Relying on pulse oximetry to avoid hypoxaemia and hyperoxia: A multicentre prospective cohort study in patients with circulatory failure.

Five hundred seventy-one patients (mean [standard deviation] Simplified Acute Physiology Score II: 58.7 [20.1]; mechanically ventilated 75.6%) with 2643 available SaO and PaO samples and corresponding 2643 SpO values were analysed. Mean bias between SpO and SaO was 1.1%, and its agreement interval ranged from -8.2 to +11.1%. SpO cutoff values of 88%, 90%, and 92% left the possibility that 8%-13% of patients had hypoxaemia. SpO < 95% left the possibility that 31% of patients had hyperoxia. All calculated areas under the receiver operating characteristics showed a lower limit of their 95% confidence interval below 0.85 CONCLUSION: In this cohort of patients with circulatory failure, SpO had poor discriminative ability to rule out hypoxaemia and hyperoxia. Overconfidence upon SpO monitoring may be dangerous.