American journal of veterinary research2026; 1-9; doi: 10.2460/ajvr.26.04.0147

Continuous Bluetooth pulse oximetry monitoring in conscious and anesthetized horses: a pilot study.

Granacka, V
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Kapaldo, N

Abstract: To assess the feasibility, patient tolerance, and accuracy of a wireless Bluetooth pulse oximeter sensor system on horses for an extended period. Unassigned: A prospective, case-control, unblinded study involved 7 horses at risk of hypoxemia and 7 healthy controls. A wireless Bluetooth transmission sensor was attached to their nostril for a prolonged period. Sensor retention time, patient tolerance, and sensor performance in capturing valid monitoring points were recorded. During the monitoring, 4 samples of arterial blood were collected, and paired measurements (SaO2) and estimations (SpO2) of oxygen hemoglobin saturation were performed. Bland-Altman analysis was used for accuracy assessment. Data are presented as median values and ranges. Unassigned: Monitoring time varied between 28 and 492 minutes (median, 356 minutes), with 11 of 14 horses maintaining the sensor at the end of the observation period. The sensor was well tolerated, and valid captured data were recorded 84.66% to 100% of the time (mean, 98.17%). Forty-nine paired SaO2/SpO2 readings were analyzed, showing that the pulse oximeter overestimated SaO2 (bias, 1.16%; precision, 1.83%). Calculated accuracy root mean square was 2.15%. Unassigned: The Bluetooth pulse oximetry monitoring is well tolerated, easily maintained, and shows good agreement with SaO2 measurements in nonhypoxemic horses. Further studies are needed to assess its performance under circumstances of decreased blood oxygenation. Unassigned: Wireless Bluetooth pulse oximetry can be used in conscious, nonhypoxemic horses at risk of a desaturation event requiring continuous/prolonged oxygenation monitoring as an accurate alternative to blood gas analysis.

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Publication Date: 2026-06-11 PubMed ID: 42276116DOI: 10.2460/ajvr.26.04.0147Google Scholar: Lookup

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Summary

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Overview

This study evaluated the use of a wireless Bluetooth pulse oximeter sensor to continuously monitor oxygen saturation in conscious and anesthetized horses over an extended time period.
The researchers assessed the device’s feasibility, how well horses tolerated it, and its accuracy compared to arterial blood gas measurements.

Study Design

Type: Prospective, case-control, unblinded pilot study.
Subjects: 14 horses; 7 at risk of hypoxemia and 7 healthy control horses.
Device: A wireless Bluetooth pulse oximeter sensor was attached to each horse’s nostril for continuous monitoring.
Monitoring duration: Ranged between 28 and 492 minutes with a median of 356 minutes per horse.

Key Measurements and Procedures

Sensor retention time: Whether or not the sensor remained attached until the end of the observation period (11 out of 14 horses retained the sensor).
Patient tolerance: Evaluated based on the horse’s behavior and acceptance of the attached sensor; the sensor was generally well tolerated.
Data validity: The device successfully captured valid oxygen saturation data 84.66% to 100% of the time, averaging 98.17% across all horses.
Comparison with gold standard: Four arterial blood samples were taken per horse to measure oxygen saturation (SaO2), which served as the reference.
Paired oxygen saturation readings: 49 pairs of invasive (SaO2) and noninvasive (SpO2) oxygen saturation measurements were obtained and compared.

Data Analysis

The Bland-Altman method was used to evaluate the accuracy of the pulse oximeter readings against arterial blood measurements.
Findings showed a slight overestimation of oxygen saturation by the pulse oximeter, with:

Bias (mean difference): 1.16% overestimation.
Precision (standard deviation of differences): 1.83%.
Accuracy root mean square (ARMS): 2.15%, indicating good agreement.

Conclusions and Implications

The wireless Bluetooth pulse oximeter is feasible for continuous monitoring of oxygen saturation in nonhypoxemic horses and in both conscious and anesthetized states.
The sensor is well tolerated by horses and remains in place for extended periods, providing reliable, continuous data.
Accuracy is high, with minimal overestimation compared to arterial blood gas analysis.
The study suggests this technology could serve as a noninvasive alternative to repeated blood sampling for oxygen monitoring in horses at risk for desaturation.
Further research is recommended to assess performance during actual hypoxemic events, since this pilot mostly involved nonhypoxemic horses.

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APA

Granacka V, Kapaldo N. (2026). Continuous Bluetooth pulse oximetry monitoring in conscious and anesthetized horses: a pilot study. Am J Vet Res, 1-9. https://doi.org/10.2460/ajvr.26.04.0147