Patient Safety Presentation

Oxygen Monitoring: Brain versus Finger-Tip

John M. Murkin MD, FRCPC, FCAI(hon)

Presented September 5th, 2018 at APSF Stoelting Conference 2018


  1. Narcotic-induced respiratory depression (NIRD) may be exacerbated by oxygen supplementation.(1)
  2. Supplemental oxygen minimizes change in SpO2 associated with NIRD rendering detection by pulse relatively oximetry insensitive and delayed.(1)
  3. Currently there is no data on sensitivity of brain (ScO2) and tissue (StO2) oximetry towards NIRD in presence of supplemental oxygen.(2)
  4. There is some expectation StO2 may exhibit a proportionally greater decrease than SpO2 during acute hypoxia potentially enhancing sensitivity.(3)
  5. Integrated multimodality monitoring (capnography, SpO2, StO2) may offer highest sensitivity for detection of NIRD.(4)
  6. StO2 may offer longitudinal triage and prognostic information on patient outcomes.(5)


Oxygen Monitoring Brain versus Finger-Tip – [PDF]


John M. Murkin MD, FRCPC, FCAI(hon)

John M. Murkin MD, FRCPC, FCAI(hon)

Dr. Murkin is currently full Senate Professor of Anesthesia, previous Director of Cardiac Anesthesiology, Director of Cardiac Anesthesiology Research, and past Chair of Department of Anesthesiology Research Committee at University of Western Ontario in London Canada.

His most recent ongoing peer-funded investigations focus on both the role of near infrared spectroscopy (NIRS) for assessment of cerebral oxygenation, as well as novel investigations on the impact of early sepsis on NIRS-detected microcirculatory vasoreactivity and tissue oxygenation. As a clinical scientist he has published over 150 peer reviewed papers with more than 9000 total citations having an h-index of 41 and i10-index of 108.

He is a member of the Protocol Review Committee of National Heart Lung and Blood Institute assessing funding priorities for cardiac surgical studies. More recently he has also become an invited participant in the NIH panel assessing grant proposals investigating therapeutic strategies in traumatic brain injury. Dr. Murkin has also been a panelist on the AHA Emerging Science Series webcast. As a founding member, he has recently been elected President of MiECTiS, a new multidisciplinary society dedicated to optimizing physiologically-based cardiopulmonary bypass and evolving circulatory technologies.