazuski, J.
- Affiliations
- Barnes-Jewish Hospital (US)
- Washington University in St. Louis (US)
- Corresponding author
- Schallom, Marilyn
- Venue
- Heart & Lung
- Publisher
- Elsevier BV
- Published
- 2018-03
- Volume
- 47
- Issue
- 2
- Pages
- 93-99
- ISSN
- 0147-9563 (ISSN-L)
- OpenAlex
- W2793433978
- Cited by
- 30
- References
- 21
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 1 · 2023: 1 · 2022: 23 · 2021: 1 · 2020: 1
- FWCI
- 0.20
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Heart & Lung (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Physical Sciences › Engineering › Biomedical Engineering › Non-Invasive Vital Sign Monitoring
- Health Sciences › Medicine › Surgery › Hemodynamic Monitoring and Therapy
- Health Sciences › Medicine › Surgery › Healthcare Technology and Patient Monitoring
- Keywords
- oxygen saturation monitoring, sensor accuracy, pressure ulcers, critically ill patients, co-oximetry, measurement failure, skin assessment, hypoperfusion
- MeSH terms
- Adult, Aged, Arteries, Critical Care, Pressure Ulcer, Female, Forehead, Humans, Male, Middle Aged, Nose, Oximetry, Oxygen, Pressure, Prospective Studies, Skin, Critical Illness
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