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New Monitors for Measuring Low Oxygen Levels in Critically Ill Infants: Presented at ASA By Arushi Sinha SAN FRANCISO, CA -- October 23, 2007 -- One of the challenges facing accurate quantification of oxyhaemoglobin saturation levels occurs when the levels are below the sensitivity levels of traditional oximeters. This is particularly crucial in the case of infants, where oxygen saturation levels may fall dangerously low (below 70%). Therefore, researchers evaluated the accuracy of two new options for measuring oxyhaemoglobin saturation levels and presented their findings here at the Annual Meeting of the American Society of Anesthesiologists (ASA). "In children who have congenital heart disease, oxygen saturations can be as low as 60%," explained study presenter Peter Cox, MD, Clinical Director, Department of Critical Care Medicine, Hospital for Sick Children, Toronto, Ontario, Canada. Dr. Cox examined the efficacy of new types of sensors for quantifying oxyhaemoglobin saturation levels among young patients with congenital cyanotic cardiac lesions (CCCL). The study compared two sensors: the Masimo SET Radical with Blue sensor and the Nellcor N600 with Lo-Sat and Max-I sensor. The two sensors were compared against a control sensor (Masimo LNOP), for their effectiveness in quantifying oxyhaemoglobin saturations below 70% among ICU patients. The 12 study subjects were patients in the ICU and had a mean age of 6.5 months (range: 7 days to 23 months) and mean weight of 5.2 kg (+- 2.5 kg). Arterial blood gases (ABG), particularly oxygen saturation (SaO2) levels, were measured using the different sensors, which were placed on the thumb of the left hand, or the great toe of either foot--as recommended by the manufacturer--in each infant. In this patient group, a total of 60 ABG readings were obtained, and the mean SaO2 was found to be 72.3% (range: 85%-56.1%). For the purposes of this study, accuracy was defined to be a combination of the most precision and narrow bias, using a variety of statistics. Of the three types of sensors, including the control, the Masimo SET Radical with Blue sensor was found to have the most precision at 3.50, compared with 5.26 for the Nellcor N600 and 6.24 for the control. The ARMS statistic, an accuracy statistic used by the Food and Drug Administration, was found to be 3.97 for the Masimo SET Radical with Blue sensor, 6.49 for the Nellcor N600, and 6.51 for the control sensor. Based on these results, the researchers concluded that the Masimo Blue sensor demonstrated acceptable accuracy, particularly in patients with CCCL. The researchers also noted that there might be sensor performance and calibration issues to explain the observed differences in performance. "There is a new pulse oximeter that is accurate at low saturation levels," concluded Dr. Cox. [Presentation title: New Pulse Oximetry Sensors With Low Saturation Accuracy Claims - a Clinical Evaluation. Abstract A1540] E-mail this page to a friend or colleague! To print, use this version