胎儿血红蛋白对早产儿脉搏血氧饱和度测定准确性的影响。

Effect of fetal haemoglobin on the accuracy of pulse oximetry in preterm infants.

作者信息

Rajadurai V S, Walker A M, Yu V Y, Oates A

机构信息

Department of Paediatrics, Monash Medical Centre, Melbourne, Victoria, Australia.

出版信息

J Paediatr Child Health. 1992 Feb;28(1):43-6. doi: 10.1111/j.1440-1754.1992.tb02615.x.

DOI:10.1111/j.1440-1754.1992.tb02615.x

PMID:1372809

Abstract

Pulse oximeters are programmed with a calibration curve derived from studies done in adults. Whether fetal haemoglobin levels affect their reliability is unclear. This study reports the accuracy of pulse oximetry in 22 preterm infants (mean 31 weeks, range 25-36 weeks gestation) between 1 h and 73 days of age. Oxygen saturation obtained from a Nellcor N-200 pulse oximeter (SpO2) was compared with simultaneous arterial values (functional SaO2) measured by a Radiometer OSM3 Hemoximeter over a SpO2 range of 83-99%. Fetal haemoglobin (HbF), carboxyhaemoglobin (HbCO) and methaemoglobin (HbMet) measured by the hemoximeter ranged between 0-100%, 0-3.5% and 0-0.8% respectively. Linear regression analysis revealed a close correlation between SpO2 and functional SaO2 (SpO2 = 0.75 SaO2 + 24.43, r = 0.88, P less than 0.001) over a wide range of values for PCV, heart rate, blood pressure, PaO2, PaCO2 and pH. The mean SpO2-SaO2 difference of 1.3, (s.d. 2.5%, P less than 0.001) was unaffected by HgF, HbCO or HbMet but was increased in infants receiving inotropic support. We conclude that the Nellcor N-200 pulse oximeter gives reliable oxygen saturation measurements unaffected by the HbF level in preterm infants.

摘要

脉搏血氧仪采用的校准曲线是根据针对成年人的研究得出的。胎儿血红蛋白水平是否会影响其可靠性尚不清楚。本研究报告了22例孕周为25 - 36周（平均31周）的早产儿在出生后1小时至73天内脉搏血氧测定的准确性。将Nellcor N - 200脉搏血氧仪测得的血氧饱和度（SpO₂）与Radiometer OSM3血氧计同时测得的动脉血氧饱和度（功能性SaO₂）进行比较，SpO₂范围为83% - 99%。血氧计测得的胎儿血红蛋白（HbF）、碳氧血红蛋白（HbCO）和高铁血红蛋白（HbMet）分别在0 - 100%、0 - 3.5%和0 - 0.8%之间。线性回归分析显示，在血细胞比容、心率、血压、动脉血氧分压（PaO₂）、动脉血二氧化碳分压（PaCO₂）和pH值的广泛范围内，SpO₂与功能性SaO₂之间存在密切相关性（SpO₂ = 0.75 SaO₂ + 24.43，r = 0.88，P < 0.001）。SpO₂与SaO₂的平均差值为1.3（标准差2.5%，P < 0.001），不受HbF、HbCO或HbMet影响，但在接受强心药物支持的婴儿中有所增加。我们得出结论，Nellcor N - 200脉搏血氧仪能提供可靠的血氧饱和度测量值，不受早产儿HbF水平的影响。