LETTER
Use of Pulse Oximetry for Assessing Ulnar Collateral Flow
James A. Kruse, MD
15 September 1996 | Volume 125 Issue 6 | Page 522
TO THE EDITOR:
O'Mara and Sullivan [1] report the anecdotal use of pulse oximetry for evaluating collateral patency before radial artery cannulation, and they propose that the technique be called the Sullivan test. Other reports on this use of finger pulse oximetry and pulse transduction have been published, and there is a potentially important distinction between the two methods.
Fuhrman and colleagues [2] found that finger plethysmography could detect abnormal circulatory patterns but that significant changes in blood flow in the hand did not result in decreased oxyhemoglobin saturation as assessed by pulse oximetry. They concluded that "plethysmography can be used to demonstrate palmar collateral circulation, but pulse oximetry cannot." On the basis of results of their own studies, Glavin and Jones [3] recommended that pulse monitors and pulse oximetry not be used together for this purpose.
Notwithstanding the controversy over the necessity of collateral flow assessment in general [4] and the findings of Glavin and Jones [3], it appears that finger pulse detection may have merit for assessing ulnar collateral flow. However, further study is required before pulse oximetry can be routinely recommended for this application.
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Author and Article Information
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Wayne State University, Detroit, MI 48201
1. O'Mara K, Sullivan B. A simple bedside test to identify ulnar collateral flow [Letter]. Ann Intern Med. 1995; 123:637.
2. Fuhrman TM, Pippin WD, Talmadge LA, Reilley TE. Evaluation of collateral circulation of the hand. J Clin Monit. 1992; 8:28-32.
3. Glavin RJ, Jones HM. Assessing collateral circulation in the hand—four methods compared. Anaesthesia. 1989; 44:594-5.
4. Williams T, Schenken JR. Radial artery puncture and the Allen test. Ann Intern Med. 1987; 106:164-5.
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