Department of Anaesthesiology, Singapore General Hospital, Singapore.
Singapore Med J. 2019 Aug;60(8):432-435. doi: 10.11622/smedj.2019031. Epub 2019 Mar 11.
Pulse oximetry is the standard monitoring technique of functional oxygen saturation (SpO). As the use of fingernail polish has been described to alter SpO readings, its removal is commonly recommended prior to measurement. Gel-based manicures have gained popularity in recent years due to their attractiveness and longevity. However, the removal of gel nail polish requires a specialised procedure. Valuable time and resources can be saved if removal can be avoided. To our knowledge, there are no available studies on the effect of gel-based manicures on pulse oximetry readings. Hence, we evaluated the effect with two oximeters, using different technology and wavelength combinations.
17 healthy female adult volunteers were recruited for this single-blind randomised controlled trial. Subjects with hypothermia, hypotension, poor plethysmographic waveform and nail pathology were excluded. Colours tested were: black, purple, navy blue, green, light blue, white, yellow, orange, pink and red. Pulse oximetry was measured at 15- and 30-second intervals using two different pulse oximeters, the Philips M1191BL and Masimo SET®. Means were compared using paired t-tests.
Using the Masimo oximeter, light blue (ΔM = 0.97% ± 0.96%; p = 0.001) and orange (ΔM = 0.76 ± 1.17%; p = 0.016) gel nail polish resulted in a statistically significant increase from baseline SpO readings. With the Philips oximeter, the limits of agreement ranged from 2% for pink to 17% for black, indicating imprecision.
Gel-based manicures can result in overestimations of actual readings, delaying detection of hypoxaemia. Gel nail polish should be routinely removed or an alternative monitoring technique sought.
脉搏血氧饱和度（SpO ）是功能氧饱和度的标准监测技术。由于指甲油的使用已被描述为改变 SpO 读数，因此在测量前通常建议去除指甲油。近年来，凝胶指甲美甲因其吸引力和耐用性而广受欢迎。然而，去除凝胶指甲需要专门的程序。如果可以避免去除指甲油，则可以节省宝贵的时间和资源。据我们所知，目前尚无关于凝胶指甲美甲对脉搏血氧饱和度读数影响的研究。因此，我们使用两种不同技术和波长组合的脉搏血氧计评估了其影响。
这项单盲随机对照试验共招募了 17 名健康的成年女性志愿者。排除体温过低、低血压、血流动力学波形不佳和指甲病理的受试者。测试的颜色有：黑色、紫色、深蓝色、绿色、浅蓝色、白色、黄色、橙色、粉红色和红色。使用两种不同的脉搏血氧计，即飞利浦 M1191BL 和 Masimo SET®，每隔 15 秒和 30 秒测量一次脉搏血氧饱和度。使用配对 t 检验比较平均值。
使用 Masimo 脉搏血氧计，浅蓝色（ΔM = 0.97% ± 0.96%；p = 0.001）和橙色（ΔM = 0.76 ± 1.17%；p = 0.016）凝胶指甲美甲会导致 SpO 基线读数的统计学显著增加。使用飞利浦脉搏血氧计，粉红色的一致性限为 2%，黑色的一致性限为 17%，表明不精确。
凝胶指甲美甲会导致实际读数的高估，从而延迟低氧血症的检测。指甲应该常规去除或寻求替代监测技术。
