“This is Part 2 of an interview that is one of the most startling I’ve posted over the past 8 years. The revelation here is that the pulse oximeters we’ve been using for decades, to measure oxygen in the blood, are not always accurate in people of color. They may overestimate the amount of oxygen in the blood and miss low oxygen levels – potentially leading to delayed treatment and adverse outcomes. What’s shocking to me is that this has been documented in the medical literature for nearly two decades and little to no action has been taken. The implications are profound, especially given the disparity in deaths we witnessed along racial lines during the Covid pandemic, and the on-going widespread utilization of pulse oximetry in the post pandemic era.
Our guest, the esteemed Dr. Kryger, provides us with his expert perspective on this still emerging situation. In this episode we’ll discover:
Why Dr. Kryger believes it’s taken so long – decades – for some action to be taken to address the inaccuracies in pulse oximetry.
Dr. Kryger’s perspective on the impact that inaccurate pulse oximetry measurements had during the Covid pandemic and its impact in the post-pandemic period.
What Dr. Kryger believes that professionals, as well as the American public, should be aware of – in regard to pulse oximetry measurement – and what actions can be taken right now.
This is one of those critically important and urgent issues that we need to learn more about and do more about. As our guest points out, the magnitude of this problem is enormous in that nearly 40% of the people who pulse oximeters are used on are people of color.
My purpose here is to create awareness and motivate positive action. Along those lines, I would urge you to read and respond to the FDA’s recently released discussion paper (the public is invited to respond up until Jan 16, 2024); as well as attend the FDA’s upcoming virtual public advisory meeting on Feb 2 2024.
I would also urge you to forward this podcast to your clinical colleagues as well as hospital and healthcare executives.
“In this “Breathe Easy Critical Perspective” podcast, Dr. Dominique Pepper interviews Dr. Michael Sjoding. They discuss his NEJM publication about bias in pulse oximetry measurement. Dr. Sjoding is an Assistant Professor in the Division of Pulmonary and Critical Care at the University of Michigan.”
ARE PULSE OXIMETERS RACIST? WHAT I LEARNED ABOUT HEALTH EQUITY AND STRUCTURAL RACISM AT ATS 2023
“On this episode I share some of what I learned about health equity and structural racism while at the American Thoracic Society conference in Washington, DC, with a focus on spirometry reference equations and pulse oximetry.
I mention several papers in this episode, [linked in the podcast notes].”
Contributor: Aaron Lessen, MD
Educational Pearls:
Study in NEJM looked at occult hypoxemia, when oxygen saturation reads at >92% when the actual saturation is <88%
Rate of occult hypoxemia was 3 times higher in those who identified as black (12% vs 4%)
Keep this disparity in mind when providing care to patients of all backgrounds and incorporate into clinical decision-making
Fair Pulse Ox 