medicine & public health
The Pulse of Inequality: Investigating Racial Disparities in Pulse Oximetry Readings By Simran Malik
Image courtesy of HemoCue
O
xygen is the most abundant element in the human body, making up 65% of a person’s body mass.1 It is utilized by the cell for various purposes, but a notable function is oxygen’s role in cellular respiration. Without oxygen, cellular respiration cannot be completed; consequently, human cells would not have an adequate amount of ATP to carry out their important functions. Some organs have a greater demand for oxygen, like the brain, heart, and kidneys. In fact, if the brain’s oxygen supply is interrupted for as little as four minutes, permanent brain damage would occur.2 This is because the brain requires oxygen for the metabolism of glucose3 that influences critical brain functions such as thinking, learning, and memory.4 Due to the importance of high oxygen levels, a measurement device called a pulse oximeter provides insight into the amount of oxygen circulating a person’s blood. Unfortunately, pulse oximetry suffers from a fatal flaw: melanin, a
substance in cells that is responsible for skin pigmentation, interferes with the accuracy of oxygen level measurements. The presence of melanin can lead to an overestimation of oxygen levels when the actual values are much lower. Many may find it surprising that this inaccuracy exists considering the importance of pulse oximetry in all aspects of healthcare. Many published articles discuss the problems with pulse oximetry, yet much of the public continues to trust the traditional pulse oximeter to deliver accurate measurements. The problem with this inaccuracy is that it only affects certain populations, and it creates a gap in the precision of healthcare across different racial and ethnic groups. These misleading results may cause patients to not receive adequate treatment for their low oxygen levels. Despite this, there seems to be a surprisingly low urgency in the scientific community towards correcting this problem. Luckily, here at the University of North Carolina at Chapel Hill, Wubin Bai,
66
Ph.D., and his talented research team are working towards solving this ignored problem and eliminating this medical disparity in pulse oximetry. The Bai Lab aims to use fundamental research and translate it to healthcare or environmental impacts. Dr. Bai enjoys his work as he feels that he is essentially a middle ground
Dr. Wubin Bai