Article Text

Does pulse oximeter use impact health outcomes? A systematic review
  1. Abigail J Enoch1,
  2. Mike English2,3,
  3. Sasha Shepperd1
  1. 1Nuffield Department of Population Health, University of Oxford, Oxford, UK
  2. 2KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
  3. 3Nuffield Department of Medicine, University of Oxford, Oxford, UK
  1. Correspondence to Abigail J Enoch, Nuffield Department of Population Health, Richard Doll Building, Old Road Campus, Headington, Oxford OX3 7LF, UK; abigail.enoch{at}


Objective Do newborns, children and adolescents up to 19 years have lower mortality rates, lower morbidity and shorter length of stay in health facilities where pulse oximeters are used to inform diagnosis and treatment (excluding surgical care) compared with health facilities where pulse oximeters are not used?

Design Studies were obtained for this systematic literature review by systematically searching the Database of Abstracts of Reviews of Effects, Cochrane, Medion, PubMed, Web of Science, Embase, Global Health, CINAHL, WHO Global Health Library, international health organisation and NGO websites, and study references.

Patients Children 0–19 years presenting for the first time to hospitals, emergency departments or primary care facilities.

Interventions Included studies compared outcomes where pulse oximeters were used for diagnosis and/or management, with outcomes where pulse oximeters were not used. Main outcome measures: mortality, morbidity, length of stay, and treatment and management changes.

Results The evidence is low quality and hypoxaemia definitions varied across studies, but the evidence suggests pulse oximeter use with children can reduce mortality rates (when combined with improved oxygen administration) and length of emergency department stay, increase admission of children with previously unrecognised hypoxaemia, and change physicians’ decisions on illness severity, diagnosis and treatment. Pulse oximeter use generally increased resource utilisation.

Conclusions As international organisations are investing in programmes to increase pulse oximeter use in low-income settings, more research is needed on the optimal use of pulse oximeters (eg, appropriate oxygen saturation thresholds), and how pulse oximeter use affects referral and admission rates, length of stay, resource utilisation and health outcomes.

  • Health services research
  • Outcomes research
  • Paediatric Practice
  • Respiratory
  • Evidence Based Medicine

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See:

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