• Posted February 26, 2024

Faulty Pulse Oximeters Could Worsen Heart Failure in Black Patients

Pulse oximeters, devices that measure your blood's oxygen levels, are known to work less accurately in Black patients.

Now, new research suggests faulty readings might also be worsening the care of Black people who battle heart failure.

The findings could signal a needed shift in heart failure care, said senior study author Dr. Sarah Adie.

"For our Black patients with heart failure, we need to either measure oxygen saturation directly from the blood or use other methods to measure hemodynamics if we are using them to guide treatment of these patients,"said Adie, an adjunct clinical assistant professor at the University of Michigan College of Pharmacy in Ann Arbor. 

The problems around pulse oximeters first surfaced during the pandemic, when experts began to notice faulty readings when the devices were used by darker-skinned patients.

Pulse oximeter readings are especially important in treating heart failure, Adie's group noted, since they're used in decisions involving the need for potentially lifesaving heart transplants or implanted heart pumps.

"We know that Black patients are already less likely to receive heart pumps or transplants compared to their white counterparts, and these inaccurate [oximeter] readings can further widen a disparity that must be addressed by our health care system," study lead author Dr. Scott Ketcham said in a university news release. He's a third year fellow in cardiovascular medicine at University of Michigan Health.  

In the study, Adie, Ketcham and colleagues reviewed the medical histories of adult heart failure patients treated in Michigan's medical and surgical cardiac ICUs between 2016 and late 2022.

They found that, too often, pulse oximeters underestimated rates of heart blood flow in Black patients, and overestimated arterial resistance to blood flow -- both significant factors when doctors are deciding on how to treat heart failure.

The new study was published recently in the journal Circulation: Cardiovascular Quality and Outcomes.

Inaccurate readings could affect the care of Black patients in various ways, study co-author Dr. Matthew Konerman explained.

"In addition to possibly precluding Black patients from being candidates for LVADs [a type of heart pump] or heart transplants, these inaccurate measurements could result in the unnecessary use of medications that affect heart and vessel function,"said Konerman, a heart failure cardiologist at the U-M Health's Frankel Cardiovascular Center.

The U.S. Food and Drug Administration, which oversees and regulates medical devices, is aware of the problem. Earlier this month, the agency convened a public advisory committee meeting focused on new ways to evaluate the performance of pulse oximeters when used by various types of patients.

More information

The U.S. Food and Drug Administration has more on pulse oximeters.

SOURCE: University of Michigan, news release, Feb. 20, 2024