Accuracy of Pulse Oximetry in Children
Abstract
OBJECTIVE: For children with cyanotic congenital heart disease or acute hypoxemic respiratory failure, providers frequently make decisions based on pulse oximetry, in the absence of an arterial blood gas. The study objective was to measure the accuracy of pulse oximetry in the saturations from pulse oximetry (SpO2) range of 65% to 97%. METHODS: This institutional review board–approved prospective, multicenter observational study in 5 PICUs included 225 mechanically ventilated children with an arterial catheter. With each arterial blood gas sample, SpO2 from pulse oximetry and arterial oxygen saturations from CO-oximetry (SaO2) were simultaneously obtained if the SpO2 was ≤97%. RESULTS: The lowest SpO2 obtained in the study was 65%. In the range of SpO2 65% to 97%, 1980 simultaneous values for SpO2 and SaO2 were obtained. The bias (SpO2 – SaO2) varied through the range of SpO2 values. The bias was greatest in the SpO2 range 81% to 85% (336 samples, median 6%, mean 6.6%, accuracy root mean squared 9.1%). SpO2 measurements were close to SaO2 in the SpO2 range 91% to 97% (901 samples, median 1%, mean 1.5%, accuracy root mean squared 4.2%). CONCLUSIONS: Previous studies on pulse oximeter accuracy in children present a single number for bias. This study identified that the accuracy of pulse oximetry varies significantly as a function of the SpO2 range. Saturations measured by pulse oximetry on average overestimate SaO2 from CO-oximetry in the SpO2 range of 76% to 90%. Better pulse oximetry algorithms are needed for accurate assessment of children with saturations in the hypoxemic range.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
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 [55]
Cites
International Organization for Standardization (ISO)
Turner, B. (2003) · doi:10.1057/9780230271326_102 · Cited by 2,957 · see citing works
Target Ranges of Oxygen Saturation in Extremely Preterm Infants
Shriver, E. K. (2010) · New England Journal of Medicine · doi:10.1056/nejmoa0911781 · Cited by 964 · see citing works
Oxygen Saturation and Outcomes in Preterm Infants
The BOOST II United Kingdom, A. (2013) · New England Journal of Medicine · doi:10.1056/nejmoa1302298 · Cited by 507 · see citing works
Effects of skin pigmentation on pulse oximeter accuracy at low saturation
Bickler, P. E., Feiner, J. R., & Severinghaus, J. W. (2005) · Anesthesiology · doi:10.1097/00000542-200504000-00004 · Cited by 427 · see citing works
Schmidt, B. K., Whyte, R. K., Asztalos, E. V., Moddemann, D. M., Poets, C. F., Rabi, Y., Solimano, A. J., Roberts, R. S., & for the Canadian Oxygen Trial (COT) Group (2013) · JAMA · doi:10.1001/jama.2013.5555 · Cited by 405 · see citing works
Feiner, J. R., Severinghaus, J. W., & Bickler, P. E. (2007) · Anesthesia & Analgesia · doi:10.1213/01.ane.0000285988.35174.d9 · Cited by 400 · see citing works
Khemani, R. G., Thomas, N. J., Venkatachalam, V., Scimeme, J., Berutti, T. W., Schneider, J. B., Ross, P. A., Willson, D. F., Hall, M. W., & Newth, C. J. L. (2012) · Critical Care Medicine · doi:10.1097/ccm.0b013e31823bc61b · Cited by 223 · see citing works
Self-citationCharacteristics of Children Intubated and Mechanically Ventilated in 16 PICUs
Khemani, R. G., Markovitz, B. P., & Curley, M. A. Q. (2009) · CHEST Journal · doi:10.1378/chest.09-0207 · Cited by 135 · see citing works
Self-citationBatchelder, P. B., & Raley, D. M. (2007) · Anesthesia & Analgesia · doi:10.1213/01.ane.0000268495.35207.ab · Cited by 62 · see citing works
Effect of fetal haemoglobin on the accuracy of pulse oximetry in preterm infants
Rajadurai, V. S., Walker, A., YU, V. Y. H., & Oates, A. (1992) · Journal of Paediatrics and Child Health · doi:10.1111/j.1440-1754.1992.tb02615.x · Cited by 48 · see citing works
