SaO2 versus SpO2

With background knowledge

Types of haemoglobins
 Deoxyhaemoglobin (Hb)
 Oxyhaemoglobin (HbO2)
 Methaemoglobin (Methb)
 Carboxyhaemoglobin (COHb)
 Sulfhaemoglobin (SfHb)
 Carboxysulfhaemoglobin (COSfhb)

 Where the concentration of

oxyhaemoglobin dominates in the
blood
SaO2
 A parameter measured by CO-oximeter
 The ratio of oxyhaemoglobin over all types of
haemoglobin
SpO2
 A parameter measured by pulse-oximeter
 The ratio of oxyhaemoglobin over the
concentration of oxyhaemoglobin and
deoxyhaemoglobin
CO-oximeter
measuring SaO2
 Traditional way of measuring oxygen
saturation in arterial blood
 Measurement taken on several wavelengths
of light
 Achieved with the usage of blood gas
analyzer
Pulse-oximeter
measuring SpO2
 Non-invasive way of oxygen level
measurement
 Both transmission mode and reflection
modes available
 Transmission : fingertip, earlobe
 Reflection : forehead, cheek, calf, thigh
 Poorer SNR occurs at reflection mode
 Most-commonly dual-wavelength method
used
Malfunction of pulse-
oximetry
 Consider a heavy smoker with 15% COhb
 Pulse-oximeter is unable to distinguish
between COhb and HbO2
 In the case where SaO2 is 84%
◦ A result of 99% SpO2 will be shown
◦ The reading is heavily affected
◦ Situation of user endangered when wrong action
taken
Summary of pulse oximetry
 Measure blood saturation levels. Unable to
detect tissue hypoxia as a result of anaemia
 Unable to distinguish the dysfunctional
haemoglobins – over estimate SaO2 level
 Not an accurate devise.. Yet good indicator of
saturation and desaturation level
 More reliable if reflective probe used to tape
to the body
 Digital version not necessarily better than
analogue one
Summary of pulse oximetry
 Venous pulsation artificially lower than SaO2
 A guide to peripheral circulation
 Aim to keep levels above 95%
 Action taken quickly if below 90%