A comparison of finger and forehead pulse oximeters in heart failure patients during maximal exercise.
Kevin L Kelly, Alex R Carlson, Thomas G Allison and 1 others
PMID 31735457WHAT IT FOUND
During treadmill stress testing, forehead pulse oximeters read higher oxygen saturation than finger devices in heart failure patients.
At peak exercise, finger devices reported lower pulse rate than ECG. Forehead placement may be preferable in heart failure.
Key findings
01During exercise, the finger-placed pulse oximeter read lower oxygen saturation than the forehead-placed pulse oximeter in both heart failure and coronary artery disease patients.
02At peak exercise in heart failure, the finger pulse oximeter reported a lower pulse rate than the forehead pulse oximeter and ECG (104±24, 113±25 and 134±14 beats per minute).
03At peak exercise in coronary artery disease, the finger pulse oximeter, forehead pulse oximeter and ECG reported similar heart or pulse rates (131±13, 126±12 and 134±14 beats per minute).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study did not take arterial blood gas samples, so it could not show which pulse oximeter was truly accurate for oxygen saturation. It used only one manufacturer's devices, so the results may not apply to other pulse oximeters. It analysed 29 patients, with only 20 heart failure patients, so it is a small single-centre study. The comparison was made during a treadmill stress test, so it may not apply to resting monitoring, sleep, decompensated heart failure, or walk tests. Some participants were excluded because a device failed or they used a bike, so the results apply to patients who can complete treadmill testing with working devices.
Declared interests
The supplied publication types list NIH extramural and non-U.S. government research support. No author conflict-of-interest declaration is provided in the supplied text.
The easy way to misread this
Do not conclude that forehead pulse oximeters are proven to give the true oxygen saturation in heart failure. The study did not compare either device with arterial blood gas, used only one manufacturer, and inferred better forehead accuracy mainly from agreement between forehead pulse rate and ECG.