Background Commercially available wearable (ambulatory) pulse oximeters have been recommended as a method for managing patients at risk of physiological deterioration, such as active patients with COVID-19 disease receiving care in hospital isolation rooms; however, their reliability in usual hospital settings is not known. Objective We report the performance of wearable pulse oximeters in a simulated clinical setting when challenged by motion and low levels of arterial blood oxygen saturation (SaO 2 ). Methods The performance of 1 wrist-worn (Wavelet) and 3 finger-worn (CheckMe O2+, AP-20, and WristOx2 3150) wearable, wireless transmission–mode pulse oximeters was evaluated. For this, 7 motion tasks were performed: at rest, sit-to-stand, tapping, rubbing, drinking, turning pages, and using a tablet. Hypoxia exposure followed, in which inspired gases were adjusted to achieve decreasing SaO 2 levels at 100%, 95%, 90%, 87%, 85%, 83%, and 80%. Peripheral oxygen saturation (SpO 2 ) estimates were compared with simultaneous SaO 2 samples to calculate the root-mean-square error (RMSE). The area under the receiver operating characteristic curve was used to analyze the detection of hypoxemia (ie, SaO 2 <90%). Results SpO 2 estimates matching 215 SaO 2 samples in both study phases, from 33 participants, were analyzed. Tapping, rubbing, turning pages, and using a tablet degraded SpO 2 estimation (RMSE>4% for at least 1 device). All finger-worn pulse oximeters detected hypoxemia, with an overall sensitivity of ≥0.87 and specificity of ≥0.80, comparable to that of the Philips MX450 pulse oximeter. Conclusions The SpO 2 accuracy of wearable finger-worn pulse oximeters was within that required by the International Organization for Standardization guidelines. Performance was degraded by motion, but all pulse oximeters could detect hypoxemia. Our findings support the use of wearable, wireless transmission–mode pulse oximeters to detect the onset of clinical deterioration in hospital settings. Trial Registration ISRCTN Registry 61535692; http://www.isrctn.com/ISRCTN61535692 International Registered Report Identifier (IRRID) RR2-10.1136/bmjopen-2019-034404
【저자키워드】 hypoxia, hospital, mHealth, continuous monitoring, Diagnostic accuracy, Deterioration, Hypoxemia, wearable pulse oximeter, wearable technology, patient monitoring, blood oxygen, 【초록키워드】 hypoxia, reliability, risk, oxygen, COVID-19 disease, organization, Registration, oxygen saturation, sensitivity, specificity, Accuracy, Hypoxemia, Patient, Isolation, estimate, characteristic, performance, disease, Care, Clinical deterioration, physiological, receiver operating characteristic, arterial blood, Pulse Oximeters, Pulse oximeter, Support, Tablet, Blood oxygen saturation, Participants, peripheral oxygen saturation, receiver operating characteristic curve, Identifier, motion, root, ISRCTN registry, clinical setting, report, pulse, arterial blood oxygen saturation, rubbing, Tapping, peripheral, objective, Wavelet, Result, analyzed, was used, detect, evaluated, required, receiving, adjusted, comparable, calculate, patients with COVID-19, Philip, 【제목키워드】 detection, Diagnostic accuracy, Hypoxemia, oximeter,