Van Ginderdeuren Filip, Van Cauwelaert Karlien, Malfroot Anne
Department of Physiotherapy, Academisch Ziekenhuis, Vrije Universiteit Brussel (VUB), Laarbeeklaan 101, B-1090, Brussels, Belgium.
J Cyst Fibros. 2006 May;5(2):125-8. doi: 10.1016/j.jcf.2006.01.007. Epub 2006 Feb 28.
To determine the influence of digital clubbing on oxygen saturation by pulse oximetry measurements (SpO2) in Cystic Fibrosis patients.
Measuring the arterial oxygen saturation at the fingertip by pulse-oximetry is commonly used in the management of CF patients. In these patients, clinical signs of hyperoxia are often observed with oxygen supplies based on digital oximetry readings. This suggests inaccuracies in the digital measurement method, which in its turn may be caused by digital clubbing. In order to study the influence of digital clubbing, measurements between fingertip and forehead sensor were compared in a clubbing and non-clubbing CF-population. The ear sensor measurements are used as a reference variable.
Two groups were examined. Group 1 consisted of 50 CF patients without digital clubbing (DPD/IPD ratio<1.00). Group 2 consisted of 50 CF patients with digital clubbing (DPD/IPD ratio>1.00). Patients were measured at rest before any treatment and with their daily oxygen supply, if applicable. Saturation was simultaneously measured with three Criticare SpO2 T pulse oximeters, using a fingertip sensor at the right index (transmission oximetry), a forehead sensor at the forehead (reflectance oximetry) and an ear sensor at the right ear.
Using the Bland and Altman method no clear difference was found between the saturation measurements of right ear versus forehead sensor in the two groups. When the measurements of right ear versus fingertip sensor are compared there is still no difference for the non-clubbing group. On the contrary, for the clubbing group lower saturation scores were measured by the fingertip probe compared to the right ear measurement. The differences in saturation became greater as the saturation value at fingertip was lower.
Digital clubbing significantly influences the registrations of the SpO2 measurements by means of a fingertip probe, underestimating the saturation. It can be advised to use the ear sensor as good alternative for these patients.
通过脉搏血氧饱和度测量（SpO2）来确定杵状指对囊性纤维化患者血氧饱和度的影响。
通过脉搏血氧测定法测量指尖动脉血氧饱和度常用于囊性纤维化患者的治疗管理。在这些患者中，基于数字血氧测定读数提供氧气时，常观察到高氧血症的临床体征。这表明数字测量方法存在不准确之处，而这反过来可能是由杵状指引起的。为了研究杵状指的影响，在有杵状指和无杵状指的囊性纤维化人群中比较了指尖传感器和前额传感器的测量结果。耳部传感器测量结果用作参考变量。
检查了两组。第1组由50名无杵状指的囊性纤维化患者组成（DPD/IPD比率<1.00）。第2组由50名有杵状指的囊性纤维化患者组成（DPD/IPD比率>1.00）。患者在接受任何治疗前休息时进行测量，如有必要，使用其日常氧气供应。使用三台Criticare SpO2 T脉搏血氧仪同时测量饱和度，在右手食指使用指尖传感器（透射血氧测定法），在前额使用前额传感器（反射血氧测定法），在右耳使用耳部传感器。
使用布兰德-奥特曼方法，两组中右耳与前额传感器的饱和度测量之间未发现明显差异。当比较右耳与指尖传感器的测量结果时，无杵状指组仍无差异。相反，对于有杵状指组，与右耳测量相比，指尖探头测量的饱和度得分较低。随着指尖饱和度值降低，饱和度差异变得更大。
杵状指通过指尖探头显著影响SpO2测量的记录，低估了饱和度。建议对这些患者使用耳部传感器作为良好的替代方法。
