• 1.

    Matthews NS, Mohn TJ, Yang M, et al. Factors associated with anesthetic-related death in dogs and cats in primary care veterinary hospitals. J Am Vet Med Assoc 2017;250:655665.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 2.

    Bainbridge D, Martin J, Arango M, et al. Perioperative and anaesthetic-related mortality in developed and developing countries: a systematic review and meta-analysis. Lancet 2012;380:10751081.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 3.

    Richardson EM, McMillan M. Survey on conduct of anaesthetic monitoring in small animal practice in the UK. Vet Rec 2019;185:570.

  • 4.

    Brodbelt DC, Pfeiffer DU, Young LE, et al. Results of the confidential enquiry into perioperative small animal fatalities regarding risk factors for anesthetic-related death in dogs. J Am Vet Med Assoc 2008;233:10961104.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 5.

    Sano H, Barker K, Odom T, et al. A survey of dog and cat anaesthesia in a sample of veterinary practices in New Zealand. N Z Vet J 2018;66:8592.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 6.

    Brodbelt DC, Pfeiffer DU, Young LE, et al. Risk factors for anaesthetic-related death in cats: results from the confidential enquiry into perioperative small animal fatalities (CEPSAF). Br J Anaesth 2007;99:617623.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 7.

    Brodbelt DC, Blissitt KJ, Hammond RA, et al. The risk of death: the confidential enquiry into perioperative small animal fatalities. Vet Anaesth Analg 2008;35:365373.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 8.

    Grubb T, Sager J, Gaynor JS, et al. 2020 AAHA Anesthesia and Monitoring Guidelines for Dogs and Cats. J Am Anim Hosp Assoc 2020;56:5982.

  • 9.

    Lipnick MS, Feiner JR, Au P, et al. The accuracy of 6 inexpensive pulse oximeters not cleared by the Food and Drug Administration: the possible global public health implications. Anesth Analg 2016;123:338345.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 10.

    Faul F, Erdfelder E, Lang AG, et al. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 2007;39:175191.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 11.

    Bland JM, Altman DG. Measuring agreement in method comparison studies. Stat Methods Med Res 1999;8:135160.

  • 12.

    Smith RN, Hofmeyr R. Perioperative comparison of the agreement between a portable fingertip pulse oximeter v. a conventional bedside pulse oximeter in adult patients (COMFORT trial). S Afr Med J 2019;109:154158.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 13.

    Mannheimer PD. The light-tissue interaction of pulse oximetry. Anesth Analg 2007;105:S10S17.

  • 14.

    Kelleher JF, Ruff RH. The penumbra effect: vasomotion-dependent pulse oximeter artifact due to probe malposition. Anesthesiology 1989;71:787791.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 15.

    Mair A, Martinez-Taboada F, Nitzan M. Effect of lingual gauze swab placement on pulse oximeter readings in anaesthetised dogs and cats. Vet Rec 2017;180:49.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 16.

    Mair A, Ferreira J, Ricco C, et al. Appraisal of the ‘penumbra effect’ using lingual pulse oximetry in anaesthetized dogs and cats. Vet Anaesth Analg 2020;47:177182.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 17.

    Kishi Y, So S, Harada Y, et al. Three-dimensional SEM study of arteriovenous anastomoses in the dog's tongue using corrosive resin casts. Acta Anat (Basel) 1988;132:1727.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 18.

    Bickler PE, Feiner JR, Severinghaus JW. Effects of skin pigmentation on pulse oximeter accuracy at low saturation. Anesthesiology 2005;102:715719.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 19.

    Adler JN, Hughes LA, Vivilecchia R, et al. Effect of skin pigmentation on pulse oximetry accuracy in the emergency department. Acad Emerg Med 1998;5:965970.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 20.

    Fluck RR Jr, Schroeder C, Frani G, et al. Does ambient light affect the accuracy of pulse oximetry? Respir Care 2003;48:677680.

  • 21.

    Trivedi NS, Ghouri AF, Shah NK, et al. Effects of motion, ambient light, and hypoperfusion on pulse oximeter function. J Clin Anesth 1997;9:179183.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 22.

    Schramm WM, Bartunek A, Gilly H. Effect of local limb temperature on pulse oximetry and the plethysmographic pulse wave. Int J Clin Monit Comput 1997;14:1722.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 23.

    Langton JA, Lassey D, Hanning CD. Comparison of four pulse oximeters: effects of venous occlusion and cold-induced peripheral vasoconstriction. Br J Anaesth 1990;65:245247.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 24.

    Barker SJ, Hyatt J, Shah NK, et al. The effect of sensor malpositioning on pulse oximeter accuracy during hypoxemia. Anesthesiology 1993;79:248254.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 25.

    Southall DP, Samuels M. Inappropriate sensor application in pulse oximetry. Lancet 1992;340:481482.

  • 26.

    Goldman JM, Petterson MT, Kopotic RJ, et al. Masimo signal extraction pulse oximetry. J Clin Monit Comput 2000;16:475483.

  • 27.

    Hummler HD, Engelmann A, Pohlandt F, et al. Accuracy of pulse oximetry readings in an animal model of low perfusion caused by emerging pneumonia and sepsis. Intensive Care Med 2004;30:709713.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 28.

