Intensive Care Medicine

, Volume 45, Issue 12, pp 1832–1834 | Cite as

Revisiting oxygen dissociation curves and bedside measured arterial saturation in critically ill children

  • Danny Eytan
  • Mjaye L. Mazwi
  • Andrew J. Goodwin
  • Sebastian D. Goodfellow
  • Azadeh Assadi
  • Robert W. Greer
  • Anusha Jegatheeswaran
  • Peter C. LaussenEmail author

Dear Editor,

The oxygen dissociation curve (ODC) relates the partial pressure of oxygen in the blood (pO2) to the hemoglobin oxygen saturation (SO2) [1, 2]. It is crucial in determining oxygen delivery to the tissues and fundamental to critical care practice [3]. We aimed to revisit this curve in critically ill children using a large physiologic and laboratory dataset.

This study utilizes continuously recorded physiologic data (5,783,484 SpO2 values) and blood gas tests from patients ≤ 18 years of age (3582 patients with 112,101 tests) who were admitted to the critical care unit at the Hospital for Sick Children, Toronto. Details on data capture, analyses and discussion of the results can be found in the online supplementary material.

Figure  1a–c shows the non-conditional oxygen dissociation distribution. For our patient population, the median ODC is shifted rightward from the classic report [ 2]. While traditionally viewed as a sigmoid line, examining our large dataset for the...



Oxygen dissociation curve


Peripheral oxygen saturation derived from the pulse oximeter


Blood hemoglobin oxygen saturation


Partial pressure of oxygen in the blood


Partial pressure of carbon dioxide in the blood


Compliance with ethical standards

Conflicts of interest

Peter Laussen—lead developer T3 software platform, and unpaid medical consultant Etiometry LLC, Boston, Massachusetts. None of the other authors have any conflict of interest.

Supplementary material

134_2019_5792_MOESM1_ESM.docx (606 kb)
Supplementary material 1 (DOCX 605 kb)


  1. 1.
    Hill AV (1913) The combinations of haemoglobin with oxygen and with carbon monoxide. I. Biochem J 7:471–480PubMedPubMedCentralGoogle Scholar
  2. 2.
    Severinghaus JW (1979) Simple, accurate equations for human blood O2 dissociation computations. J Appl Physiol Respir Environ Exerc Physiol 46:599–602PubMedGoogle Scholar
  3. 3.
    Collins JA, Rudenski A, Gibson J, Howard L, O’Driscoll R (2015) Relating oxygen partial pressure, saturation and content: the haemoglobin-oxygen dissociation curve. Breathe (Sheff) 11:194–201CrossRefGoogle Scholar
  4. 4.
    Kim EH, Lee JH, Song IK, Kim HS, Jang YE, Yoo S, Kim JT (2019) Accuracy of pulse oximeters at low oxygen saturations in children with congenital cyanotic heart disease: an observational study. Paediatr Anaesth 29(6):597–603CrossRefGoogle Scholar
  5. 5.
    Griksaitis MJ, Scrimgeour GE, Pappachan JV, Baldock AJ (2016) Accuracy of the Masimo SET(R) LNCS neo peripheral pulse oximeter in cyanotic congenital heart disease. Cardiol Young 26:1183–1186CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Danny Eytan
    • 1
    • 2
    • 3
  • Mjaye L. Mazwi
    • 1
    • 4
  • Andrew J. Goodwin
    • 1
    • 5
  • Sebastian D. Goodfellow
    • 1
  • Azadeh Assadi
    • 1
    • 9
  • Robert W. Greer
    • 1
  • Anusha Jegatheeswaran
    • 6
    • 7
  • Peter C. Laussen
    • 1
    • 8
    Email author
  1. 1.Department of Critical Care MedicineHospital for Sick ChildrenTorontoCanada
  2. 2.Faculty of MedicineTechnionHaifaIsrael
  3. 3.Department of Paediatric Critical CareRambam Medical CenterHaifaIsrael
  4. 4.Department of PaediatricsUniversity of TorontoTorontoCanada
  5. 5.School of Electrical and Information EngineeringUniversity of SydneySydneyAustralia
  6. 6.Division of Cardiovascular Surgery, Department of SurgeryThe Hospital for Sick ChildrenTorontoCanada
  7. 7.Department of SurgeryUniversity of TorontoTorontoCanada
  8. 8.Department of AnaesthesiaUniversity of TorontoTorontoCanada
  9. 9.Institute of Biomaterial and Biomedical EngineeringUniversity of TorontoTorontoCanada

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