Reliability, clinical performance and trending ability of a pulse oximeter and pulse co-oximeter, in monitoring blood oxygenation, at two measurement sites, in immobilised white rhinoceros (Ceratotherium simum)

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Authors

Mtetwa, Thembeka Kim
Snelling, Edward P.
Buss, Peter Erik
Donaldson, Ashleigh C.
Roug, Annette
Meyer, L.C.R. (Leith Carl Rodney)

Journal Title

Journal ISSN

Volume Title

Publisher

BMC

Abstract

BACKGROUND: Monitoring blood oxygenation is essential in immobilised rhinoceros, which are susceptible to opioid induced hypoxaemia. This study assessed the reliability, clinical performance and trending ability of the Nonin PalmSAT 2500 A pulse oximeter’s and the Masimo Radical-7 pulse co-oximeter’s dual-wavelength technology, with their probes placed at two measurement sites, the inner surface of the third-eyelid and the scarified ear pinna of immobilised white rhinoceroses. Eight white rhinoceros were immobilised with etorphine-based drug combinations and given butorphanol after 12 min, and oxygen after 40 min, of recumbency. The Nonin and Masimo devices, with dual-wavelength probes attached to the third-eyelid and ear recorded arterial peripheral oxygen-haemoglobin saturation (SpO2) at pre-determined time points, concurrently with measurements of arterial oxygen-haemoglobin saturation (SaO2), from drawn blood samples, by a benchtop AVOXimeter 4000 co-oximeter (reference method). Reliability of the Nonin and Masimo devices was evaluated using the Bland-Altman and the area root mean squares (ARMS) methods. Clinical performance of the devices was evaluated for their ability to accurately detect clinical hypoxemia using receiver operating characteristic (ROC) curves and measures of sensitivity, specificity, and positive and negative predictive values. Trending ability of the devices was assessed by calculating concordance rates from four-quadrant plots. RESULTS: Only the Nonin device with transflectance probe attached to the third-eyelid provided reliable SpO2 measurements across the 70 to 100% saturation range (bias −1%, precision 4%, ARMS 4%). Nonin and Masimo devices with transflectance probes attached to the third-eyelid both had high clinical performance at detecting clinical hypoxaemia [area under the ROC curves (AUC): 0.93 and 0.90, respectively]. However, the Nonin and Masimo devices with transmission probes attached to the ear were unreliable and provided only moderate clinical performance. Both Nonin and Masimo devices, at both measurement sites, had concordance rates lower than the recommended threshold of ≥90%, indicating poor trending ability. CONCLUSIONS: The overall assessment of reliability, clinical performance and trending ability indicate that the Nonin device with transflectance probe attached to the third-eyelid is best suited for monitoring of blood oxygenation in immobilised rhinoceros. The immobilisation procedure may have affected cardiovascular function to an extent that it limited the devices’ performance.

Description

DATA AVAILABITY STATEMENT: The datasets generated and/or analysed during the current study are available in the University of Pretoria data repository, https://figshare. com/s/56087e8a1ba4fb6c1b51.

Keywords

Chemical immobilisation, Oxygen-haemoglobin saturation, Wildlife, SDG-03: Good health and well-being, SDG-15: Life on land, White rhinoceros (Ceratotherium simum), Blood oxygenation, Pulse co-oximeter, Pulse oximeter, Reliability, Clinical performance

Sustainable Development Goals

SDG-03:Good heatlh and well-being
SDG-15:Life on land

Citation

Mtetwa, T.K., Snelling, E.P., Buss, P.E. et al. Reliability, clinical performance and trending ability of a pulse oximeter and pulse co-oximeter, in monitoring blood oxygenation, at two measurement sites, in immobilised white rhinoceros (Ceratotherium simum). BMC Veterinary Research 20, 319 (2024). https://doi.org/10.1186/s12917-024-04179-5.