Language
English
Publication Date
10-2-2024
Journal
American Journal of Tropical Medicine and Hygiene
DOI
10.4269/ajtmh.23-0656
PMID
39106851
PMCID
PMC11448522
PubMedCentral® Posted Date
8-6-2024
PubMedCentral® Full Text Version
Post-print
Abstract
Acute lower respiratory infections (ALRI) are the leading post-neonatal cause of death in children under 5 years old. There is a high prevalence of pediatric ALRI-related hypoxemia in low- and middle-income countries. The WHO defines clinically meaningful hypoxemia in children as a SpO2 (peripheral oxygen saturation) < 90%. Multiple studies put this convention into question and found SpO2 of 90% to 92% to be associated with child ALRI mortality. An evolving body of evidence suggests that pulse oximeters systematically overestimate oxygen saturation in individuals with dark skin tones. We conducted a narrative review of pediatric studies evaluating pulse oximeter accuracy in children without COVID-19. Four studies, one prospective, examined pulse oximeter accuracy in children of varying ages with dark skin tones. All studies had limitations that affect their generalizability. There is evidence that certain pulse oximeters may overestimate oxygen saturation in children with dark skin tones. Further prospective research is urgently needed to identify affected populations and clinical implications. Despite recognized challenges, we strongly urge continued and expanded use of pulse oximetry as its use will save lives.
Keywords
Child, Child, Preschool, Humans, Infant, COVID-19, Developing Countries, Hypoxia, Oximetry, Oxygen Saturation, Respiratory Tract Infections, Skin Pigmentation
Published Open-Access
yes
Recommended Citation
Hooli, Shubhada; Colbourn, Tim; Shah, Manish I; et al., "Pulse Oximetry Accuracy in Children with Dark Skin Tones: Relevance to Acute Lower Respiratory Infection Care in Low- and Middle-Income Countries" (2024). Faculty and Staff Publications. 5796.
https://digitalcommons.library.tmc.edu/baylor_docs/5796