Perkins Gavin D, McAuley Daniel F, Giles Simon, Routledge Helen, Gao Fang
Intensive Care Unit, Birmingham Heartlands and Solihull NHS Trust (Teaching), Birmingham Heartlands Hospital, Birmingham, UK.
Crit Care. 2003 Aug;7(4):R67. doi: 10.1186/cc2339. Epub 2003 Jun 11.
This study investigates the relation between changes in pulse oximeter oxygen saturation (SpO2) and changes in arterial oxygen saturation (SaO2) in the critically ill, and the effects of acidosis and anaemia on precision of using pulse oximetry to predict SaO2.
Forty-one consecutive patients were recruited from a nine-bed general intensive care unit into a 2-month study. Patients with significant jaundice (bilirubin >40 micromol/l) or inadequate pulse oximetry tracing were excluded.
A total of 1085 paired readings demonstrated only moderate correlation (r= 0.606; P < 0.01) between changes in SpO2 and those in SaO2, and the pulse oximeter tended to overestimate actual changes in SaO2. Anaemia increased the degree of positive bias whereas acidosis reduced it. However, the magnitude of these changes was small.
Changes in SpO2 do not reliably predict equivalent changes in SaO2 in the critically ill. Neither anaemia nor acidosis alters the relation between SpO2 and SaO2 to any clinically important extent.
本研究调查了危重症患者脉搏血氧饱和度（SpO2）变化与动脉血氧饱和度（SaO2）变化之间的关系，以及酸中毒和贫血对使用脉搏血氧测定法预测SaO2准确性的影响。
从一个拥有9张床位的综合重症监护病房连续招募41名患者，进行为期2个月的研究。排除有明显黄疸（胆红素>40微摩尔/升）或脉搏血氧饱和度描记图不充分的患者。
总共1085对读数显示，SpO2变化与SaO2变化之间仅存在中度相关性（r = 0.606；P < 0.01），且脉搏血氧仪往往高估了SaO2的实际变化。贫血增加了正偏差程度，而酸中毒则降低了正偏差程度。然而，这些变化的幅度较小。
在危重症患者中，SpO2变化不能可靠地预测SaO2的等效变化。贫血和酸中毒均未在任何临床上重要的程度上改变SpO2与SaO2之间的关系。
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