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How artificial nails with applied nail polish do alter oxygen saturation determined by pulse oximetry


Hinkelbein, J.; Koehler, H.; Fiedler, F.

European Journal of Anaesthesiology (EJA): June 2004 - Volume 21 - Issue - p 42–43
Monitoring: Equipment and Computers

Mannheim University Hospital, Institute of Anesthesiology and Intensive Care Medicine, Mannheim, Germany

Background and Goal of Study: Pulse oximetry is a mandatory technique during peri-operative anesthesia and intensive care medicine to determine functional oxygen saturation. In general, artificial nails do not compromise the measurement in a clinically relevant way [1], whereas nail polish has been reported to cause a significant effect [2]. The combination of both - artificial nails plus nail polish - may lead to incorrect measurements and misinterpretation. So far, data for ventilated critically ill patients with artificial nails and applied nail polish are not available.

Materials and Methods: After approval of the local ethics committee acrylic paste (Resin F®, Wilde Cosmetics, Eltville/Germany) was applied at the third finger of each patients' right hand and hardened. Then black nail polish (ASTOR, Barcelona/Spain) was applied standardized in one layer. Oxygen saturation was simultaneously determined at this finger (psaO2(Ac+NpPO)) and at another finger of the same hand (psaO2(NATPO)) as reference (Siemens SC1281, Danvers/USA and attached Sensor DS-100A, Nellcor, Pleasanton/ USA). The statistical analysis was performed with SAS® (Release 8.02).

Results and Discussions: 25 patients (18 male, 7 female, 57.5 ± 15.1 years old) participated in this study. The mean oxygen saturation at the natural nail (psaO2(NATPO)) was 96.9 ± 2.23% and decreased to 96.6 ± 2.78% (psaO2(Ac+NpPO)) at the finger with the artificial nail and nail polish applied. This resulted in a mean bias of −0.35 ± 1.82% (P = 0.35). Therefore the precision was lower as well (higher standard deviation) but was not statistically different (P > 0.05).

Conclusion(s): Artificial acrylic fingernails in combination with black nail polish do not impair the measurement of oxygen saturation by pulse oximetry clinically relevant. Further on, the indicated mean oxygen saturation is obviously lower with both in contrast to natural nails.

Acknowledgements: We received no financial support to perform this study. Acrylic paste was supplied by Wilde Cosmetics, Germany.

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1 Peters SM. AANA J 1997; 65: 361-363.
    2 Hinkelbein J. Abstracts EuSEM 2003: 62.
      © 2004 European Society of Anaesthesiology