{"doi":"10.1016/j.xjon.2023.02.011","title":"Racial and ethnical discrepancy in hypoxemia detection in patients on extracorporeal membrane oxygenation","abstract":"ObjectiveTo determine whether there is racial/ethnical discrepancy between pulse oximetry (SpO2) and oxygen saturation (SaO2) in patients receiving extracorporeal membrane oxygenation (ECMO).MethodsThis was a retrospective observational study at a tertiary academic ECMO center with adults (>18 years) on venoarterial (VA) or venovenous (VV) ECMO. Datapoints were excluded if oxygen saturation ≤70% or SpO2–SaO2 pairs were not measured within 10 minutes. The primary outcome was the presence of a SpO2–SaO2 discrepancy between different races/ethnicities. Bland–Altman analyses and linear mixed-effects modeling, adjusting for prespecified covariates, were used to assess the SpO2–SaO2 discrepancy between races/ethnicities. Occult hypoxemia was defined as SaO2 <88% with a time-matched SpO2 ≥92%.ResultsOf 139 patients receiving VA-ECMO and 57 patients receiving VV-ECMO, we examined 16,252 SpO2–SaO2 pairs. The SpO2–SaO2 discrepancy was greater in VV-ECMO (1.4%) versus VA-ECMO (0.15%). In VA-ECMO, SpO2 overestimated SaO2 in Asian (0.2%), Black (0.94%), and Hispanic (0.03%) patients and underestimated SaO2 in White (−0.06%) and nonspecified race (−0.80%) patients. The proportion of SpO2–SaO2 measurements considered occult hypoxemia was 70% from Black compared to 27% from White patients (P < .0001). In VV-ECMO, SpO2 overestimated SaO2 in Asian (1.0%), Black (2.9%), Hispanic (1.1%), and White (0.50%) patients and underestimated SaO2 in nonspecified race patients (−0.53%). In linear mixed-effects modeling, SpO2 overestimated SaO2 by 0.19% in Black patients (95% confidence interval, 0.045%-0.33%, P = .023). The proportion of SpO2–SaO2 measurements considered occult hypoxemia was 66% from Black compared with 16% from White patients (P < .0001).ConclusionsSpO2 overestimates SaO2 in Asian, Black, and Hispanic versus White patients, and this discrepancy was greater in VV-ECMO versus VA-ECMO, suggesting the need for physiological studies.","journal":"JTCVS Open","year":2023,"id":357011,"datarank":0.41588830833596724,"base_score":2.772588722239781,"endowment":2.772588722239781,"self_citation_contribution":0.41588830833596724,"citation_network_contribution":0.0,"self_endowment_contribution":0.41588830833596724,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":15,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9524,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":570741,"name":"Benjamin L. Shou","orcid":"0000-0003-2825-3301","position":1,"is_corresponding":false},{"id":1071793,"name":"David Zhao","orcid":"0000-0002-6819-5794","position":2,"is_corresponding":false},{"id":865968,"name":"Christopher Wilcox","orcid":"0000-0002-8456-0552","position":3,"is_corresponding":false},{"id":307606,"name":"Steven P. Keller","orcid":"0000-0002-3870-9811","position":4,"is_corresponding":false},{"id":865972,"name":"Glenn Whitman","orcid":"0000-0003-3225-2360","position":5,"is_corresponding":false},{"id":865971,"name":"Bo Soo Kim","orcid":"0000-0001-6277-7649","position":6,"is_corresponding":false},{"id":510529,"name":"Sung‐Min Cho","orcid":"0000-0002-5132-0958","position":7,"is_corresponding":false},{"id":897987,"name":"Kate Calligy","orcid":null,"position":8,"is_corresponding":false},{"id":897404,"name":"Patricia M. Brown","orcid":"0000-0002-6045-0068","position":9,"is_corresponding":false},{"id":895976,"name":"Diane Alejo","orcid":"0000-0003-2751-9577","position":10,"is_corresponding":false},{"id":29038,"name":"Scott Anderson","orcid":"0000-0002-0331-6129","position":11,"is_corresponding":false},{"id":865969,"name":"Matthew Acton","orcid":"0000-0002-0763-0246","position":12,"is_corresponding":false},{"id":865970,"name":"Hannah Rando","orcid":"0000-0002-6592-930X","position":13,"is_corresponding":false},{"id":668771,"name":"Henry Chang","orcid":null,"position":14,"is_corresponding":false},{"id":865764,"name":"Andrew Kalra","orcid":"0000-0001-8338-019X","position":0,"is_corresponding":true}],"reference_count":47,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T01:13:30.556819Z","pmid":"37425474","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}