Hostname: page-component-cd9895bd7-lnqnp Total loading time: 0 Render date: 2024-12-28T04:56:07.086Z Has data issue: false hasContentIssue false
  • English
  • Français

Accuracy of the Masimo SET® LNCS neo peripheral pulse oximeter in cyanotic congenital heart disease

Published online by Cambridge University Press:  16 October 2015

Michael J. Griksaitis ,
Gemma E. Scrimgeour ,
John V. Pappachan  and
Andrew J. Baldock
Michael J. Griksaitis
Affiliation:
Paediatric Intensive Care Unit, Southampton Children’s Hospital, University Hospital Southampton, United Kingdom
Gemma E. Scrimgeour
Affiliation:
Paediatric Intensive Care Unit, Southampton Children’s Hospital, University Hospital Southampton, United Kingdom
John V. Pappachan
Affiliation:
Paediatric Intensive Care Unit, Southampton Children’s Hospital, University Hospital Southampton, United Kingdom
Andrew J. Baldock*
Affiliation:
Paediatric Intensive Care Unit, Southampton Children’s Hospital, University Hospital Southampton, United Kingdom
*
Correspondence to: Dr A. Baldock, FRCA, Paediatric Intensive Care Unit, Southampton Children’s Hospital, Tremona Road, Southampton, United Kingdom, SO16 6YD. Tel: +02381204949; Fax: +02381205014; E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction

Non-invasive peripheral pulse oximeters are routinely used to measure oxyhaemoglobin saturation (SpO2) in cyanotic congenital heart disease. These probes are calibrated in healthy adult volunteers between arterial saturations of ~75 and 100%, using the gold standard of co-oximetry on arterial blood samples. There are little data to attest their accuracy in cyanotic congenital heart disease.

Aims

We aimed to assess the accuracy of a commonly used probe in children with cyanotic congenital heart disease.

Methods

Children with cyanotic congenital heart disease admitted to the Paediatric Intensive Care Unit with an arterial line in situ were included to our study. Prospective simultaneous recordings of SpO2, measured by the Masimo SET® LNCS Neo peripheral probe, and co-oximeter saturations (SaO2) measured by arterial blood gas analysis were recorded.

Results

A total of 527 paired measurements of SpO2 and SaO2 (using an ABL800 FLEX analyser) in 25 children were obtained. The mean bias of the pulse oximeter for all SaO2 readings was +4.7±13.8%. The wide standard deviation indicates poor precision. This mean bias increased to +7.0±13.7% at SaO2 recordings <75%. The accuracy root mean square of the recordings was 3.30% across all saturation levels, and this increased to 4.98% at SaO2 <75%.

Conclusions

The performance of the Masimo SET® LNCS Neo pulse oximeter is poor when arterial oxyhaemoglobin saturations are below 75%. It tends to overestimate saturations in children with cyanotic congenital heart disease. This may have serious implications for clinical decisions.

Keywords

Pulse oximetrycyanotic congenital heart diseasemulti-wavelength co-oximetryoxyhaemoglobin saturationscyanosisBland–Altman
Type
Original Articles
Information
Cardiology in the Young , Volume 26 , Issue 6 , August 2016 , pp. 1183 - 1186
Check for updates
Copyright
© Cambridge University Press 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. American Society of Anesthesiologists. Committee of Standards and Practice Parameters. Standards for basic anesthetic monitoring, 2011. Retrieved April 23, 2015, from https://www.asahq.org/resources/standards-and-guidelines.Google Scholar
2. The Association of Anaesthetists of Great Britain and Ireland. Recommendations for standards of monitoring during anaesthesia and recovery, 2007; 4th edn. Retrieved April 23, 2015, from http://www.aagbi.org/sites/default/files/standardsofmonitoring07.pdf Google Scholar
3. Kamat, V. Pulse oximetry. Indian J Anaesth 2002; 46: 261–268.Google Scholar
4. U.S. Food and Drug Administration. 510(k) clearances, 2009. Retrieved July 10, 2014, from http://www.accessdata.fda.gov/scripts/cdrh/devicesatfda/index.cfm?Search_Term=Oximeter%2E Google Scholar
5. Jensen, LA, Onyskiw, JE, Prasad, NGN. Meta-analysis of arterial oxygen saturation monitoring by pulse oximetry in adults. Heart Lung 1998; 27: 387–408.Google Scholar
6. Schmitt, HJ, Schuetz, WH, Proeschel, PA, et al. Accuracy of pulse oximetry in children with cyanotic congenital heart disease. J Cardiothorac Vasc Anesth 1993; 7: 61–65.Google Scholar
7. Prudhoe, S, Abu-Harb, M, Richmond, S, et al. Neonatal screening for critical cardiovascular anomalies using pulse oximetry. Arch Dis Child Fetal Neonatal Ed 2013; 98: F346–F350.Google Scholar
8. Dawson, JA, Bastrenta, P, Cavigioli, F, et al. The precision and accuracy of Nellcor and Masimo oximeters and low oxygen saturations (70%) in newborn lambs. Arch Dis Child Fetal Neonatal Ed 2014; 99: F278–F281.Google Scholar
9. Solevag, AL, Dannevig, I, Saltyte-Benth, J, et al. Reliability of pulse oximetry in hypoxic newborn pigs. J Matern Fetal Neonatal Med 2014; 27: 833–838.Google Scholar
10. Dubowitz, G, Breyer, K, Lipnic, M, et al. Accuracy of the Lifebox pulse oximeter during hypoxia in healthy volunteers. Anaesthesia 2013; 68: 1220–1223.Google Scholar
11. Milner, QJW, Mathews, GR. An assessment of the accuracy of pulse oximeters. Anaesthesia 2011; 67: 396–401.Google Scholar
12. Ross, PA, Newth, CJ, Khemani, RG. Accuracy of pulse oximetry in children. Pediatrics 2014; 133: 22–29.Google Scholar
13. Ahmed, SJM, Rich, W, Finer, NN. The effect of averaging time on oximetry values in the premature infant. Pediatrics 2010; 125: e115–e121.Google Scholar
14. Bland, JM, Altman, DG. Agreement between methods of measurement with multiple observations per individual. J Bioph St 2007; 17: 571–582.CrossRefGoogle ScholarPubMed
15. Krouwer, JS. Why Bland-Altman plots should use X, not (Y+X)/2 when X is a reference method. Stat Med 2008; 27: 778–780.CrossRefGoogle Scholar
16. Torres, A, Skender, KM, Wohrley, JD, et al.. Pulse oximetry in children with cyanotic congenital heart disease: effects of cardiopulmonary bypass and cyanosis. J Intensive Care Med 2004; 19: 229–234.Google Scholar
17. Boxer, RA, Gottesfeld, I, Singh, S, LaCorte, MA, Parnell, VA, Walker, P. Noninvasive pulse oximetry in children with cyanotic congenital heart disease. Crit Care Med 1987; 15: 1062–1064.Google Scholar
18. Sedaghat-Yadzi, F, Torres, A, Fortuna, R, Geiss, DM. Pulse oximetry accuracy and precision affected by sensor location in cyanotic children. Pediatr Crit Care Med 2008; 9: 393–397.Google Scholar
19. Das, J, Aggarwal, A, Aggarwal, NK. Pulse oximeter accuracy and precision at five different sensor locations in infants and children with cyanotic heart disease. Indian J Anaesth 2010; 54: 531–534.Google ScholarPubMed