Race-based and skin pigmentation-related inaccuracies in pulse oximetry have recently been highlighted in several large electronic health record-based retrospective cohort studies across diverse patient populations and healthcare settings. Overestimation of oxygen saturation by pulse oximeters, particularly in hypoxic states, is disparately higher in Black compared to other racial groups. Compared to adult literature, pediatric studies are relatively few and mostly reliant on birth certificates or maternal race-based classification of comparison groups. Neonates, infants, and young children are particularly susceptible to the adverse life-long consequences of hypoxia and hyperoxia. Successful neonatal resuscitation, precise monitoring of preterm and term neonates with predominantly lung pathology, screening for congenital heart defects, and critical decisions on home oxygen, ventilator support and medication therapies, are only a few examples of situations that are highly reliant on the accuracy of pulse oximetry. Undetected hypoxia, especially if systematically different in certain racial groups may delay appropriate therapies and may further perpetuate health care disparities. The role of biological factors that may differ between racial groups, particularly skin pigmentation that may contribute to biased pulse oximeter readings needs further evaluation. Developmental and maturational changes in skin physiology and pigmentation, and its interaction with the operating principles of pulse oximetry need further study. Importantly, clinicians should recognize the limitations of pulse oximetry and use additional objective measures of oxygenation (like co-oximetry measured arterial oxygen saturation) where hypoxia is a concern.

最近，在针对不同患者群体和医疗机构的几项大型基于电子健康记录的回顾性队列研究中，强调了脉搏血氧饱和度中基于种族和皮肤色素沉着相关的误差。与其他种族群体相比，黑人的脉搏血氧计高估血氧饱和度的情况要高得多，特别是在缺氧状态下。与成人文献相比，儿科研究相对较少，并且大多依赖于出生证明或基于母亲种族的比较组分类。新生儿、婴儿和幼儿特别容易受到缺氧和高氧的不良终生后果的影响。成功的新生儿复苏、以肺部病理为主的早产儿和足月新生儿的精确监测、先天性心脏缺陷筛查以及家庭供氧、呼吸机支持和药物治疗的关键决策，只是高度依赖于复苏准确性的情况的几个例子。脉搏血氧仪。未被发现的缺氧，特别是如果某些种族群体存在系统性差异，可能会延迟适当的治疗，并可能进一步加剧医疗保健的差异。不同种族群体之间可能存在差异的生物因素的作用，特别是可能导致脉搏血氧计读数出现偏差的皮肤色素沉着，需要进一步评估。皮肤生理和色素沉着的发育和成熟变化及其与脉搏血氧测定法操作原理的相互作用需要进一步研究。重要的是，临床医生应认识到脉搏血氧测定法的局限性，并在缺氧问题时使用额外的客观氧合测量方法（如协同血氧测定法测量动脉血氧饱和度）。