Aggarwal, N., Das, J., & Aggarwal, A. (2010) · Indian Journal of Anaesthesia · doi:10.4103/0019-5049.72642 · Cited by 28 · see citing works
Pulse oximeter accuracy and precision affected by sensor location in cyanotic children
Sedaghat-Yazdi, F., Torres, A., Fortuna, R. S., & Geiss, D. M. (2008) · Pediatric Critical Care Medicine · doi:10.1097/pcc.0b013e3181727967 · Cited by 25 · see citing works
Torres, A., Skender, K. M., Wohrley, J. D., Aldag, J. C., Raff, G. W., Bysani, G. K., & Geiss, D. M. (2004) · Journal of Intensive Care Medicine · doi:10.1177/0885066604263819 · Cited by 23 · see citing works
Effects of Fetal Hemoglobin on Accurate Measurements of Oxygen Saturation in Neonates
Shiao, S.-Y. P. K. (2005) · The Journal of Perinatal & Neonatal Nursing · doi:10.1097/00005237-200510000-00010 · Cited by 15 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Clinical Practice Guideline: The Diagnosis, Management, and Prevention of Bronchiolitis
Ralston, S. L., Lieberthal, A. S., Meissner, H. C., Alverson, B. K., Baley, J. E., Gadomski, A., Johnson, D. W., Light, M. J., Maraqa, N., Mendonça, E. A., et al. (2014) · PEDIATRICS · doi:10.1542/peds.2014-2742 · Cited by 1,731 · see citing works
Friedman, J., Rieder, M. J., Walton, J. M., & Canadian Paediatric Society (2014) · Paediatrics & Child Health · doi:10.1093/pch/19.9.485 · Cited by 247 · see citing works
Baraldi, E., Lanari, M., Manzoni, P., Rossi, G. A., Vandini, S., Rimini, A., Romagnoli, C., Colonna, P., Biondi, A., Biban, P., et al. (2014) · The Italian Journal of Pediatrics/Italian journal of pediatrics · doi:10.1186/1824-7288-40-65 · Cited by 191 · see citing works
Shi, C., Goodall, M., Dumville, J., Hill, J., Norman, G., Hamer, O., Clegg, A., Watkins, C. L., Georgiou, G., Hodkinson, A., et al. (2022) · doi:10.1101/2022.02.16.22271062 · Cited by 158 · see citing works
UPDATE - 2022 Italian guidelines on the management of bronchiolitis in infants
Manti, S., Staiano, A., Orfeo, L., Midulla, F., Marseglia, G. L., Ghizzi, C., Zampogna, S., Carnielli, V. P., Favilli, S., Ruggieri, M., et al. (2023) · The Italian Journal of Pediatrics/Italian journal of pediatrics · doi:10.1186/s13052-022-01392-6 · Cited by 140 · see citing works
Racial discrepancy in pulse oximeter accuracy in preterm infants
Vesoulis, Z., Tims, A., Lodhi, H., Lalos, N., & Whitehead, H. (2022) · Journal of Perinatology · doi:10.1038/s41372-021-01230-3 · Cited by 120 · see citing works
A review of the effect of skin pigmentation on pulse oximeter accuracy
Al-Halawani, R., Charlton, P. H., Qassem, M., & Kyriacou, P. A. (2023) · Physiological Measurement · doi:10.1088/1361-6579/acd51a · Cited by 119 · see citing works
The Various Oximetric Techniques Used for the Evaluation of Blood Oxygenation
Nitzan, M., Nitzan, I., & Arieli, Y. S. (2020) · Sensors · doi:10.3390/s20174844 · Cited by 99 · see citing works
The Effect of Skin Pigmentation on the Accuracy of Pulse Oximetry in Infants with Hypoxemia
Foglia, E. E., Whyte, R. K., Chaudhary, A., Mott, A., Chen, J., Propert, K. J., & Schmidt, B. (2017) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2016.11.043 · Cited by 96 · see citing works
Martín, D., Johns, C., Sorrell, L., Healy, E., Phull, M., Olusanya, O., Peters, M. J., & Fabes, J. (2024) · British Journal of Anaesthesia · doi:10.1016/j.bja.2024.01.023 · Cited by 80 · see citing works
Miller, J. W., Divanovic, A. A., Hossain, M. M., Mahmoud, M. A., & Loepke, A. W. (2016) · Canadian Journal of Anesthesia/Journal canadien d anesthésie · doi:10.1007/s12630-016-0617-y · Cited by 62 · see citing works
Accuracy of Pulse Oximeters Intended for Hypoxemic Pediatric Patients
Harris, B. U., Char, D. S., Feinstein, J. A., Verma, A., Shiboski, S. C., & Ramamoorthy, C. (2016) · Pediatric Critical Care Medicine · doi:10.1097/pcc.0000000000000660 · Cited by 57 · see citing works
