Home Medizin Studie zeigt rassistische Voreingenommenheit bei Pulsoximeter-Messwerten für Patienten mit schwarzer Herzinsuffizienz

Studie zeigt rassistische Voreingenommenheit bei Pulsoximeter-Messwerten für Patienten mit schwarzer Herzinsuffizienz

von NFI Redaktion

A study by Michigan Medicine has found that racially biased measurements of blood oxygen levels using pulse oximeters may further limit the opportunities for Black patients with heart failure to receive potentially life-saving treatments, such as heart pumps and transplants.

„This is particularly important as we know that Black patients already receive heart pumps or transplants less frequently than their white counterparts, and these inaccurate measurements can exacerbate an inequality that needs to be addressed by our healthcare system,“ said Scott W. Ketcham, MD, third-year fellow in cardiovascular medicine at the University of Michigan Health.


Scott W. Ketcham, MD, Erstautor, Fellow im dritten Jahr für Herz-Kreislauf-Medizin an der University of Michigan Health

During the COVID-19 pandemic, UM researchers found that pulse oximeters—devices attached to the finger to measure blood oxygen levels indirectly—may not provide accurate readings for Black patients.

Providers of heart failure use pulse oximeter measurements to make decisions on medication management and determine whether patients are candidates for heart transplantation or left ventricular assist devices, known as LVADs, which help pump blood through the heart.

In a study of adult heart failure patients treated between 2016 and the end of 2022 in the medical and surgical intensive care units for heart failure at UM Health, researchers found that pulse oximeter measurements underestimated how much blood was being pumped from a patient’s heart and overestimated vascular resistance.

The results are published in Circulation: Cardiovascular Quality and Outcomes.

„These inaccurate measurements may not only exclude Black patients from being candidates for LVADs or heart transplants, but could also lead to unnecessary use of medications that impair heart and vascular function,“ said co-author Matthew C. Konerman, MD, a heart failure cardiologist at UM Health Frankel Cardiovascular Center.

On February 2, 2024, the U.S. Food and Drug Administration held a public advisory committee meeting to discuss approaches to improving methods for evaluating the performance of pulse oximeters with regard to skin pigmentation, race, and ethnicity.

If changes are evaluated and considered, the results should, according to the research team, prompt heart failure providers to rethink their treatment strategies.

„For our Black patients with heart failure, we need to either measure oxygen saturation directly in the blood or use other methods to measure hemodynamics when using them as a guide for treating these patients,“ said lead author Sarah K. Adie, PharmD, BCCP, a clinical pharmacy specialist in cardiology at UM Health and adjunct clinical assistant professor at UM College of Pharmacy.

Source:

Michigan Medicine – University of Michigan

Journal reference:

Ketcham, SW, et al. (2024) Racial bias in pulse oximetry measurement: considerations in patients with heart failure. Circulation: Cardiovascular Quality and Outcomes. doi.org/10.1161/CIRCOUTCOMES.123.010390.

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