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Is pulse oximeter a reliable tool for non-critically ill patients with COVID-19?
Gürün Kaya, Aslihan; Öz, Miraç; Akdemir Kalkan, Irem; Gülten, Ezgi; Çinar, Güle; Azap, Alpay; Kaya, Akin.
  • Gürün Kaya A; Department of Chest Diseases, Ankara University Faculty of Medicine, Ankara, Turkey.
  • Öz M; Department of Chest Diseases, Ankara University Faculty of Medicine, Ankara, Turkey.
  • Akdemir Kalkan I; Department of Infectious Diseases and Clinical Microbiology, Ankara University Faculty of Medicine, Ankara, Turkey.
  • Gülten E; Department of Infectious Diseases and Clinical Microbiology, Ankara University Faculty of Medicine, Ankara, Turkey.
  • Çinar G; Department of Infectious Diseases and Clinical Microbiology, Ankara University Faculty of Medicine, Ankara, Turkey.
  • Azap A; Department of Infectious Diseases and Clinical Microbiology, Ankara University Faculty of Medicine, Ankara, Turkey.
  • Kaya A; Department of Chest Diseases, Ankara University Faculty of Medicine, Ankara, Turkey.
Int J Clin Pract ; 75(12): e14983, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1462809
ABSTRACT

INTRODUCTION:

Guidelines recommend using a pulse oximeter rather than arterial blood gas (ABG) for COVID-19 patients. However, significant differences can be observed between oxygen saturation measured by pulse oximetry (SpO2 ) and arterial oxygen saturation (SaO2 ) in some clinical conditions. We aimed to assess the reliability of the pulse oximeter in patients with COVID-19.

METHODS:

We retrospectively reviewed ABG analyses and SpO2 levels measured simultaneously with ABG in patients hospitalised in COVID-19 wards.

RESULTS:

We categorised total 117 patients into two groups, in whom the difference between SpO2 and SaO2 was ≤4% (acceptable difference) and >4% (large difference). A large difference group exhibited higher neutrophil count, C-reactive protein, ferritin, fibrinogen, D-dimer and lower lymphocyte count. Multivariate analyses revealed that increased fibrinogen, increased ferritin and decreased lymphocyte count were independent risk factors for a large difference between SpO2 and SaO2 . The total study group demonstrated the negative bias of 4.02% with the limits of agreement of -9.22% to 1.17%. The bias became significantly higher in patients with higher ferritin, fibrinogen levels and lower lymphocyte count.

CONCLUSION:

Pulse oximeters may not be sufficient to assess actual oxygen saturation, especially in COVID-19 patients with high ferritin and fibrinogen levels and low lymphocyte count with low SpO2 measurements.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Humans Language: English Journal: Int J Clin Pract Journal subject: Medicine Year: 2021 Document Type: Article Affiliation country: Ijcp.14983

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Humans Language: English Journal: Int J Clin Pract Journal subject: Medicine Year: 2021 Document Type: Article Affiliation country: Ijcp.14983