Melanometry for objective evaluation of skin pigmentation in pulse oximetry studies
Vasudevan, S., Vogt, W. C., Weininger, S., & Pfefer, T. J. (2024) · Communications Medicine · doi:10.1038/s43856-024-00550-7 · Cited by 46 · see citing works
Caffeine decreases intermittent hypoxia in preterm infants nearing term-equivalent age
Dobson, N. R., Rhein, L. M., Darnall, R. A., Corwin, M. J., Heeren, T., Eichenwald, E. C., James, L. P., McEntire, B. L., Hunt, C. E., The Caffeine Study Group, et al. (2017) · Journal of Perinatology · doi:10.1038/jp.2017.82 · Cited by 42 · see citing works
Pulse Oximetry with Two Infrared Wavelengths without Calibration in Extracted Arterial Blood
Hay, O. Y., Cohen, M., Nitzan, I., Kasirer, Y. M., Shahroor-Karni, S., Yitzhak Yitzhaky, B., Engelberg, S., & Nitzan, M. (2018) · Sensors · doi:10.3390/s18103457 · Cited by 40 · see citing works
Accuracy of a portable pulse oximeter in monitoring hypoxemic infants with cyanotic heart disease
Harris, B. U., Stewart, S. E., Verma, A., Hoen, H. M., Stein, M. L., Wright, G. E., & Ramamoorthy, C. (2019) · Cardiology in the Young · doi:10.1017/s1047951119001355 · Cited by 37 · see citing works
Wackernagel, D., Blennow, M., & Hellström, A. (2020) · Acta Paediatrica · doi:10.1111/apa.15225 · Cited by 37 · see citing works
Ráfl, J., Bachman, T. E., Rafl-Huttova, V., Walzel, Š., & Rožánek, M. (2022) · Digital Health · doi:10.1177/20552076221132127 · Cited by 35 · see citing works
Racial/Ethnic differences in the presentation and management of severe bronchiolitis
Santiago, J., Mansbach, J. M., Chou, S., Delgado, C., Piedra, P. A., Sullivan, A. F., Espinola, J. A., & Camargo, C. A. (2014) · Journal of Hospital Medicine · doi:10.1002/jhm.2223 · Cited by 32 · see citing works
Emdin, C. A., Mir, F., Sultana, S., Kazi, A., Zaidi, A. K. M., Dimitris, M. C., & Roth, D. E. (2015) · BMC Pediatrics · doi:10.1186/s12887-015-0463-z · Cited by 31 · see citing works
Skin Pigmentation and Pulse Oximeter Accuracy in the Intensive Care Unit: A Pilot Prospective Study
Fawzy, A., Ali, H., Dziedzic, P. H., Potu, N., Calvillo, E., Golden, S. H., Iwashyna, T. J., Suárez, J. I., Hager, D. N., & Garibaldi, B. T. (2024) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.202401-0036le · Cited by 28 · see citing works
Racial and skin color mediated disparities in pulse oximetry in infants and young children
Sharma, M., Brown, A. W., Powell, N. M., Rajaram, N., Tong, L., Mourani, P. M., & Schootman, M. (2024) · Paediatric Respiratory Reviews · doi:10.1016/j.prrv.2023.12.006 · Cited by 28 · see citing works
Banerjee, A., Bhattacharyya, N. K., Ghosh, R., Singh, S., Adhikari, A., Mondal, S., Roy, L., Bajaj, A., Ghosh, N., Bhushan, A., et al. (2023) · Scientific Reports · doi:10.1038/s41598-023-29041-w · Cited by 26 · see citing works
Accuracy of Pulse Oximetry in the Presence of Fetal Hemoglobin—A Systematic Review
Pritišanac, E., Urlesberger, B., Schwaberger, B., & Pichler, G. (2021) · Children · doi:10.3390/children8050361 · Cited by 22 · see citing works
Bassat, Q., Lanaspa, M., Machevo, S., O’Callaghan‐Gordo, C., Madrid, L., Nhampossa, T., Acácio, S., Roca, A., & Alonso, P. L. (2016) · Tropical Medicine & International Health · doi:10.1111/tmi.12738 · Cited by 23 · see citing works
Hypoxemic and hyperoxemic likelihood in pulse oximetry ranges: NICU observational study
Bachman, T. E., Newth, C. J. L., Iyer, N. P., Ross, P. A., & Khemani, R. G. (2018) · Archives of Disease in Childhood Fetal & Neonatal · doi:10.1136/archdischild-2017-314448 · Cited by 21 · see citing works
Self-citationBachman, T. E., Iyer, N. P., Newth, C. J. L., Ross, P. A., & Khemani, R. G. (2020) · BMC Pediatrics · doi:10.1186/s12887-020-02225-3 · Cited by 21 · see citing works
