Pulse oximetry in pediatric patients with darker skin tones may overestimate oxygen saturation, which can lead to undertreatment of hypoxemia, dangerously low blood oxygen levels, researchers at Vanderbilt University Medical Center report.
Findings from the Pulse Oximetry and Skin Tone in Children (POSTer-Child) study were published Feb. 12 in a letter to the editor of The New England Journal of Medicine. First author Joseph Starnes, MD, MPH, is a fellow in Pediatric Cardiology.
The study reviewed oxygen saturation determined by two commonly used pulse oximetry devices in 320 patients under age 21 who underwent cardiac catheterization at VUMC in 2024.
One of the devices failed to detect low oxygen levels, a situation known as “occult hypoxemia,” in 7% of patients with the darkest skin tone, compared to zero percent of those with the lightest skin tone.
Starnes and his colleagues concluded that current FDA guidelines are “inadequate” to ensure the accuracy of pulse oximetry, and that further study is needed. New guidelines are currently under consideration.
The research was supported in part by National Institutes of Health grants T32HS026122 and UL1TR002243, and the Jordan Hackett Foundation.
