SaO2 versus SpO2

With background knowledge

Types of haemoglobins
Deoxyhaemoglobin  Oxyhaemoglobin  Methaemoglobin  Carboxyhaemoglobin  Sulfhaemoglobin  Carboxysulfhaemoglobin
 

(Hb) (HbO2) (Methb) (COHb) (SfHb) (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 pulseoximetry

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%

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