Freund P R, Overand P T, Cooper J, Jacobson L, Bosse S, Walker B, Posner K L, Cheney F W
Department of Anesthesiology, University of Washington School of Medicine, Seattle.
J Clin Monit. 1991 Jul;7(3):253-8. doi: 10.1007/BF01619270.
Since pulse oximetry is now an ASA standard for intraoperative monitoring, we sought to determine the intraoperative failure rate for this device. We prospectively evaluated the intraoperative failure rate of our pulse oximeters at the four University of Washington Hospitals (University of Washington Medical Center, Veterans Affairs Medical Center [VAMC], Children's Hospital and Medical Center, and Harborview Medical Center [HMC]) recorded from April 1989 to August 1989. We defined failure as the inability to obtain any oximetry reading for a cumulative period of more than 30 minutes during any anesthetic procedure after all equipment malfunctions had been eliminated. Our puse oximeters failed in 124 of 11,046 cases studied; this is a failure rate of 1.12%, which ranged from 0.56% at HMC to 4.24% at VAMC. The failure rate at VAMC (4.24%) was significantly higher than the other hospitals (p less than 0.001). Those cases associated with the pulse oximeter failure had the following characteristics: (1) an ASA status of 3 or higher, (2) lengthy operations, and (3) elderly patients. When the device did fail in a patient, it did not function for 32% of the mean anesthesia time. We conclude that the intraoperative use of the pulse oximetry can provide information about blood oxygen saturation in most patients. However, in approximately 1% of the patients we studied in the operating room, mechanically functioning pulse oximeters failed to provide readings of blood oxygen saturations during routine operative use.
由于脉搏血氧饱和度测定现已成为美国麻醉医师协会（ASA）术中监测的一项标准，我们试图确定该设备的术中故障率。我们前瞻性评估了1989年4月至1989年8月在华盛顿大学的四家医院（华盛顿大学医学中心、退伍军人事务医疗中心[VAMC]、儿童医院和医疗中心以及海港景医疗中心[HMC]）记录的脉搏血氧仪的术中故障率。我们将故障定义为在排除所有设备故障后，在任何麻醉过程中累计超过30分钟无法获得任何血氧饱和度读数。在研究的11046例病例中，我们的脉搏血氧仪有124例出现故障；故障率为1.12%，范围从HMC的0.56%到VAMC的4.24%。VAMC的故障率（4.24%）显著高于其他医院（p小于0.001）。与脉搏血氧仪故障相关的病例具有以下特征：（1）ASA分级为3级或更高，（2）手术时间长，（3）老年患者。当该设备在患者中出现故障时，其在平均麻醉时间的32%内无法正常工作。我们得出结论，术中使用脉搏血氧饱和度测定法可为大多数患者提供有关血氧饱和度的信息。然而，在我们在手术室研究的大约1%的患者中，机械功能正常的脉搏血氧仪在常规手术使用期间未能提供血氧饱和度读数。
