Berkenbosch John W, Tobias Joseph D
Kosair Children's Hospital, University of Louisville, 571 S Floyd, Suite 332, Louisville, KY 40202, USA.
Respir Care. 2006 Jul;51(7):726-31.
During conditions of poor perfusion, the accuracy of conventional extremity-based pulse oximeters may be limited. Limited evidence suggests that forehead perfusion may be better preserved during such periods, but pediatric experience with newer forehead reflectance sensors is limited. We prospectively compared the accuracy of a forehead reflectance sensor, the Max-Fast, with a new-generation digit sensor in pediatric patients.
Pediatric patients > 10 kg and who had arterial catheters were eligible for enrollment. Blood oxygen saturation was simultaneously measured with forehead and digit sensors, and compared to corresponding CO-oximetry-measured arterial oxygen saturation values (S(aO2)) taken at the same times. We used Bland-Altman analysis to calculate the bias and precision of the forehead sensor and the digit sensor relative to the S(aO2) values.
We obtained 116 sample sets from 28 patients. The S(aO2) values ranged from 84.1% to 99.2%. The bias and precision of the forehead-to-S(aO2) difference were 0.6% and 2.7%, respectively, versus 1.4% and 2.6%, respectively, for the digit-to-S(aO2) difference (p < 0.05). Bias and precision were 0.7% and 2.6% versus 1.7% and 2.3% for the forehead and digit sensors, respectively, (p < 0.05) in patients who received vasoactive medications, compared with 0.5% and 2.8% versus 1.1% and 2.8% (p = not significant), respectively, in patients who did not receive vasoactive medications.
The Max-Fast sensor estimated S(aO2) as accurately as did a new-generation digit sensor in well-perfused pediatric patients.
在灌注不良的情况下，传统的基于肢体的脉搏血氧仪的准确性可能会受到限制。有限的证据表明，在此期间前额灌注可能得到更好的保留，但儿科使用新型前额反射传感器的经验有限。我们前瞻性地比较了儿科患者中前额反射传感器Max-Fast与新一代手指传感器的准确性。
体重>10kg且有动脉导管的儿科患者符合入组条件。同时使用前额和手指传感器测量血氧饱和度，并与同一时间通过共血氧测定法测量的相应动脉血氧饱和度值（S(aO2)）进行比较。我们使用Bland-Altman分析来计算前额传感器和手指传感器相对于S(aO2)值的偏差和精密度。
我们从28名患者中获得了116组样本。S(aO2)值范围为84.1%至99.2%。前额与S(aO2)差值的偏差和精密度分别为0.6%和2.7%，而手指与S(aO2)差值的偏差和精密度分别为1.4%和2.6%（p<0.05）。接受血管活性药物治疗的患者中，前额和手指传感器的偏差和精密度分别为0.7%和2.6%以及1.7%和2.3%（p<0.05），而未接受血管活性药物治疗的患者中，相应的偏差和精密度分别为0.5%和2.8%以及1.1%和2.8%（p=无显著性差异）。
在灌注良好的儿科患者中，Max-Fast传感器估计S(aO2)的准确性与新一代手指传感器相当。