Self-citationKhemani, R. G., Celikkaya, E. B., Shelton, C. R., Kale, D., Ross, P. A., Wetzel, R. C., & Newth, C. J. L. (2013) · Respiratory Care · doi:10.4187/respcare.02806 · Cited by 20 · see citing works
Self-citationUtility of Skin Tone on Pulse Oximetry in Critically Ill Patients: A Prospective Cohort Study
Hao, S., Dempsey, K., de Matos, J. C. R. G., Cox, C. E., Rotemberg, V. M., Gichoya, J. W., Kibbe, W. A., Hong, C., & Wong, A.-K. I. (2024) · Critical Care Explorations · doi:10.1097/cce.0000000000001133 · Cited by 18 · see citing works
Yadav, V. K., Choudhary, N., Inwati, G. K., Rai, A., Singh, B., Solanki, B., Paital, B., & Sahoo, D. K. (2023) · Frontiers in Medicine · doi:10.3389/fmed.2023.1147373 · Cited by 17 · see citing works
Pulse Oximetry Overestimates Oxyhemoglobin in Neonates with Critical Congenital Heart Disease
Murphy, D. P., Pak, Y., & Cleary, J. P. (2016) · Neonatology · doi:10.1159/000442379 · Cited by 17 · see citing works
Evaluation of Pulse Oximetry in Healthy Brachycephalic Dogs
Arulpagasam, S., Lux, C. N., Odunayo, A., Biskup, J. J., & Sun, X. (2018) · Journal of the American Animal Hospital Association · doi:10.5326/jaaha-ms-6654 · Cited by 17 · see citing works
Origins of Racial and Ethnic Bias in Pulmonary Technologies
Sjoding, M. W., Ansari, S., & Valley, T. S. (2022) · Annual Review of Medicine · doi:10.1146/annurev-med-043021-024004 · Cited by 18 · see citing works
Accuracy of the Masimo SET® LNCS neo peripheral pulse oximeter in cyanotic congenital heart disease
Griksaitis, M. J., Scrimgeour, G., Pappachan, J., & Baldock, A. J. (2015) · Cardiology in the Young · doi:10.1017/s1047951115002188 · Cited by 17 · see citing works
Oxygen Saturation Targeting and Bronchopulmonary Dysplasia
Darlow, B. A., & Morley, C. J. (2015) · Clinics in Perinatology · doi:10.1016/j.clp.2015.08.008 · Cited by 16 · see citing works
Kim, E., Lee, J., Song, I., Kim, H., Jang, Y., Yoo, S., & Kim, J. (2019) · Pediatric Anesthesia · doi:10.1111/pan.13642 · Cited by 16 · see citing works
Improving Evidence Based Bronchiolitis Care
Cahill, A. A., & Cohen, J. S. (2018) · Clinical Pediatric Emergency Medicine · doi:10.1016/j.cpem.2018.02.003 · Cited by 14 · see citing works
The Oxygen Saturation Index as Early Predictor of Outcomes in Congenital Diaphragmatic Hernia
Horn-Oudshoorn, E. J. J., Vermeulen, M. J., Knol, R., Pas, A. B. T., Otter, S. C. M. C.-D., Schnater, J. M., Reiss, I. K. M., & DeKoninck, P. L. J. (2022) · Neonatology · doi:10.1159/000527407 · Cited by 14 · see citing works
Englund, J. A., Cohen, R., Bianco, V., Domachowske, J. B., Langley, J. M., Madhi, S. A., Zaman, K., Bueso, A., Ceballos, A., Cousin, L., et al. (2023) · Journal of the Pediatric Infectious Diseases Society · doi:10.1093/jpids/piad028 · Cited by 13 · see citing works
Bhalla, A. K., Khemani, R. G., Hotz, J. C., Morzov, R., & Newth, C. J. L. (2018) · Respiratory Care · doi:10.4187/respcare.06209 · Cited by 14 · see citing works
Self-citationAmerican Academy of Pediatrics 2014 Bronchiolitis Guidelines: Bonfire of the Evidence
Walsh, P. F., & Rothenberg, S. J. (2015) · Western Journal of Emergency Medicine · doi:10.5811/westjem.2015.1.24930 · Cited by 14 · see citing works
Ghanayem, N. S., Ahmed, M., Anders, M. M., Tume, S. C., Vu, E. L., & Hoffman, G. M. (2018) · Elsevier eBooks · doi:10.1016/b978-1-4557-0760-7.00022-x · Cited by 12 · see citing works
Voulgarelis, S., Fathi, F., Stucke, A. G., Daley, K. D., Kim, J., Zimmerman, M. A., Hong, J. C., Starkey, N. J. E., Allen, K. P., & Yu, B. (2021) · Journal of Biomedical Optics · doi:10.1117/1.jbo.26.5.055002 · Cited by 12 · see citing works
Serra‐Negra, J. M., de Abreu, M. H. N. G., Flores-Mendoza, C. E., Brant, M., & Auad, S. M. (2019) · European Archives of Paediatric Dentistry · doi:10.1007/s40368-019-00422-y · Cited by 11 · see citing works
Pulse oximetry in bronchiolitis: is it needed?
