, Volume 33, Issue 3, pp 282–292 | Cite as

Utility of Pulse Oximetry to Detect Aspiration: An Evidence-Based Systematic Review

  • Deanna Britton
  • Amy Roeske
  • Stephanie K. Ennis
  • Joshua O. Benditt
  • Cassie Quinn
  • Donna Graville
Review Article


Pulse oximetry is a commonly used means to measure peripheral capillary oxyhemoglobin saturation (SpO2). Potential use of pulse oximetry to detect aspiration is attractive to clinicians, as it is readily available, quick, and noninvasive. However, research regarding validity has been mixed. This systematic review examining evidence on the use of pulse oximetry to detect a decrease in SpO2 indicating aspiration during swallowing is undertaken to further inform clinical practice in dysphagia assessment. A multi-engine electronic search was conducted on 8/25/16 and updated on 4/8/17 in accordance with standards published by the Preferred Reporting for Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA). Inclusion criteria included use of pulse oximetry to detect aspiration with simultaneous confirmation of aspiration via a gold standard instrumental study. Keywords included dysphagia or aspiration AND pulse oximetry. Articles meeting criteria were reviewed by two blinded co-investigators. The search yielded 294 articles, from which 19 were judged pertinent and reviewed in full. Ten met the inclusion criteria and all were rated at Level III-2 on the Australian Diagnostic Levels of Evidence. Study findings were mixed with sensitivity ranging from 10 to 87%. Potentially confounding variables were observed in all studies reviewed, and commonly involved defining “desaturation” within a standard measurement error range (~ 2%), mixed populations, mixed viscosities/textures observed during swallowing, and lack of comparison group. The majority of studies failed to demonstrate an association between observed aspiration and oxygen desaturation. Current evidence does not support the use of pulse oximetry to detect aspiration.


Pulse oximetry Aspiration Deglutition Swallowing Deglutition disorders 



The authors would like to thank Breanna Schwarz, B.S., for her assistance with literature searches and data organization.

Compliance with Ethical Standards

Conflict of interest

Deanna Britton continues to receive royalties from Plural Publishing, Pro-Ed, Inc., and Medbridge Education. She is additionally affiliated (Affiliate Assistant Professor) with the Department of Rehabilitation Medicine at the University of Washington, Seattle, WA. Joshua O. Benditt owns stock in Ventec. The remaining authors indicate no conflicts of interest.

Ethical Approval

This article does not contain any studies with human participants or animals performed by any of the authors.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2017

Authors and Affiliations

  1. 1.Department of Speech & Hearing SciencesPortland State University (PSU)PortlandUSA
  2. 2.Northwest Clinic for Voice and Swallowing (NWCVS), Department of Otolaryngology - Head & Neck SurgeryOregon Health & Sciences University (OHSU)PortlandUSA
  3. 3.Providence Sacred Heart Medical CenterSpokaneUSA
  4. 4.AuburnUSA
  5. 5.Division of Pulmonary and Critical Care MedicineUniversity of Washington Medical Center (UWMC)SeattleUSA

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