Accuracy and Motion

  • Nellcor™ pulse oximetry technology is engineered with cardiac-based digital signal processing, and this has given us low saturation accuracy specifications between the measurement range of 60 - 80 percent, with an accuracy of +/- 3 digits.1
  • Nellcor™ pulse oximetry sensors with OxiMax™ technology are validated for use between the SpO2 measurement range of 70-100 percent with an accuracy of +/- 2 digits.2
  • Nellcor™ pulse oximetry with OxiMax™ technology meets standards for motion tolerance and is also compliant with ISO 80601-2-61.3

Nellcor™ Pulse Oximetry Technology

A Cardiac-Based Solution

Our methods for determining SpO2 values are founded on the fact that the patient’s true arterial oxygen saturation is associated with the patient’s cardiac-induced pulse. It focuses on the persistent and generally repetitive nature of these signals to determine SpO2.

Digi-Cal Advantage

Nellcor™ pulse oximetry with OxiMax™ technology works by incorporating a small digital memory chip within every sensor. The calibration curve is placed in the sensor itself and does not rely on preprogrammed data housed in the host monitor to calculate SpO2.

This means the monitor is engineered to deliver accurate SpO2 and pulse rate readings even when confronted with challenging conditions such as patient motion and low perfusion.4

Critical Congenital Heart Disease (CCHD) Screening

With a +/-2 neonatal accuracy, Nellcor™  pulse oximetry technology meets the criteria established by Alex R. Kemper, MD, MPH, MS in the Strategies for Implementing Screening for Critical Congenital Heart Disease recommendations published in the American Academy of Pediatrics Journal in 2011.5

These recommendations state that CCHD screening is performed using a pulse oximeter FDA-cleared for use with newborns, has been validated for low-perfusion conditions, is motion tolerant and has an accuracy of two percent root-mean-square accuracy.5

The addition of pulse oximetry screening (POS - with new-generation, motion-tolerant technology) to existing screening methods such as antenatal ultrasound and postnatal examination increases the overall detection of CCHD to 90-96%, irrespective of the detection rates of the other screening methods.6,7,8

It is estimated that the cost of pulse oximetry CCHD screening is between $10–$15 per infant.  When considering conservative estimates of potentially averted adverse events and extended hospital stays, an economic analysis calculated that CCHD screening appears cost-effective relative to other services.9

Alarm Management

Nellcor™ SatSeconds alarm management technology is engineered to support hospitals in addressing the Joint Commission 2019 National Patient Safety Goal for alarm safety in hospitals (NPSG 06.01.01).10

Nellcor™ Sat Seconds Alarm Management

Proven to reduce nuisance alarms for all patients and by 40 percent with a setting of 50 for neonates.11 The technology is engineered to:

  • Calculate the duration of the event, multiplied by the number of percentage points that SpO2 falls outside of the saturation alarm threshold.
  • Provide range of alarm settings – 10, 25, 50, or 100 minutes so changes to the settings can be made depending on the clinical environment and patient condition.

Nellcor™ Saturation Pattern Detection (SPD) Alert

This alert is designed to detect patterns of desaturation that may be indicative of repetitive reductions in airflow.

  • The alert uses a triangle icon that when “full” triggers an alarm to alert staff about these worrisome patterns. It can provide staff with information that helps to balance pain medication and airway safety and can alert staff to investigate situations they may not otherwise have known about.

 

Looking for information about how to help reduce alarm fatigue?

Read more about alarm management and discover the updated management guidelines.

Respiration Rate

Nellcor™ respiration rate technology provides a continuous assessment of oxygenation and respiration rate trends through a single finger sensor. This technology may also provide an early warning of impending respiratory distress — to help you intervene early.12,13

A single sensor can be used to measure SpO2, pulse rate and respiration rate, eliminating the need for additional sensors such as those used for acoustic measurement of respiratory rate.

The software calculates respiration rate with an accuracy of +/- 1 breath per minute relative to a capnography-based reference.14  It uses pulse oximetry technology, sensors, and workflows to derive respiration rate based on the changes in the photoplehysmogram (pleth) waveform that occurs as a result of breathing. Breathing causes changes in the cardiovascular, respiratory, and autonomic nervous systems and results in changes in the pleth waveform. These modulations can be used to calculate respiration rate.

