Comparison of nasal and forehead oximetry accuracy and pressure injury in critically ill patients.

BACKGROUND In critically ill patients, clinicians can have difficulty obtaining accurate oximetry measurements. OBJECTIVE To compare the accuracy of nasal alar and forehead sensor measurements and incidence of pressure injury. METHODS 43 patients had forehead and nasal alar sensors applied. Arterial samples were obtained at 0, 24, and 120 hours. Oxygen saturations measured by co-oximetry were compared to sensor values. Skin was assessed every 8 hours. RESULTS Oxygen saturations ranged from 69.8%-97.8%, with 18% of measures < 90%. Measurements were within 3% of co-oximetry values for 54% of nasal alar compared to 35% of forehead measurements. Measurement failures occurred in 6% for nasal alar and 22% for forehead. Three patients developed a pressure injury with the nasal alar sensor and 13 patients developed a pressure injury with the forehead sensor (χ2 = 7.68; p = .006). CONCLUSIONS In this group of patients with decreased perfusion, nasal alar sensors provided a potential alternative for continuous monitoring of oxygen saturation.