
Appendix B: Principles of Operation
During monitoring, the instrument’s software reads this resistor
and selects coefficients that are appropriate for the wavelength of
that sensor’s red LED; these coefficients are then used to
determine SpO
2. This resistor is read when the monitor is turned
on, periodically thereafter, and each time a new sensor is
connected.
Additionally, to compensate for differences in tissue thickness,
the intensity of the sensor’s LEDs are adjusted automatically.
Functional versus Fractional Saturation
This monitor measures functional saturation — oxygenated
hemoglobin expressed as a percentage of the hemoglobin that can
transport oxygen
. It does not detect significant amounts of
dysfunctional hemoglobin, such as carboxyhemoglobin or
methemoglobin
. In contrast, hemoximeters such as the IL482
report fractional saturation — oxygenated hemoglobin expressed
as a percentage of all measured hemoglobin, including measured
dysfunctional hemoglobins
. To compare functional saturation
measurements to those from an instrument that measures
fractional saturation, fractional measurements must be converted
as follows:
functional saturation =
fractional saturation
100 - (% carboxyhemoglobin + % methemoglobin )
x100
Measured versus Calculated Saturation
When saturation is calculated from a blood gas partial pressure of
oxygen (PO
2), the calculated value may differ from the SpO2
measurement of a pulse oximeter
. This usually occurs because the
calculated saturation was not appropriately corrected for the
effects of variables that shift the relationship between PO
2 and
saturation (Figure 13): pH, temperature, the partial pressure of
carbon dioxide (PCO
2), 2,3-DPG, and fetal hemoglobin.
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