ICU Cases · Equipment & physics
Short case — the unreliable pulse oximeter
A short case on pulse-oximetry bias from skin pigmentation and low perfusion, and confirming oxygenation with an arterial SaO2.
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Prompt
A short case on pulse-oximetry bias from skin pigmentation and low perfusion, and confirming oxygenation with an arterial SaO2.
Presentation
A patient with darker skin in septic shock, with cold peripheries on noradrenaline, has SpO2 94% and a poor plethysmographic trace.[1]
References4ShowHide
- [1]Cotton SA, Lee JA, Malhotra A, et al. Do Differences in Skin Pigmentation Affect Detection of Hypoxemia by Pulse Oximetry: A Systematic Review of the Literature. Clinical nursing research, 2025.PMID 41045137
- [2]León-Valladares D, Barrio-Mateu LA, Cortés-Carmona N, et al. Determining factors of pulse oximetry accuracy: a literature review. Revista clinica espanola, 2024.PMID 38599519
- [3]Moon K, Daino N, Gomez P, et al. Pulse Oximetry-A Perioperative Perspective. Diagnostics (Basel, Switzerland), 2026.PMID 42351472
- [4]Jubran A Pulse oximetry. Critical care (London, England), 2015.PMID 26179876