PULSE OXIMETER

Pulse oximetry is a noninvasive method for monitoring a person’s oxygen saturation. Though its reading of peripheral oxygen saturation (SpO₂) is not always identical to the more desirable reading of arterial oxygen saturation (SaO₂) from arterial blood gas analysis, the two are correlated well enough that the safe, convenient, noninvasive, inexpensive pulse oximetry method is valuable for measuring oxygen saturation in clinical use.

In its most common (transmissive) application mode, a sensor device is placed on a thin part of the patient’s body, usually a fingertip or earlobe, or in the case of an infant, across a foot. The device passes two wavelengths of light through the body part to a photodetector. It measures the changing absorbance at each of the wavelengths, allowing it to determine the absorbances due to the pulsing arterial blood alone, excluding venous blood, skin, bone, muscle, fat, and (in most cases) nail polish.

Reflectance pulse oximetry is a less common alternative to transmissive pulse oximetry. This method does not require a thin section of the person’s body and is therefore well suited to a universal application such as the feet, forehead, and chest, but it also has some limitations. Vasodilation and pooling of venous blood in the head due to compromised venous return to the heart can cause a combination of arterial and venous pulsations in the forehead region and lead to spurious SpO₂ results. Such conditions occur while undergoing anesthesia with endotracheal intubation and mechanical ventilation or in patients in the Trendelenburg position.