Comparison of nasal and forehead oximetry accuracy and pressure injury in critically ill patients

Heart Lung. 2018 Mar-Apr;47(2):93-99. doi: 10.1016/j.hrtlng.2017.12.002.

Abstract

Background: In critically ill patients, clinicians can have difficulty obtaining accurate oximetry measurements.

Objective: To compare the accuracy of nasal alar and forehead sensor measurements and incidence of pressure injury.

Methods: 43 patients had forehead and nasal alar sensors applied. Arterial samples were obtained at 0, 24, and 120 hours. Oxygen saturations measured by co-oximetry were compared to sensor values. Skin was assessed every 8 hours.

Results: Oxygen saturations ranged from 69.8%-97.8%, with 18% of measures < 90%. Measurements were within 3% of co-oximetry values for 54% of nasal alar compared to 35% of forehead measurements. Measurement failures occurred in 6% for nasal alar and 22% for forehead. Three patients developed a pressure injury with the nasal alar sensor and 13 patients developed a pressure injury with the forehead sensor (χ2 = 7.68; p = .006).

Conclusions: In this group of patients with decreased perfusion, nasal alar sensors provided a potential alternative for continuous monitoring of oxygen saturation.

Trial registration: ClinicalTrials.gov NCT02382133.

Keywords: Critically ill; Norepineprhine; Oxygen; Pressure injury; Pulse oximetry.

Publication types

  • Comparative Study
  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Arteries
  • Critical Care* / methods
  • Critical Illness
  • Female
  • Forehead* / blood supply
  • Humans
  • Male
  • Middle Aged
  • Nose* / blood supply
  • Oximetry* / adverse effects
  • Oximetry* / methods
  • Oxygen / blood
  • Pressure Ulcer* / epidemiology
  • Pressure* / adverse effects
  • Prospective Studies
  • Skin* / injuries

Substances

  • Oxygen

Associated data

  • ClinicalTrials.gov/NCT02382133