Diagnostic Importance of Pulse Oximetry in the Determination of the Stage of Chronic Arterial Insufficiency of Lower Extremities

Abstract

Introduction Chronic arterial insufficiency (CAI) of lower extremities is important socio-economical and healthcare problem, due to its high incidence of morbidity, disability and mortality.

Objective The aim of our work was to determine the diagnostic importance of pulse oximetry in the early detection of stage of lower extremities CAI based on peripheral arterial oxygen saturation of haemoglobin (SpO₂).

Methods Prospectively, we analyzed a group of 50 patients, admitted at the Vascular Department of Surgical Clinic in Niš during the period from September 2006 to October 2007, with evident symptoms and signs of different stages of lower extremities CAI verified by ultrasonography. In patients with lower extremity disorder of tissue arterial capillaries, SpO₂ was determined by pulse oximetry.

Results Using pulse oximetry, depending on the of stage of lower extremities CAI, we revealed a considerable difference in the stages of functional ischemia SpO₂: Fontaine I – 95.33±1.41%, Fontaine IIa – 92.14±2.27% and Fontaine IIb – 79.67±2.73%; in stage critical ischemia SpO₂: Fontaine III – 62.54±4.39% and Fontaine IV – 47.67±6.16%. In 3 patients with gangrenous foot and fingers SpO₂ was immeasurable and progressive decrease in SpO₂ of arterial capillaries (p<0.01 between stages).

Conclusion Due to the reliability and simplicity of pulse oximetry it can be a routinely used diagnostic device for patients with early determined stage of lower extremities CAI.

Keywords: pulse oximetry; haemoglobin oxygen saturation; chronic arterial insufficiency of lower extremities.