• Rev Esp Cardiol (Engl Ed) · Oct 2012

    Pulse oximetry in the diagnosis of acute heart failure.

    • Josep Masip, Maria Gayà, Joaquim Páez, Antoni Betbesé, Francisco Vecilla, Ruben Manresa, and Pilar Ruíz.
    • Unidad de Cuidados Intensivos, Hospital Sant Joan Despí Moisès Broggi, Consorci Sanitari Integral, Universidad de Barcelona, Sant Joan Despí, Barcelona, España. jmasip@ub.edu
    • Rev Esp Cardiol (Engl Ed). 2012 Oct 1;65(10):879-84.

    Introduction And ObjectivesOxygen saturation by pulse oximetry is commonly used for monitoring critical patients, but its utility as a diagnostic marker of acute heart failure has not been assessed. This study analyzed the diagnostic role of oxygen saturation by pulse oximetry in a series of patients with acute myocardial infarction.MethodsIn a prospective observational cohort study of 220 consecutive patients with acute myocardial infarction, data collection included baseline oxygen saturation by pulse oximetry (without oxygen), physiologic measurements, Killip class and data from portable chest radiography, recorded at the same hour on each of the first three days after admission. Patients were followed up for one year.ResultsThere were 612 assessments. Baseline oxygen saturation by pulse oximetry decreased progressively in relation to the presence and the severity of acute heart failure assessed by Killip classes 1 to 3 (mean: 95, 92 and 85, respectively; P<.001) or by Radiology Score 0 to 4 (95, 94, 92, 89 and 83, respectively; P<.001), with a correlation coefficient of 0.66 and 0.63, respectively. Receiver operating characteristic curves disclosed the cut-off of oxygen saturation by pulse oximetry<93 to have the greatest area, with a sensitivity of 65%, specificity 90%, and overall test accuracy 83%. Patients grouped according to lowest oxygen saturation by pulse oximetry showed significantly different rates of one-year mortality or rehospitalization for heart failure.ConclusionsBaseline oxygen saturation by pulse oximetry is useful in establishing the diagnosis and severity of heart failure in acute settings such as myocardial infarction and may have prognostic implications.The diagnosis may be suspected when baseline oxygen saturation by pulse oximetry is <93. Full English text available from:www.revespcardiol.org.Copyright © 2012 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

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