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Significant Delay in the Detection of Desaturation between Finger Transmittance and Earlobe Reflectance Oximetry Probes during Fiberoptic Bronchoscopy: Analysis of 104 Cases

  • INTERVENTIONAL BRONCHOSCOPY
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Abstract

Purpose

There is clinical significance to a delay in response time for detecting desaturation by pulse oximetry. Our aim in this study was to compare the response time of the reflectance and transmittance saturation probes during fiberoptic bronchoscopy (FOB) under monitored anesthesia care.

Methods

A prospective study included 104 patients scheduled for FOB. Patients were monitored with transmittance (finger) and reflectance (ear) oximetry probes. The response time was evaluated during desaturation and resaturation. We also acquired blood tests for arterial oxygen saturation to assess the agreement with the oximetry probes.

Results

Ninety patients had a desaturation episode during FOB and were included in the final analysis. Mean time difference between the reflectance ear probe (reference probe) and transmittance finger probe for the detection of desaturation (SpO2 = 90%) was + 36 s (CI 27.0–45.0, P < 0.001). The time difference between probes at end of desaturation episode (SpO2 = 95%) was + 31 s (CI 19.0–43.0; P < 0.001). A significant difference in response time was evident throughout the episode in all saturation values. The reflectance ear probe showed better agreement with arterial blood gases. The bias (and precision) for the earlobe and finger oximeters were of 0.24 (1.04) and 2.31 (3.37), respectively.

Conclusion

The data displayed by a centrally located reflectance probe are more accurate and allows for earlier identification, treatment, and resolution of desaturation events. In light of these data and the added value of the reflectance probe ability to measure transcutaneous PCO2, we recommend monitoring bronchoscopy by a reflectance oximetry probe.

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Abbreviations

FOB:

Fiberoptic bronchoscopy

ABG:

Arterial blood gases

SpO2 :

Pulse oximeter saturation

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Author notes

  1. Elitsur Brachfeld and Barak Pertzov contributed equally to this paper.

Authors and Affiliations

  1. Pulmonary Division, Rabin Medical Center, Petach Tikva, Israel

    Barak Pertzov, Avraham Unterman, Evgeni Gershman, Nader Abdel-Rahman, Dror Rosengarten & Mordechai Reuven Kramer

  2. Department of Anesthesia, Rabin Medical Center, Petach Tikva, Israel

    Elitsur Brachfeld

  3. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Barak Pertzov, Elitsur Brachfeld, Avraham Unterman, Evgeni Gershman, Nader Abdel-Rahman, Dror Rosengarten & Mordechai Reuven Kramer

  4. Pulmonary Institute, Rabin Medical Center, Beilinson Campus, 49100, Petach Tikva, Israel

    Barak Pertzov

Authors
  1. Barak Pertzov
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  2. Elitsur Brachfeld
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Correspondence to Barak Pertzov.

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Pertzov, B., Brachfeld, E., Unterman, A. et al. Significant Delay in the Detection of Desaturation between Finger Transmittance and Earlobe Reflectance Oximetry Probes during Fiberoptic Bronchoscopy: Analysis of 104 Cases. Lung 197, 67–72 (2019). https://doi.org/10.1007/s00408-018-0180-0

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  • DOI: https://doi.org/10.1007/s00408-018-0180-0

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