Pulse Ox Reports - REAL Desaturations

Can someone tell me what to look for on a waveform chart to indicate a real oxygen desaturation and not be passed off as an artifact? What I'm asking is if the chart shows a drop in oxygen, what would the pulse rate do? Go up or go down?

The best explanation to your question is to watch this Flash Presentation from Resmed. Note how it simply explains and illustrates fluctuation of heart rate corresponding to different sleep breathing patterns.


http://www.resmed.com/us/multimedia/und ... 40x380.swf

Also, generate your SP02 report and post it. Let others on the forum take a look. If your using a data enabled machine, generate your reports that correspond to your SP02 report for that day.

Take care,

SG

SuperGeeky wrote:Also, generate your SP02 report and post it. Let others on the forum take a look. If your using a data enabled machine, generate your reports that correspond to your SP02 report for that day.SG

I can do that and might try to post it later today (don't have time right this second to scan it). The reason I'm asking is that every time there's a serious desatuation AND the pulse rate goes way up, my doctor says it's an artifact and not a real desaturation. I was just wondering if someone could tell me quickly what to expect in the pulse rate for an actual oxygen desat.

Here's the report. I want to point out that I realize the report itself indicates artifacts. But I've seen a similar pattern and the report indicates NO artifacts. Sorry about the report being crooked. I had it right on my scanner, but it just kept coming out crooked --

The pulse rate can increase or decrease with a desaturation. However if the pulse rate is WAY out of normal limits we might dismiss it as artifact. The trending of your oxygen saturation may be more important. A few brief random desats might be ok to ignore but frequent desats could be an indication of a problem. Also respiratory events followed by severe desats or desats that resolve with pressure changes? These might be a more reliable indication of your oxygen status. I hope this helps your understanding.

Thank you for this information. From what you're saying, I would almost need to get a report from the ventilator to see what it was doing during that period to see if the pulse ox report is accurate or what we're seeing is an artifact. That's the problem because I haven't been able to determine IF I can get the DirectView program. My DME will not run one for me unless my doctor orders it.

The low oxygen/high pulse rate that shows on this report is something I see frequently on almost every pulse ox we do. The one from the DME had it too. My doctor dismissed it as an artifact, but when I told her I remember waking up at that time, she noted it.

I was just trying to figure out if I should be looking at these more closely or just dismissing them.

Bumping because I was hoping for a little more input. Like I've said -- I see this pattern on almost every pulse ox test we do, both from the DME and mine. Always a slight dip, but not usually below 88, but almost always one huge dip with a corresponding spike in pulse rate.

Madalot wrote:Bumping because I was hoping for a little more input. Like I've said -- I see this pattern on almost every pulse ox test we do, both from the DME and mine. Always a slight dip, but not usually below 88, but almost always one huge dip with a corresponding spike in pulse rate.

It looks like it might be movement artifact because it is so out of line with the rest of the report. If you have recorded this multiple time it's hard to say? Also noted only about 1.5% of the time as below 90% so it appears the software has excluded this period of time probably as artifact because it looks longer than 1.5%?

I got those types of spikes when the CMS 50D clip was sliding around my finger & losing good contact. I got some Velcro and taped a peice around the cord and my finger to help stabilize the clip and those patterns stopped. I did not have wakeups that I remembered during those periods.

Big Daddy RRT,RPSGT wrote:

Madalot wrote:Bumping because I was hoping for a little more input. Like I've said -- I see this pattern on almost every pulse ox test we do, both from the DME and mine. Always a slight dip, but not usually below 88, but almost always one huge dip with a corresponding spike in pulse rate.

It looks like it might be movement artifact because it is so out of line with the rest of the report. If you have recorded this multiple time it's hard to say? Also noted only about 1.5% of the time as below 90% so it appears the software has excluded this period of time probably as artifact because it looks longer than 1.5%?

This is very possible. Usually, the report lists no artifacts, but on this particular one, it did. I'm guessing that for the reasons you stated, my doctor is also considering them artifacts, even if the report isn't necessarily indicating that.

Muse-Inc wrote:I got those types of spikes when the CMS 50D clip was sliding around my finger & losing good contact. I got some Velcro and taped a peice around the cord and my finger to help stabilize the clip and those patterns stopped. I did not have wakeups that I remembered during those periods.

The clip on this is extremely tight. As a matter of fact, my finger is usually fairly numb by morning. I've been known to need to switch fingers during the night but this has only happened once or twice and the drop/spike happens almost every time I test.

I guess I'll just consider it nothing to worry about and let it go. Thanks for the input!!

Madalot, you've gotten lots of input, but perhaps if I provide my own experience it might help. As you note, you can move about and see some desaturation events. I tend not to worry about the short events. However, when I have problems with desaturations, I tend to see a graph that looks like the following:



As you can see at the end of the event, I seem to have an increased heart rate. I know from when I did not have my ASV unit, I felt as if my body pumped a whole lot of adrenaline into my blood stream. Fight or Flight. I assume that's exactly what happened in an attempt to awaken me enough to break the cycle that's leading to the apnea.

I also tend to look for mask leaks at the same time. And if there is a reported desaturation, but I don't see that increase in heart rate, then I tend to ignore the event. It might in fact be a desaturation, but it is not enough to significantly disturb my sleep.

But remember, this is just my experience. Your body might have learned a different trick (such as leg movement) to awaken you.

I hope that helps.

Thanks John --

For that input and sharing one of your reports for me to see. I think you're right though -- a couple of desats that don't last long aren't worth being concerned over. And I think on the report I posted, that one massive drop probably WAS an artifact. I wish the report summary wouldn't count the artifacts and include them as the Minimum oxygen level. The report said that my minimum was 59, but that's also from that point that appears to be an artifact. The other desat was probably right at 88%, but again, it didn't last more than a few seconds, so probably not worth being too concerned over.

I guess I'll plan to keep doing what I've been doing -- checking 2-3 times a week and watching for any pattern that might indicate a possible problem creeping up.

Thank you again.