Pulse Oximetry as screening tool for L'E'A'D

1
Pulse Oximetry as screening tool for L.E.A.D
2
Two Studies have been conducted comparing Pulse
Oximetry with ABPI

• Parameswaran et al Arch Intern Med Feb 2005
  Vol1654 442-446
• Johansson et al Diabetic Medicine April
  2002 Vol 94 307-310

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Results of 2005 study

• Tested 57 people with Type II Diabetes
• Exclusions
• Age lt40
• Known LEAD
• Any symptoms of LEAD
• Results 31 had LEAD defined as Monophasic
  waveform of lower extremity arteries on Doppler
  waveform analysis

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Comparison of two methods in 2005 study

• ABPI
• Sensitivity 63
• Specificity 97
• LEAD diagnosed with result less lt 0.9

• Pulse Oximetry
• Sensitivity 77
• Specificity 97
• LEAD diagnosed if toe 2 less than finger when
  supine or if toe SpO2 dropped 2 on foot
  elevation of 12 inches

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Conclusions of Study

• Pulse Oximetry of Toes seems as accurate as ABPI
  to screen for LEAD in patients with Type II
  Diabetes

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Discussion Point

• Does Pulse Oximetry provide a more convenient
  method than ABPI in assessing whether referral
  should be made to the Vascular Team?
• Problem Device doesnt fit all shape toes.
• Plus Point Alternative of ABPI gives false
  results of good pressures due to arterial
  calcification