Nellcor™ respiration rate software is engineered to complement pulse oximetry, pulse rate and the Nellcor™ saturation pattern detection alert (SPD) to help provide a more complete picture of a patient’s respiratory status.

Expanding Your Monitoring Platforms

Should you rely on monitoring SpO2 alone to provide the best care for your patients? Continuous monitoring of both oxygenation and ventilation are two key factors to help reduce respiratory compromise early enough to identify the problem and provide intervention.15

In fact, respiratory compromise — incidents of respiratory insufficiency, failure and arrest — is an avoidable patient safety issue.16 A 2016 analysis of 44,551 acute respiratory events revealed a mortality rate of 39.4%.17

This is why we offer a portfolio of respiratory monitoring solutions including pulse oximetry, capnography and remote monitoring technology that work in harmony to help you focus on what you do best: help save lives.

 

For more information about our respiratory & monitoring solutions, visit our website.

About the author

Kolleen Konecny is a Product Specialist for the Vital Sync™ remote monitoring and clinical decision support solution at Medtronic US.

  • 1. 1NMS.Accuracy-LoSat. PM1000N Operators Man p176-200, PM100 Operators Manual p117-153, Uniform Sensor Accuracy Guide Part No 10091796.

  • 2. 12MNF.Accuracy. PM1000N Operators Man p217-219, PM100 Operators Manual p117-153.

  • 3. 10NMS.Motion Tolerance/CCHD Screening/SPD. NCT01720355 at ClinicalTrials.gov.

  • 4. Covidien FDA 510(k) K123581.

  • 5. Kemper AR, Mahle WT, Martin GR et al. Strategies for implementing screening for critical congenital heart disease. Pediatrics. 2011;128(5):e1259-1267.

  • 6. de-Wahl Granelli A, Wennergren M, Sandberg K, et al. Impact of pulse oximetry screening on the detection of duct dependent congenital heart disease: a Swedish prospective screening study in 39 821 newborns. BMJ. 2009; 338:a3037.

  • 7. Ewer, K. Review of pulse oximetry screening for critical congenital heart defects in newborn infants. Curr Opin Cardiol. 2013, 28:92–96.

  • 8. Riede FT, Wörner C, Dähert I, et al. Effectiveness of neonatal pulse oximetry screening for detection of critical congenital heart disease in daily clinical routine – results from a prospective multicenter study. Eur J Pediatr. 2010; 169:975–981.

  • 9. Gross SD, Riehle-Colarusso T, Gaffney, M et al. CDC Grand Rounds: Newborn Screening for Hearing Loss and Critical Congenital Heart Disease. Morbidity and Mortality Weekly Report. Vol. 66 No. 33, August 25, 2017.

  • 10. The Joint Commission. National patient safety goals effective January 2019. Hospital Accreditation Program, NPSG.06.01.01. p.1-17

  • 11. 1NM.SatSeconds. Based on Internal Report Nellcor (Clark R. Baker). Alarm Performance of the N-595 With Sat-Seconds During Controlled Non-Motion Breathedowns. April 19, 2001.

  • 12. Taenzer AH, Pyke JB, McGrath SP, Blike GT. Impact of pulse oximetry surveillance on rescue events and intensive care unit transfers: a before-and-after concurrence study. Anesthesiology. 2010;112(2):282-287.

  • 13. Aneman A, Parr M. Medical emergency teams: a role for expanding intensive care? Acta Anaesthesiol Scand. 2006;50(10):1255-1265.

  • 14. 1NRR. Accuracy of Respiratory Rate. Bergese SD. Multicenter study validating accuracy of a continuous respiratory rate measurement derived from pulse oximetry: A comparison with capnography. Anesth Anal. 2017; 124 (2): 1153-1159.

  • 15. Maddox R, Oglesby H, Williams C, Fields M, Danello S, Continuous respiratory monitoring and a “smart” infusion system improve safety of patient-controlled analgesia in the postoperative period.  Am J Health-Syst Pharm. 2006; 63:157-64.

  • 16. Lee LA, Caplan RA, Stephens LS, et al. Postoperative opioid-induced respiratory depression: a closed claims analysis. Anesthesiology. 2015;122(3):659-665.

  • 17. Andersen LW, Berg KM, Chase M, et al. Acute respiratory compromise on inpatient wards in the United States: Incidence, outcomes, and factors associated with in-hospital mortality. Resuscitation. 2016;105:123-129.