Hinkelbein Jochen, Genzwuerker Harald V, Sogl Reiner, Fiedler Fritz
University Clinic for Anesthesiology and Intensive Care Medicine, Faculty of Clinical Medicine Mannheim, Ruprecht-Karls-University Heidelberg, University Hospital Mannheim, Mannheim, Germany.
Resuscitation. 2007 Jan;72(1):82-91. doi: 10.1016/j.resuscitation.2006.06.024. Epub 2006 Nov 13.
Nail polish of different colours may alter accuracy and precision of pulse oximetry as previous data in healthy volunteers suggest. This trial evaluates the oxygen saturation determined by pulse oximetry and haematoximetry with nail polish of nine different colours applied.
Fifty critically ill and mechanically ventilated patients in an ICU were investigated in a prospective clinical-experimental trial. On nine finger nails polish of different colours was applied in a predetermined consecutive order. Functional oxygen saturation was determined by pulse oximetry (SpO2) on each finger for each colour with the finger sensor probe both in the normal position and at a 90 degrees rotation. Simultaneously oxygen saturation was determined by haematoximetry (SaO2). Accuracy (bias, DeltaS = SaO2-SpO2) and precision (standard deviation, S.D.) of pulse oximetry were analyzed with the t-test. A value of P < 0.05 was considered significant.
While black (DeltaS = +1.6+/-3.0%), purple (DeltaS = +1.2+/-2.6%) and dark blue nail polish (DeltaS = +1.1+/-3.5%, each N = 50) had the greatest effect (P < 0.05), all other colours, including colourless nail polish, had a smaller effect (mean bias +0.2 to +0.9%). A rotation of 90 degrees reduced the bias from +2.8 to +1.3% (N = 10, n.s.).
Nail polish does not alter pulse oximetry readings in mechanically ventilated patients to a clinically relevant extent. The mean error of measurement for all colours was within the manufacturers' specified range of +/-2%. A 90 degrees rotation of the sensor probe does not eliminate errors in measurement. To remove nail polish might be helpful to decrease the error of measurement in some cases.
正如先前在健康志愿者身上得到的数据所显示的，不同颜色的指甲油可能会改变脉搏血氧饱和度测定的准确性和精确性。本试验评估了在涂抹九种不同颜色指甲油的情况下，通过脉搏血氧饱和度测定法和血液氧含量测定法所测定的血氧饱和度。
在一项前瞻性临床实验性试验中，对重症监护病房（ICU）的50名重症且接受机械通气的患者进行了研究。按照预先确定的连续顺序，在九根手指指甲上涂抹不同颜色的指甲油。对于每种颜色，使用手指传感器探头在正常位置和旋转90度的情况下，通过脉搏血氧饱和度测定法（SpO2）测定每根手指的功能性血氧饱和度。同时，通过血液氧含量测定法（SaO2）测定血氧饱和度。使用t检验分析脉搏血氧饱和度测定法的准确性（偏差，DeltaS = SaO2 - SpO2）和精确性（标准差，S.D.）。P值 < 0.05被认为具有显著性。
黑色（DeltaS = +1.6 +/- 3.0%）、紫色（DeltaS = +1.2 +/- 2.6%）和深蓝色指甲油（DeltaS = +1.1 +/- 3.5%，每组N = 50）的影响最大（P < 0.05），而所有其他颜色，包括无色指甲油，影响较小（平均偏差为 +0.2%至 +0.9%）。旋转90度可使偏差从 +2.8%降至 +1.3%（N = 10，无统计学意义）。
指甲油对机械通气患者脉搏血氧饱和度测定读数的影响在临床上并不显著。所有颜色的平均测量误差均在制造商规定的 +/-2%范围内。传感器探头旋转90度并不能消除测量误差。在某些情况下，去除指甲油可能有助于减少测量误差。
