Comparison of Pulse Oximeter with Arterial Blood Gas Analysis in Determination of Spo2 in Covid 19 at a Tertiary Care Centre in Central India.

Abstract

BACKGROUND: Covid 19 or SARS-COV-2 has created havoc in recent years and has put the world into a standstill with a high mortality and morbidity putting a pressure on the infrastructure of health system and making it difficult to manage all patients in hospital. As the search for triage system to judge the patients who would require home isolation and self-monitoring and the patients who will require in hospital management is still going on, some minor instruments and apparatus can be of great help in self-monitoring by patients and early detection of hypoxia or deterioration of condition can prompt then to contact health professional at an early stage. One such minor pocket apparatus is pulse oximeter. But, its effectiveness of determining the oxygen saturation can be misleading in some critical patients and they may require invasive procedure like arterial blood gas estimation for triaging patients of critical care. The present study compares the efficacy of pulse oximeter versus arterial blood gas analysis in measuring the accuracy of oxygen carrying capacity in critical covid 19 cases on oxygen therapy by different means.

METHODOLOGY: Patients with COVID-19 who required oxygen to maintain saturation and the intubated patients on mechanical ventilation were admitted to the COVID ICU set-up of Datta Meghe Medical College and Shalinitai Meghe Hospital and Research Centre, Wanadongri, Hingna were analysed and documentation of their vitals were done. The study was a prospective cross-sectional hospital-based study from July 2020 till Dec 2020. Total 50 patients who fulfilled the criteria were recruited for the study group. The degree of discordance between value of PaO2 with the saturation shown by pulse oximeter was recorded.

RESULT: Out of total 50 patients in study, 15 patients (30%) had a SpO2 of >90% with a measured PaO2of <60 mmHg which was discordant according to the standard curve.

CONCLUSION: The discordance of oxygen measurements between arterial blood gas analysis and peripheral pulse oximeter reading is an important factor in determining the evaluation and management of the acute hypoxemic respiratory failure in patients who required mechanical ventilatory support as seen in patients with COVID-19.