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Cited by 296Respiratory Support and MechanismsHemodynamic Monitoring and TherapyNon-Invasive Vital Sign Monitoring

Reliability of pulse oximetry in titrating supplemental oxygen therapy in ventilator-dependent patients

Jubran, Amal, Tobin, Martin J.·1990·Chest
DOI 10.1378/chest.97.6.1420
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Abstract

Pulse oximetry is widely used in the critical care setting, but few studies have examined its usefulness in clinical decision making. One area where pulse oximetry might be useful is in the titration of fractional inspired O2 concentration (FIO2) in ventilator-dependent patients. Unfortunately, documented guidelines for this use do not exist, and in a survey of directors of intensive care units, we found that they employed a wide range of target O2 saturation (SpO2) values. Consequently, we undertook a study to determine if SpO2 could be reliably substituted for measurements of arterial O2 tension (PaO2) when adjusting FIO2 in ventilator-dependent patients. We examined a number of SpO2 target values in 54 critically ill patients aiming for a PaO2 of greater than or equal to 60 mm Hg, while minimizing the risk of O2 toxicity. In white patients, we found that a SpO2 target of 92 percent was reliable in predicting a satisfactory level of oxygenation. However, in black patients, such a SpO2 reading was commonly associated with significant hypoxemia (PaO2 as low as 49 mm Hg), and a higher SpO2 target, 95 percent, was required. In addition, inaccurate oximetry readings (ie, greater than 4 percent difference between SpO2 and direct SaO2 measurements) were more common in black (27 percent) than in white patients (11 percent, p less than 0.05). In conclusion, a SpO2 target of 92 percent was reliable when titrating supplemental O2 in white patients receiving mechanical ventilation; however, in black patients, such a SpO2 reading was commonly associated with significant hypoxemia, and a higher SpO2 target, 95 percent, was required to ensure a satisfactory level of oxygenation.

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Crossref · 10.1378/chest.97.6.1420

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  • A study about applying a pulse oximeter device in titration of fractional inspired O2 concentration in ventilator-dependent patients revealed that a SpO2 reading of 92% was reliable when titrating supplemental O2 in light-skinned patients receiving mechanical ventilation, but in dark-skinned patients the same SpO2 value was commonly related to significant hypoxemia, and higher SpO2 measurements of

    “A study about applying a pulse oximeter device in the titration of fractional inspired O2 concentration in ventilator-dependent patients revealed that a SpO2 reading of 92% was reliable when titrating supplemental O2 in light-skinned patients receiving mechanical ventilation. However, in dark-skinned patients, the same SpO2 value was commonly related to significant hypoxemia, and a higher SpO2”

    From Skin pigmentation influence on pulse oximetry accuracy: a systematic review and bibliometric analysis (2022) · cites this paper as [88]

  • A study in 1990 in ventilator-dependent patients when titrating supplemental O2 reported inaccurate measurements in dark-skinned patients.

    “A study performed in 1990 in ventilator-dependent patients when titrating supplemental O2 report inaccurate measurements in dark-skinned patients [88].”

    From Skin pigmentation influence on pulse oximetry accuracy: a systematic review and bibliometric analysis (2022) · cites this paper as [88]

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Authors
Jubran, A., & Tobin, M. J.
Affiliations
The University of Texas Health Science Center at Houston (US)
ORCID
Venue
Chest
Publisher
Elsevier BV
Published
1990-06
Volume
97
Issue
6
Pages
1420-1425
ISSN
0012-3692 (ISSN-L)
DOI
10.1378/chest.97.6.1420
OpenAlex
W1996518979
Cited by
296
References
22
Citations by year
2026: 16 · 2025: 18 · 2024: 25 · 2023: 29 · 2022: 54 · 2021: 11 · 2020: 8 · 2019: 4 · 2018: 4 · 2017: 3 · 2016: 5 · 2015: 5 · 2014: 13 · 2013: 4 · 2012: 6
FWCI
7.56
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • CHEST Journal (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
  • Health Sciences › Medicine › Surgery › Hemodynamic Monitoring and Therapy
  • Physical Sciences › Engineering › Biomedical Engineering › Non-Invasive Vital Sign Monitoring
Keywords
pulse oximetry, supplemental oxygen, mechanical ventilation, arterial oxygen tension, hypoxemia, racial differences, arterial oxygen saturation, oxygen toxicity, critically ill patients
MeSH terms
Algorithms, Black or African American, Female, Humans, Intensive Care Units, Male, Middle Aged, Oximetry, Oxygen, Oxygen Inhalation Therapy, Partial Pressure, Ventilators, Mechanical, White People

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