Does skin pigment impact pulse oximeter accuracy?

The effect of skin pigmentation on pulse oximeter accuracy remains poorly characterized. Pulse oximeters may be less accurate in patients with darker skin, especially at lower oxygen saturations. Of note, this inaccuracy can tend to overestimate oxygen saturation, which may lead to false reassurance during clinically real hypoxemia. The amount of inaccuracy varies significantly between different devices, manufacturers, and probes. The OpenOximetry.org Project is actively working to better understand the impact of pigment on oximeter accuracy and to develop new strategies to eliminate this source of error.

References: Okunlola et al, Resp Care, Nov 2021, Bickler et al, Anesthesiology 2005; Feiner et al, Anesth Analg 2007; Adler et al, Acad Emerg Med 1998; Bothma et al, S Afr Med J 1996; Zeballos et al, Am Rev Respir Dis 1991; Ries et al, Chest 1989; Emery J Perinatol 1987; Sjoding et al, N Engl J Med 2020

Keywords: skin, pigment, skin tone, accuracy