‘Flawed devices’ result in less ICU oxygen for dark-skinned patients

People of colour were given less oxygen than their White counterparts because of pulse oximetres that generate falsely elevated readings in people with darker skin, researchers looking at cases of over 3,000 patients at a US hospital say.

Black, Asian and Hispanic patients were given 0.2 to 0.4 litres per minute less oxygen than their white counterparts, researchers say.
Black, Asian and Hispanic patients were given 0.2 to 0.4 litres per minute less oxygen than their white counterparts, researchers say. (Reuters file)

Racial minorities receive less oxygen in the intensive care unit (or ICU) than white patients because of a flaw in a medical device found in hospitals across the world, a US study has said.

The pulse oximetre, first developed in the 1970s, clips to a patient’s finger and uses red and infrared light absorption to assess hemoglobin. But it is known to generate falsely elevated readings in people with darker skin.

In new research published in JAMA Internal Medicine on Monday, Eric Raphael Gottlieb and colleagues looked back at records of 3,069 patients at the Beth Israel Deaconess Medical Center in Boston who spent at least 12 hours in the hospital’s ICU.

They compared oxygen saturation estimates on the pulse ox devices to more accurate direct readings taken of hemoglobin oxygen saturation.

After controlling for other variables, they found that Black, Asian and Hispanic patients were given 0.2 to 0.4 litres per minute less oxygen than their white counterparts.

“Our findings present a unique and compelling opportunity to improve equity through device reengineering and by reevaluating how data are interpreted,” the team wrote.

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Measurement biases

Another recent study on the same topic showed that measurement biases in oxygen saturation levels were associated with a time delay in eligibility for Covid-19 treatment for Black and Hispanic patients.

An accompanying editor’s note said devices exist that perform more equitably, but have never been widely distributed.

“Health care systems, including academic centers, are large-scale purchasers of pulse oximetres,” the editorial said. 

“If they make a commitment to buy only devices that function across skin tones, manufacturers would respond.”

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Source: AFP

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