Hendaus, M. A., Jomha, F. A., & Alhammadi, A. H. (2015) · Therapeutics and Clinical Risk Management · doi:10.2147/tcrm.s93176 · Cited by 10 · see citing works
Lyng, J. W., Harris, M. I., Mandt, M. J., Moore, B. R., Gross, T., Gausche‐Hill, M., & Donofrio-Ödmann, J. J. (2022) · Prehospital Emergency Care · doi:10.1080/10903127.2021.1992551 · Cited by 10 · see citing works
Elron, E., Bromiker, R., Gleisner, O., Hay, O. Y., Goldberg, O., Nitzan, I., & Nitzan, M. (2023) · Sensors · doi:10.3390/s23031434 · Cited by 11 · see citing works
Usual and Advanced Monitoring in Patients Receiving Oxygen Therapy
Lellouche, F., & L’Her, E. (2020) · Respiratory Care · doi:10.4187/respcare.07623 · Cited by 12 · see citing works
Zhou, L., Aljiffry, A., Lee, Y. J., Matthews, J., Seitter, B., Soltis, I., Huang, Y., Maher, K., & Yeo, W.-H. (2025) · Biosensors and Bioelectronics · doi:10.1016/j.bios.2025.117372 · Cited by 9 · see citing works
Kochilas, L. K., Menk, J. S., Saarinen, A., Gaviglio, A., & Lohr, J. L. (2014) · Pediatric Cardiology · doi:10.1007/s00246-014-1048-6 · Cited by 9 · see citing works
Tosif, S., & Duke, T. (2016) · Journal of Tropical Pediatrics · doi:10.1093/tropej/fmw100 · Cited by 9 · see citing works
Scrimgeour, G., Griksaitis, M. J., Pappachan, J., & Baldock, A. J. (2016) · World Journal for Pediatric and Congenital Heart Surgery · doi:10.1177/2150135116673016 · Cited by 9 · see citing works
Systematic review of Apgar scores & cyanosis in Black, Asian, and ethnic minority infants
Fair, F. J., Furness, A., Higginbottom, G. A., Oddie, S., & Soltani, H. (2024) · Pediatric Research · doi:10.1038/s41390-024-03543-3 · Cited by 7 · see citing works
Noroozi-Clever, M. B., Liao, S. M., Whitehead, H. V., & Vesoulis, Z. A. (2023) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2023.113648 · Cited by 7 · see citing works
Friedman, J., Rieder, M. J., Walton, J. M., de pédiatrie, S. C., aigus, C. D. S., & dangereuses, C. D. P. E. D. S. (2014) · Paediatrics & Child Health · doi:10.1093/pch/19.9.492 · Cited by 7 · see citing works
Tang, P., Wu, J., Liu, H., Liu, Y., & Zhou, X. (2018) · PLoS ONE · doi:10.1371/journal.pone.0199193 · Cited by 7 · see citing works
False negative diagnoses of critical congenital heart disease with screening neonatal pulse oximetry
Hoffman, J. I. E. (2019) · Journal of Neonatal-Perinatal Medicine · doi:10.3233/npm-190297 · Cited by 7 · see citing works
Oxygenation saturation index in neonatal hypoxemic respiratory failure
Tsurukawa, S., Zuiki, M., Naito, Y., Kitamura, K., Matsumura, U., Kanayama, T., Ichise, E., Horiguchi, G., Teramukai, S., & Komatsu, H. (2024) · Pediatrics International · doi:10.1111/ped.15753 · Cited by 6 · see citing works
Corona, D., Ranninger, E., Joerger, F. B., Goldinger, E., Stefan, A., Torgerson, P. R., & Bettschart‐Wolfensberger, R. (2020) · Schweizer Archiv für Tierheilkunde · doi:10.17236/sat00271 · Cited by 6 · see citing works
The Accuracy of Readily Available Consumer-Grade Oxygen Saturation Monitors in Pediatric Patients
Kovesi, T. A., Saban, J., Haddad, J. F., Reddy, D. N., Webster, R. J., & Udupa, S. (2023) · Respiratory Care · doi:10.4187/respcare.11258 · Cited by 6 · see citing works
Selim, R., Kirubakaran, A., & Banerjee, J. (2025) · Pediatric Research · doi:10.1038/s41390-025-04084-z · Cited by 5 · see citing works
