Detry B, Cambier C, Frans A, Gustin P, Clerbaux T
Department of Internal Medicine, Division of Pneumology, Cliniques Universitaires Saint-Luc, UCL, B-1200 Brussels, Belgium.
Vet J. 2003 May;165(3):258-65. doi: 10.1016/s1090-0233(02)00167-3.
In human and veterinary medicine, arterial and venous haemoglobin oxygen saturations are often used to estimate the severity of a disease and to guide therapeutic decisions. In veterinary medicine, haemoglobin oxygen saturation (SO(2)) is usually calculated using a blood gas analyser and algorithms developed for humans. It is possible, therefore, that the values obtained in animals may be distorted, particularly in animals with a high haemoglobin oxygen affinity, like young calves. In order to verify this hypothesis, we compared the arterial (SaO(2)) and venous (SvO(2)) haemoglobin oxygen saturations calculated using three different algorithms, and the oxygen exchange fraction (OEF) at the tissue level, which is the degree of haemoglobin desaturation between arterial and venous blood (SaO(2)-SvO(2)), with the values obtained from the whole bovine oxygen equilibrium curve (OEC) determined by a reference method. The blood gas analysers underestimated SvO(2) values; consequently, the OEF was overestimated (by about 10%). Two methods of reducing these errors were assessed. As the haemoglobin oxygen affinity decreases during the first month of life in calves a relationship between PO(2) at 50% haemoglobin saturation (P50) and age was established in order to correct the calculated values of venous and arterial SO(2), taking into account the estimated position of the OEC. This method markedly reduced the error for SvO(2) and OEF. Secondly, the SO(2) was calculated using a mathematical model taking into account the age of the animal and the specific effects of pH, PCO(2), and temperature on the bovine OEC. Using this method, the mean difference between the OEF values calculated using the mathematical model and those calculated by the reference method was close to zero. The errors produced by blood gas analysers can thus be minimised in two ways: firstly, by simply introducing a P50 estimated from the age of the calf into the analyser before the measurement; and secondly, by calculating the SO(2) using a mathematical model applied to the bovine OEC.
在人类医学和兽医学中,动脉血和静脉血的血红蛋白氧饱和度常被用于评估疾病的严重程度并指导治疗决策。在兽医学中,血红蛋白氧饱和度(SO₂)通常使用血气分析仪和为人类开发的算法来计算。因此,在动物身上获得的值可能会失真,尤其是在具有高血红蛋白氧亲和力的动物中,如小牛犊。为了验证这一假设,我们比较了使用三种不同算法计算的动脉血(SaO₂)和静脉血(SvO₂)血红蛋白氧饱和度,以及组织水平的氧交换分数(OEF),即动脉血和静脉血之间血红蛋白去饱和的程度(SaO₂ - SvO₂),与通过参考方法确定的整个牛氧平衡曲线(OEC)获得的值。血气分析仪低估了SvO₂值;因此,OEF被高估了(约10%)。评估了两种减少这些误差的方法。由于小牛犊出生后第一个月内血红蛋白氧亲和力会降低,因此建立了50%血红蛋白饱和度时的氧分压(P50)与年龄之间的关系,以便在考虑OEC估计位置的情况下校正静脉血和动脉血SO₂的计算值。这种方法显著降低了SvO₂和OEF的误差。其次,使用一个数学模型计算SO₂,该模型考虑了动物的年龄以及pH、PCO₂和温度对牛OEC的特定影响。使用这种方法,使用数学模型计算的OEF值与参考方法计算的OEF值之间的平均差异接近零。因此,血气分析仪产生的误差可以通过两种方式最小化:首先,在测量前简单地将根据小牛犊年龄估计的P50输入分析仪;其次,使用应用于牛OEC的数学模型计算SO₂。