Domingo Ch, Canturri E, Luján M, Moreno A, Espuelas H, Marín A
Servei de Pneumologia, Corporació Sanitària Parc Taulí, Sabadell, Barcelona, España.
Arch Bronconeumol. 2006 May;42(5):246-51. doi: 10.1016/s1579-2129(06)60454-0.
To validate a monitor for transcutaneous measurement of oxygen saturation (SpO2) and partial pressure of carbon dioxide (TcPCO2).
This observational study included 140 Caucasian nonsmokers without jaundice. Patients underwent forced spirometry, measurement of SpO2 and TcPCO2 with the SenTec monitor, and arterial blood gas analysis (readings with 2 devices) during the stabilization phase of the monitor. In the statistical analysis, values from the 2 devices for measuring arterial blood gases were compared by mean differences for PaCO2 and oxygen saturation (SaO2). The arithmetic mean of the 2 blood gas measurements was calculated and relations between them and the SpO2 and TcPCO2 were assessed by the Pearson correlation coefficient (r) and the intraclass correlation coefficient (ICC) as a measure of agreement. Bland-Altman analysis was used to test data dispersion.
Ten patients were excluded due to a systematic error in the gas calibrator. The mean (SD) time to stabilization of the monitor before reading was 13.9 (2.4) minutes. The forced expiratory volume in the first second was greater than 80% in 40 patients, between 60% and 79% in 23, between 40% and 59% in 30, and less than 40% in 37. The mean (SD) differences between arterial blood gas measurements were 0.28 (1.0) mm Hg for PaCO2, -0.06% (0.86%) for SaO2, and -0.9 (2.7) mm Hg for PaO2. In the tests for correlation and agreement, r was 0.74 and ICC was 0.73 for SaO2 and SpO2; r was 0.92 and ICC was 0.92 for PaCO2 and TcPCO2. The subgroup analyses did not show any noteworthy differences. The Bland Altman analysis showed no significant dispersion. It was observed that the SenTec monitor underestimated oxygen saturation values by around 1% with respect to SaO2 and overestimated carbon dioxide pressure by 1 mm Hg with respect to PaCO2 values.
The stabilization time recommended for the SenTec monitor before taking a reading is 20 minutes. The overestimates and underestimates by the monitor are not clinically relevant. Finally, the values for SpO2 and TcPCO2 measured by the validated monitor are reliable.
验证一种用于经皮测量氧饱和度(SpO2)和二氧化碳分压(TcPCO2)的监测仪。
这项观察性研究纳入了140名无黄疸的白种非吸烟者。患者在监测仪稳定阶段接受了用力肺活量测定、使用SenTec监测仪测量SpO2和TcPCO2,以及动脉血气分析(用2台设备读数)。在统计分析中,通过比较测量动脉血气的2台设备所测PaCO2和氧饱和度(SaO2)的均值差异。计算2次血气测量的算术平均值,并通过Pearson相关系数(r)和组内相关系数(ICC)评估它们与SpO2和TcPCO2之间的关系,作为一致性的度量。采用Bland - Altman分析来检验数据离散度。
由于气体校准仪存在系统误差,排除了10名患者。读数前监测仪达到稳定的平均(标准差)时间为13.9(2.4)分钟。第一秒用力呼气量在40名患者中大于80%,23名患者在60%至79%之间,30名患者在40%至59%之间,37名患者小于40%。动脉血气测量的平均(标准差)差异为:PaCO2为0.28(1.0)mmHg,SaO2为 - 0.06%(0.86%),PaO2为 - 0.9(2.7)mmHg。在相关性和一致性测试中,SaO2和SpO2的r为0.74,ICC为0.73;PaCO2和TcPCO2的r为0.92,ICC为0.92。亚组分析未显示任何显著差异。Bland - Altman分析未显示明显离散度。观察到SenTec监测仪相对于SaO2低估氧饱和度值约1%,相对于PaCO2值高估二氧化碳分压1mmHg。
建议在使用SenTec监测仪读数前的稳定时间为20分钟。监测仪的高估和低估在临床上不具有相关性。最后,经验证的监测仪所测SpO2和TcPCO2值是可靠的。