(CNN) – In contrast to the covid-19, the pulsioximeter has a fundamental cure for physicians and other medical professionals. However the device that monitors oxygen levels can not work well for people with dark skin, including multiple health care studies and agencies.
Pulse oximeters, which have been used during the pandemic, can result in inaccurate results, the EE.UU Administration of Medicines and Foods has warned.
Weekly Principles, Centers for Disease Control and Prevention at EU. We will also update our clinical guide on coronavirus to advertise the medicines and confirm that various study dates suggest that the pigmentation of the skin may affect the accuracy of the devices.
“If pulse oxides can be used to estimate oxygen levels, these devices have limitations that can result in inaccurate readings,” said Dr. William Maisel, Director of the FDA’s Evaluation and Quality Assessment Office at the FDA’s Radiological and Health Center in a statement.
The pulsioximeters are their little devices in the form of tweezers that adhere to the patient’s pain and constantly monitor the amount of oxygen in the blood. Covid-19 is a respiratory disease, which means that it first attacks the pulmonary glands, because the oxygen levels are a signal that the patient can be emaciated. Data from the CDC show that black Americans, Latinos and Indigenous Americans have four times more chances of being hospitalized with covid-19 than others in the United States.
Recent advertisements have been produced since a study published in December in the New England Journal of Medicine. El Dr. Michael Sjoding in various colleagues from the University of Michigan analyzes data from more than 10,000 patients. For each patient, we compare the levels of oxygen recorded by a pulse oximeter with the means for arterial gasometry, a much more precise, painful and invasive procedure.
The investigators wanted to know how often the oximeter of pulse had a relatively normal oxygen level when deberia had registered some more preoccupation.
In white thin patients, the pulse oximeter has an English digit of 3.6% of the times. In patients of negro raza, it was 11.7%.
The conclusion, says the Dr. Sjoding, that the tensile pulse oximeters are three times more likely to lose oxygen levels significantly lower, or hypoxemia, in patients of negro race. The study suggests that one in 10 black patients can be obtained with good results.
For what readings are not accurate
There is a relatively simple explanation of why. The pulse oximeters work by sending the types of light red through their hands. A sensor on the other side of the device captures this light and uses it to detect the color of the song; the brilliant red song is extremely oxygenated, while the blue song of the violin is minor. If the device is not calibrated for more dark skin, the pigmentation may affect the shape in which it absorbs the light. The scale of the dark spots can provoke a similar effect.
Experimental physicians are not alone in the pulse oximeter to make a diagnosis or decide the treatment of a patient, say the Dra. Michelle Ng Gong, Critical Counseling Medicine Jefa and Pulmonary Medicine Center of the Montefiore Medical Center in New York.
“Only the director has a patient who does not import the bad thing that is, as long as this number is good, he is not preoccupied,” said Dr. Gong. «It’s a herrament. And as a matter of fact, we need to be able to use it correctly in the context of other information ».
But, say the Dra. Gong, during the pandemic, when hospitals are abraded and the medicines that are normally not in the emergency room are lifted to show and classify the patients, the numbers of a pulse oximeter can weigh more than a pound. An inaccurate reading will be particularly problematic if the patient’s oxygen level is below the limit.
También también deben ser conscientes de sus propios prejusios unconscient, dice la Dra. Gong. Most studies, for example, when blacks are suffering from pain, are less likely to be administered as analgesic as whites. If a patient says that they have difficulty breathing, the doctors should not only discontinue reading the pulse oximeter normally.
“The unique way in which health care disparities can be reduced,” said Dr. Gong, “are the attacks of multiple fines, both of the most important contributions as of our personal interactions”.
The tampon doctors are the only ones that use pulse oximeters. While Alcanzaban hospitals have maximum capacity during the pandemic, some covid-19 patients with less severe sinuses would be sent home to monitor their progress. Following a market investigation, pulsioximetry sales for the hogar increased by 500% since the new coronavirus was read to the EU.
Amy Moran-Thomas, professor of anthropology at MIT, began researching pulse oximeters last year when he was sent to his home.
Los hallazgos no son new
Moran-Thomas describes studies that date back to the 1990s that suggest that there is a problem with pulse oximeters in patients with dark skin.
In 2005, a study conducted at the Hypoxia Lab of the University of California, San Francisco, introduced modern models of pulse oximeters that estimate the levels of oxygen in dark skin patients. Hicieron un estudio de seguimiento en 2007 has consequential similarities.
“A reading of 77 like the one I received would give me a verdant saturation as low as 69, a mediocre affair with a mayor. But medical emergency technicians or nurses in the emergency department will not be able to detect their discrepancies. The objective and neutral number appears from the point of view of the racial vista », writes Moran-Thomas in Boston Review.
Moran-Thomas was asked why the problem, identified decades ago, had not been solved yet.
“I’m an intensive care and pulmonary medicine,” says Dr. Sjoding, who started his study after learning the Moran-Thomas article. “One of our co-authors is a black medical detachment of the University of Michigan. None of us know this. None of our concoctions are studies from the decade of 2000. It is not part of our formation ».
The public attention appears to be increasing. On January 25, several senior officials sent an FDA card to investigate the issue. The FDA is responsible for approving any oximeter of pulse medicine before selling it on the market. The agency currently requires that pulse oximeters be tested in a varied range of skin tones, which means “at least 2 (test subjects) of pigmentation darkened at 15% of the subject group, which is the largest”.
The FDA states that it is reviewing carefully available data to determine if the agency’s additional studies are necessary. Recently, I developed a pulse oximeter for intelligent telephones that operate in all skin tones, using an automatic calibration period of 10 to 20 seconds to measure precision, moving the light through the light.
“These devices are not intended to be the only principal use of the information to make a clinical diagnosis or treatment decision,” said Dr. Maisel told CNN in an interview with the girls. “Alguien does not need to be satisfied with the reading of a pulse oximeter, including if it is the most accurate product”.
“Sólo asegúrese de estar consciente de eso cuando esté tomando decisions”, dice el Dr. Sjoding. “Pulse oximeter reading is at a point. And if this is the case, do you care for this patient in a different way? ».