Higher prevalence of occult hypoxemia found during anesthesia in Black patients compared to White patients

What is the paper about: This large retrospective cohort study evaluated patients at a single center under anesthesia for surgery. All patients who had a measurement of blood oxygenation (e.g., arterial blood gas) during surgery were included in the study and their measured blood oxygen saturation was compared to their pulse oximeter reading at the same time. The primary outcome was occult hypoxemia, or a measured blood oxygen saturation (SaO2) < 88% despite a pulse oximeter reading (SpO2) > 92% as stratified by self-reported race/ethnicity. The study found the prevalence of occult hypoxemia to be significantly higher in Black (2.1%) and Hispanic (1.8%) patients when compared to White patients (1.1%), even after adjusting for other patient factors.

Bottom Line: Self-reported Black and Hispanic race/ethnicity is associated with a greater prevalence occult hypoxemia when compared to White race/ethnicity.

Why the research is important: Demonstrating this discrepancy illustrates that racial/ethnic disparities exist and should be considered when caring for patients of color. Further validation of pulse oximeters in patients of color are required to further address this problem.

Said Dr. Garrett W. Burnett about the study: Previously, discrepancies in pulse oximeter performance in patients of color were thought to be at lower oxygen saturation levels. More recently, including in the present study, evidence for pulse oximeter discrepancies at higher levels in patients of color have been demonstrated. This is a problem with potentially far reaching consequences due to the vital role pulse oximeters play in modern healthcare. Further research to investigate and address this problem is required.