According to data from big research released on Monday, a fault in a commonly used medical gadget that detects oxygen levels leads critically ill Asians, Blacks, and Hispanics to receive less supplementary oxygen to help them breathe than white patients. Pulse oximeters are fingertip devices that use red and infrared light to measure oxygen levels in the blood. Skin pigmentation has been recognised to cause reading errors since the 1970s, but the differences were not thought to have an impact on patient treatment.
The study discovered that among 3,069 patients treated in a Boston intensive care unit (ICU) between 2008 and 2019, people of colour received significantly less supplemental oxygen than would be considered optimal compared to white people due to inaccuracies in pulse oximeter readings related to skin pigment. ‘Nurses and doctors make the wrong judgments and end up delivering less oxygen to persons of colour because they are deceived by erroneous pulse oximeter results’, according to Dr. Leo Anthony Celi, who directed the study.
The researchers compared pulse oximetry data to direct measurement of blood oxygen levels, which is not practicable in the ordinary patient since it requires a painful intrusive procedure. A separate study involving COVID-19 patients, published recently in the same journal, discovered ‘occult hypoxemia’ – an oxygen saturation level below 88 % despite pulse oximeter readings of 92% to 96 % – in 3.7% of blood samples from Asian patients, 3.7% of samples from Black patients, 2.8 % of samples from non-Black Hispanic patients, and only 1.7 % of samples from white patients. Only 17.2 % of the patients with occult hypoxemia were white.
The authors observed that racial and ethnic biases in pulse oximetry accuracy led to delayed or withheld therapy among Black and Hispanic patients with COVID-19. Obesity, drugs used in critically sick patients, and other variables can all have an effect on pulse oximetry, according to Celi. Imarc Group, a market research organisation, forecasts the worldwide pulse oximeter market will reach $3.25 billion by 2027, up from $2.14 billion in 2021. ‘ We think it’s very legitimate at this time to call on consumers and manufacturers to make improvements (to the devices),’ Dr. Eric Ward, writer of an editorial published with the research, told Reuters.
According to an emailed statement from Medtronic Plc (MDT.N) CEO Frank Chan, the company checks the accuracy of its pulse oximeters ‘by obtaining synchronised blood samples at each level of blood oxygen content and comparing the pulse ox readings with measurements produced from the blood sample’. He went on to say that Medtronic evaluates its devices on a larger-than-required number of people with dark skin pigmentation, ‘to assure our technology will work as intended for all patient groups’. Phillips Healthcare, the company that makes pulse oximeters, did not reply to a request for comment.
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