Pulse Oximeter Performance during Rapid Desaturation
Horáková, L., & Roubík, K. (2022) · Sensors · doi:10.3390/s22114236 · Cited by 5 · see citing works
Caruso, T. J., Mokhtari, T. E., Coughlan, M. J., Wu, D. S., Marquez, J. L., Duan, M., Freeman, H., Giustini, A. J., Tweedy, M., & Sharek, P. J. (2017) · The Joint Commission Journal on Quality and Patient Safety · doi:10.1016/j.jcjq.2016.12.001 · Cited by 5 · see citing works
Computer model of oxygenation in neonates
Ráfl, J., Rafl-Huttova, V., Möller, K., Bachman, T. E., Tejkl, L., Kudrna, P., Rožánek, M., & Roubík, K. (2019) · Current Directions in Biomedical Engineering · doi:10.1515/cdbme-2019-0019 · Cited by 4 · see citing works
McAlinden, B., Hough, J. L., & Kuys, S. S. (2022) · Physiotherapy · doi:10.1016/j.physio.2022.08.010 · Cited by 4 · see citing works
Das, A., Mhanna, M. J., Teleron-Khorsad, A., Houdek, J., Kumar, N., Gunzler, D. D., & Collin, M. F. (2015) · The Journal of Maternal-Fetal & Neonatal Medicine · doi:10.3109/14767058.2015.1057493 · Cited by 4 · see citing works
Clinical engineering and uncertainty in clinical measurements
Koumoundouros, E. (2014) · Australasian Physical & Engineering Sciences in Medicine · doi:10.1007/s13246-014-0288-3 · Cited by 4 · see citing works
Ruppel, H., Huang, L., Petit, C. J., Qureshi, A. M., Bonafide, C. P., Foglia, E. E., Feldman, J., Lane-Fall, M. B., Lynch, J. M., Chien, A. L.-L., et al. (2025) · BMJ Open · doi:10.1136/bmjopen-2025-100391 · Cited by 2 · see citing works
Accuracy and Bias of Pulse Oximetry in the Intensive Care Unit: A Prospective Observational Study
de Barros, K. B., Pinheiro, J. S., Sampaio, M. S., da Cruz, L. B., Ferreira, F. F., Basile-Filho, A., Guirro, R. R. D. J., & Bachmann, L. (2026) · Nursing in Critical Care · doi:10.1111/nicc.70433 · Cited by 3 · see citing works
Khalil, N. S. (2019) · Iris Journal of Nursing & Care · doi:10.33552/ijnc.2019.01.000520 · Cited by 3 · see citing works
Nguyen, T. K., Park, S., Park, J., Sodager, A., George, T. M., & Gandjbakhche, A. (2024) · Bioengineering · doi:10.3390/bioengineering11040385 · Cited by 3 · see citing works
Terapia de soporte en bronquiolitis aguda grave en una Unidad de Cuidado Intensivo Pediátrico
Latorre-Montoya, G. A., Sánchez-Heredia, E., Gallego-Salazar, A. F., González-Rincón, J. M., & Vásquez‐Hoyos, P. (2020) · Revista Mexicana de Pediatría · doi:10.35366/94169 · Cited by 3 · see citing works
An Assistive Device for Congenital Central Hypoventilation Syndrome Outpatients During Sleep
Biffi, E., Piazza, C., Cavalleri, M., Taddeo, P., Carcano, A., Morandi, F., & Reni, G. (2014) · Annals of Biomedical Engineering · doi:10.1007/s10439-014-1068-7 · Cited by 3 · see citing works
Shaikh, N., Tripathi, S., Whelan, A., Ford, J., Kim, M., & Deshpande, G. G. (2021) · Journal of Clinical Monitoring and Computing · doi:10.1007/s10877-021-00712-1 · Cited by 3 · see citing works
Ross, P. A., Lerman, J., & Coté, C. J. (2019) · Elsevier eBooks · doi:10.1016/b978-0-323-42974-0.00052-5 · Cited by 3 · see citing works
Self-citationPulse Oximetry Error in Patients With Single-Ventricle Palliation
Pritchett, C. M., O’Halloran, C. P., Lay, A. S., Monahan, A., & Tannous, P. (2022) · Journal of the Society for Cardiovascular Angiography & Interventions · doi:10.1016/j.jscai.2022.100394 · Cited by 3 · see citing works
