Comparison of SpO2 and HR: Apple Watch Ultra vs Masimo SET in pediatric cardiopulmonary patients (Perdomo Paz & Madrid; Respirar 2025)

Cohort: 137 pediatric inpatients (1 mo–17 y, median 6.4 y) with cardiopulmonary disease at Hospital Mario Catarino Rivas; three paired 1-min readings. Reference: Masimo SET pulse oximeter (R2). SpO2: bias 0.97 pp (LoA −3.44 to 5.38); CCC 0.88; Spearman r 0.811.

• Form factor: wrist

Introduction: Accurate monitoring of oxygen saturation (SpO2) and heart rate (HR) is essential in the management of pediatric patients with cardiopulmonary diseases. While commercial pulse oximeters are the standard for noninvasive monitoring, wearable devices such as the Apple Watch Ultra® have gained popularity as potential alternatives. Objective: This study aims to compare the accuracy of oxygen saturation (SpO2) and heart rate (HR) measurements between the Apple Watch Ultra® and conventional commercial pulse oximeters in pediatric patients with cardiopulmonary diseases. Methods: A cross-sectional analytical study was conducted in 137 pediatric patients (1 month to 17 years of age) diagnosed with cardiopulmonary diseases. Measurements were obtained using both the Apple Watch Ultra® and a Masimo SET® pulse oximeter. Lin's concordance correlation coefficient (CCC) and Spearman/Pearson correlation were used to assess agreement and correlation. Results: The CCC for SpO2 measurements was 0.88, indicating high agreement between devices. The CCC for heart rate was 0.99, with a strong correlation (r = 0.986). There were no significant differences in SpO2 values ​​between devices (p = 0.67). Conclusion: Apple Watch Ultra® provides reliable heart rate and SpO2 measurements, making it a reliable alternative in the absence of a pulse oximeter.

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