    Singh AK, Sahi MS, Mahawar B, et al. Comparative evaluation of accuracy of pulse oximeters and factors affecting their performance in a tertiary intensive care unit. J Clin Diagn Res 2017;11:OC05OC08.

    • Search Google Scholar
    • Export Citation
  • 29.

    Young SS, Skeans SM, Lamca JE, et al. Agreement of Spo2, Sao2 and Sco2 in anesthetized cynomolgus monkeys (Macaca fascicularis). Vet Anaesth Analg 2002;29:150155.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 30.

    Bernard SL, An D, Glenny RW. Validation of the Nonin 8600V pulse oximeter for heart rate and oxygen saturation measurements in rats. Contemp Top Lab Anim Sci 2004;43:4345.

    • Search Google Scholar
    • Export Citation
  • 31.

    ISO. ISO 80601-2-61:2017: medical electrical equipment—part 2–61: particular requirements for basic safety and essential performance of pulse oximeter equipment. Geneva: ISO, 2017.

    • Search Google Scholar
    • Export Citation
  • 32.

    Center for Devices and Radiological Health. Pulse oximeters - premarket notification submissions [510(k)s]: guidance for industry and Food and Drug Administration staff. Rockville, Md: FDA, 2013.

    • Search Google Scholar
    • Export Citation
  • 33.

    Nelson BW, Allen NB. Accuracy of consumer wearable heart rate measurement during an ecologically valid 24-hour period: intraindividual validation study. JMIR Mhealth Uhealth 2019;7:e10828.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 34.

    Secker C, Spiers P. Accuracy of pulse oximetry in patients with low systemic vascular resistance. Anaesthesia 1997;52:127130.

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Repeatability and accuracy of fingertip pulse oximeters for measurement of hemoglobin oxygen saturation in arterial blood and pulse rate in anesthetized dogs breathing 100% oxygen

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  • 1 Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL 61802.

Abstract

OBJECTIVE

To evaluate the repeatability and accuracy of fingertip pulse oximeters (FPO) for measurement of hemoglobin oxygen saturation in arterial blood and pulse rate (PR) in anesthetized dogs breathing 100% O2.

ANIMALS

29 healthy client-owned anesthetized dogs undergoing various surgical procedures.

PROCEDURES

In randomized order, each of 7 FPOs or a reference pulse oximeter (PO) was applied to the tongue of each intubated anesthetized dog breathing 100% O2. Duplicate measurements of oxygen saturation (Spo2) and PR were obtained within 60 seconds of applying an FPO or PO. A nonparametric version of Bland-Altman analysis was used. Coefficient of repeatability was the interval between the 5th and 95th percentiles of the differences between duplicate measurements. Bias was the median difference, and the limits of agreement were the 5th and 95th percentiles of the differences between each FPO and the PO. Acceptable values for the coefficient of repeatability of Spo2 were ≤ 6%. Agreements were accepted if the limits of agreement had an absolute difference of ≤ ± 3% in Spo2 and relative difference of ≤ ± 10% in PR.

RESULTS

Coefficient of repeatability for Spo2 was acceptable for 5 FPOs, but the limits of agreement for Spo2 were unacceptable for all FPOs. The limits of agreement for PR were acceptable for 2 FPOs.

CONCLUSIONS AND CLINICAL RELEVANCE

Results suggested that some FPOs may be suitable for accurately monitoring PRs of healthy anesthetized dogs breathing 100% O2, but mild underestimation of Spo2 was common.

Abstract

OBJECTIVE

To evaluate the repeatability and accuracy of fingertip pulse oximeters (FPO) for measurement of hemoglobin oxygen saturation in arterial blood and pulse rate (PR) in anesthetized dogs breathing 100% O2.

ANIMALS

29 healthy client-owned anesthetized dogs undergoing various surgical procedures.

PROCEDURES

In randomized order, each of 7 FPOs or a reference pulse oximeter (PO) was applied to the tongue of each intubated anesthetized dog breathing 100% O2. Duplicate measurements of oxygen saturation (Spo2) and PR were obtained within 60 seconds of applying an FPO or PO. A nonparametric version of Bland-Altman analysis was used. Coefficient of repeatability was the interval between the 5th and 95th percentiles of the differences between duplicate measurements. Bias was the median difference, and the limits of agreement were the 5th and 95th percentiles of the differences between each FPO and the PO. Acceptable values for the coefficient of repeatability of Spo2 were ≤ 6%. Agreements were accepted if the limits of agreement had an absolute difference of ≤ ± 3% in Spo2 and relative difference of ≤ ± 10% in PR.

RESULTS

Coefficient of repeatability for Spo2 was acceptable for 5 FPOs, but the limits of agreement for Spo2 were unacceptable for all FPOs. The limits of agreement for PR were acceptable for 2 FPOs.

CONCLUSIONS AND CLINICAL RELEVANCE

Results suggested that some FPOs may be suitable for accurately monitoring PRs of healthy anesthetized dogs breathing 100% O2, but mild underestimation of Spo2 was common.

Contributor Notes

Dr. Dantino's present address is the Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN 37996.

Dr. Sage's present address is the Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI 53706.

Dr. Da Costa Martins’ present address is the Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, MO 65211.

Address correspondence to Dr. Ambrisko (tambrisko@hotmail.com).