Pulse oximetry

Pulse oximetry estimates arterial oxygen saturation noninvasively from wavelength-dependent optical signals that vary with the arterial pulse. A typical sensor combines red and infrared light-emitting diodes with a photodetector. The pulsatile component helps distinguish changing arterial blood contribution from relatively steady tissue and blood contributions; it is not a direct measurement of arterial oxygen partial pressure.

A primary instrument-design note implements 660 nm and 940 nm illumination, a shared photodetector and alternating channel acquisition. It separates pulsatile and steady components before estimating saturation.^[ref] These wavelengths and electronics describe that implementation rather than every possible sensor.

Writing pulsatile and steady signal magnitudes as AC and DC, a common normalized optical quantity isFor original channel values AC${}_{\mathrm{red}}=0.01$, DC${}_{\mathrm{red}}=1.0$, AC${}_{\mathrm{IR}}=0.02$ and DC${}_{\mathrm{IR}}=1.0$, this ratio is 0.5. Halving both red-channel magnitudes leaves the ratio unchanged. This illustrates intensity normalization; it does not determine a saturation without a validated relation between $R$ and saturation.

That relation is experimentally checked against an independent reference. The FDA's technical guidance describes comparing oximeter readings with simultaneous co-oximetry of arterial samples during controlled inspired-oxygen changes in volunteers, and reporting an accuracy statistic.^[ref] Such comparisons test the whole sensor–algorithm measurement chain, rather than only the arithmetic of a two-channel ratio.

One summary is the root mean square differenceFor invented paired errors $-2,0,+2$ percentage points, $A_{\mathrm{rms}}=\sqrt{8/3}\approx 1.63$ percentage points even though mean error is zero. A small mean bias does not guarantee small individual errors.

Motion, weak pulsatile signals and additional absorbing hemoglobin species can invalidate assumptions behind a simple estimate. Pulse oximetry does not measure pH, carbon-dioxide tension or hemoglobin concentration. A stable displayed percentage therefore cannot establish every aspect of ventilation, oxygen content or gas exchange.