Georgiev, Y. H., Neunhoeffer, F., Hofbeck, M., & Michel, J. (2024) · Pediatric Anesthesia · doi:10.1111/pan.15017 · Cited by 2 · see citing works
Ráfl, J., Bachman, T. E., Martinek, T., Tejkl, L., Rafl-Huttova, V., Kudrna, P., & Roubík, K. (2018) · World Congress on Medical Physics and Biomedical Engineering, September 7 - 12, 2009, Munich, Germany · doi:10.1007/978-981-10-9035-6_134 · Cited by 2 · see citing works
Conventional Oxygen Therapy: Technical and Physiological Issues
Lellouche, F., & L’Her, E. (2021) · Springer eBooks · doi:10.1007/978-3-030-42454-1_1 · Cited by 3 · see citing works
Decreasing Goal Oxygen Saturations in Bronchiolitis Is Associated With Decreased Length of Stay
Briggs, S., Gupta, V., Thakkar, N. P., Librizzi, J., Temkit, H., & Engel, R. (2023) · Hospital Pediatrics · doi:10.1542/hpeds.2022-007020 · Cited by 2 · see citing works
Nikbakht, M. R., Sanchez-Perez, J. A., Aljiffry, A., Maher, K. O., Inan, O. T., & Rodriguez, Z. (2024) · IEEE Sensors Journal · doi:10.1109/jsen.2024.3371354 · Cited by 2 · see citing works
Pulse oximetry at two sensor placement sites in conscious foals
Rossi, H. S., Mykkänen, A. K., Junnila, J. J. T., & Hyytiäinen, H. K. (2025) · Acta veterinaria Scandinavica · doi:10.1186/s13028-025-00794-w · Cited by 2 · see citing works
Model of SpO2 signal of the neonate
Rafl-Huttova, V., Ráfl, J., Möller, K., Bachman, T. E., Kudrna, P., Rožánek, M., & Roubík, K. (2019) · Current Directions in Biomedical Engineering · doi:10.1515/cdbme-2019-0138 · Cited by 2 · see citing works
Transcutaneous Oxygen Saturation Accuracy in Critically Ill ChildrenPreprint
Brooks, J. C., Raman, S., GIBBONS, K. S., Williams, T., Dunster, K. R., Pegg, D., Harkins, M., Alphonso, N., Pham, T. M. T., & Schibler, A. (2020) · doi:10.21203/rs.2.21938/v1 · Cited by 2 · see citing works
(2020) · SOVREMENNAYA PEDIATRIYA · doi:10.15574/sp · Cited by 2 · see citing works
EquiOx: A Prospective study of pulse oximeter bias and skin pigmentation in critically-ill adultsPreprint
Hendrickson, C. M., Lipnick, M. S., Chen, D. D. Y., Chen, D., Law, T. J., Pirracchio, R., Feiner, J., Behnke, E., Chou, Y. (., Elmankabadi, S., et al. (2025) · medRxiv · doi:10.1101/2025.10.06.25337217 · Cited by 2 · see citing works
Şenaylı, Y., Keskin, G., AKIN, M., ŞENAYLI, A., ATA, R., Demirtaş, G., & ŞENEL, E. (2023) · TURKISH JOURNAL OF MEDICAL SCIENCES · doi:10.55730/1300-0144.5610 · Cited by 1 · see citing works
A clinician’s musings on oxygen: Too little or too much with life in the balance
Stevenson, D. K., Wong, R. J., Reiss, J. D., Marić, I., Pașca, A. M., & Ahern, T. L. (2025) · Journal of Perinatology · doi:10.1038/s41372-025-02398-8 · Cited by 1 · see citing works
INSTRUMENTOS DE EVALUACIÓN FISIOTERAPÉUTICA EN POBLACIÓN NEONATAL:
Santa, J. M., Martínez, A. D. P., Vanegas, J. M. A., Cuervo, A. M., & Mantilla, J. I. A. (2021) · Movimiento Científico · doi:10.33881/2011-7191.mct.15103 · Cited by 1 · see citing works
Pediatric Anesthesia Monitoring
Cohen, D. E., Diaz, L. K., & Balzer, J. R. (2017) · Elsevier eBooks · doi:10.1016/b978-0-323-34125-7.00017-6 · Cited by 1 · see citing works
Pulsioxímetro dactilar: ¿una nueva herramienta para el autocontrol en asma?
