Accuracy and Precision of Pulse Oximetry in Detecting Hypoxia at Various Sensor Locations in Infants and Children with Pneumonia

Background and Objectives: Children with pneumonia are at risk of hypoxia, and measuring peripheral oxygen saturation (SpO 2 ) is necessary to analyze blood SpO 2 levels. The objective of our study was to compare the precision of pulse oximetry probes placed at different locations and determine their accuracy with arterial blood gas (ABG) analysis for predicting hypoxia in children with pneumonia according to Integrated Management of Neonatal and Childhood Illness (IMNCI) classification. In addition, we aimed to determine the mean time required for SpO 2 measurement at different body parts, including the fingers, toes, earlobes, and forehead. Methods: We enrolled children aged 2–59 months who presented to the emergency department with pneumonia as defined by IMNCI. Sequential SpO 2 measurements were obtained from the fingers, toes, earlobes, and forehead, followed by an ABG sample. The time taken for SpO 2 measurement at each site was recorded. Results: Comparison of SpO 2 measurements in different body parts revealed that in most locations, right-sided SpO 2 values were significantly higher than left-sided SpO 2 values ( P < 0.01). Correlation analysis of SaO 2 (arterial SpO 2 ) with SpO 2 at different sites showed that the P < 0.001 at all sites, indicating the accuracy of pulse oximetry. The right middle finger showed the highest correlation coefficient (0.955). The mean time (standard deviation) taken for measuring SpO 2 at the right middle finger was lowest at 12.85 s (1.06). Conclusion: Pulse oximetry is accurate for measuring SpO 2 in cases without hypoxemia. The right middle finger is the best site for SpO 2 measurement in terms of correlation with SaO 2 .