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%