Anta, M. A. Z., Muñoz, J. M., Martín, L. N., & de la Manzanara, P. H. L. (2014) · Pediatría Atención Primaria · doi:10.4321/s1139-76322014000500007 · Cited by 1 · see citing works
Pulse Spectrophotometric Determination of Plasma Bilirubin in Newborns
Michel, E., Entenmann, A., & Michel, M. (2016) · International Journal of Biomedical and Clinical Engineering · doi:10.4018/ijbce.2016010103 · Cited by 1 · see citing works
Accuracy of pulse oximetry versus arterial blood gas in screening cyanotic heart
Ramachandran, S., Gera, A., Gera, R., Kataria, S., & Roy, M. P. (2016) · International Journal of Contemporary Pediatrics · doi:10.18203/2349-3291.ijcp20162377 · Cited by 1 · see citing works
A Novel Technique for the Administration of Sub-Ambient Oxygen in the Operating Room
Khawaja, A. A., Corridore, M., & Tobias, J. D. (2017) · Cardiology Research · doi:10.14740/cr608w · Cited by 1 · see citing works
End-tidal Carbon Dioxide Measurements in Unintentional Non-fire-related Carbon Monoxide Poisoning
Yaman, F. N., Kerkütlüoğlu, M., Güler, Ö., & Hakkoymaz, H. (2022) · Iranian Journal of Toxicology · doi:10.32598/ijt.16.4.961.1 · Cited by 1 · see citing works
Bronchiolitis Clinical Practice Guideline: The Diagnosis, Management, and Prevention of
Brown, A. S., Nathanson, I. T., Rosenblum, E., de Mendonça, A. E. O., Phelan, K. J., Zorc, J. J., Stanko‐Lopp, D., Gadomski, A., Johnson, D. W., Light, M. J., et al. (2014)
How Accurate Is the Pulse Oximeter, and Does It Matter?
Hoffman, J. I. E. (2016) · Neonatology · doi:10.1159/000442814
Nota clínica Pulsioxímetro dactilar: ¿una nueva herramienta para el autocontrol en asma?
Anta, M. A. Z., Muñoz, J. M. B. I., Martín, L. N., Hernando, P., & Anta, Z. (2014)
VALORES DE REFERENCIA DE OXIMETRÍA DE PULSO EN PREMATUROS: SEGUIMOS EN DEUDA
Oyarzún, I., & Alejandra Zamorano, W. (2021) · Neumología Pediátrica · doi:10.51451/np.v13i3.210
Research and Quality Improvement Must Evolve With Changing Clinical Practice*
Khemani, R. G. (2020) · Pediatric Critical Care Medicine · doi:10.1097/pcc.0000000000002241
Self-citation
- Authors
- Ross, P. A., Newth, C. J. L., & Khemani, R. G.
- Affiliations
- University of Southern California (US)
- Corresponding author
- Ross, Patrick A.
- Venue
- Pediatrics
- Publisher
- American Academy of Pediatrics (AAP)
- Published
- 2014-01-01
- Volume
- 133
- Issue
- 1
- Pages
- 22-29
- ISSN
- 0031-4005 (ISSN-L)
- 1098-4275
- OpenAlex
- W2162501655
- Cited by
- 129
- References
- 14
- Citations by year
- 2026: 5 · 2025: 8 · 2024: 10 · 2023: 12 · 2022: 30 · 2021: 7 · 2020: 9 · 2019: 8 · 2018: 8 · 2017: 4 · 2016: 10 · 2015: 6 · 2014: 11 · 2013: 1
- FWCI
- 5.14
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- PEDIATRICS (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 › Epidemiology › Congenital Heart Disease Studies
- Keywords
- pulse oximetry accuracy, oxygen saturation, arterial oxygen saturation, co-oximetry, cyanotic congenital heart disease, acute hypoxemic respiratory failure, mechanically ventilated children, pediatric intensive care, hypoxemia, measurement bias
- MeSH terms
- Adolescent, Algorithms, Child, Child, Preschool, Decision Support Techniques, Female, Humans, Infant, Infant, Newborn, Male, Oximetry, Oxygen, Prospective Studies, Respiration, Artificial, Reproducibility of Results, Intensive Care Units, Pediatric, Biomarkers, Multivariate Analysis, Logistic Models
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
