Comparison of nasal and forehead oximetry accuracy and pressure injury in critically ill patients

Background: In critically ill patients, clinicians can have difficulty obtaining accurate oximetry measurements. Objective: To compare the accuracy of nasal alar and forehead sensor measurements and incidence of pressure injury. Methods: 43 patients had forehead and nasal alar sensors applied. Arterial samples were obtained at 0, 24, and 120 hours. Oxygen saturations measured by co-oximetry were compared to sensor values. Skin was assessed every 8 hours. Results: Oxygen saturations ranged from 69.8%-97.8%, with 18% of measures < 90%. Measurements were within 3% of co-oximetry values for 54% of nasal alar compared to 35% of forehead measurements. Measurement failures occurred in 6% for nasal alar and 22% for forehead. Three patients developed a pressure injury with the nasal alar sensor and 13 patients developed a pressure injury with the forehead sensor (χ2 = 7.68; p =.006). Conclusions: In this group of patients with decreased perfusion, nasal alar sensors provided a potential alternative for continuous monitoring of oxygen saturation.