Department of Plastic Surgery, RWTH-University Hospital Aachen, Germany.
Inhal Toxicol. 2009 Nov;21(13):1144-7. doi: 10.3109/08958370902839754.
Invasive measurement of carboxyhemoglobin (COHb) by blood gas analysis (BGA) is accepted as the standard diagnostic procedure in diagnosis of inhalation injury and carbon monoxide (CO) intoxications. The main disadvantage of BGA with COHb testing is the unavailability in pre-hospital rescue conditions. The non-invasive SpCO analysis using pulse CO oximetry (Rad57, Masimo Corp., USA) represents an easy-to-handle device to facilitate the diagnosis of CO intoxication. Between January 2006 and August 2008, 20 patients who were admitted with CO intoxication to our burn centre were included in this study. Blood gas analysis including COHb testing was performed on the first day, hourly. At the same time, SpCO was determined using the Rad57 pulse CO oximeter. Patients received inhalative oxygen according to the parameters of blood gas analysis or hyperbaric oxygenation if COHb > 10%. Five young healthy volunteers served as control group. The SpCO of the volunteers was cross-checked against their COHb levels, which were measured by blood gas analysis. Results of pulse CO oximetry revealed a mean error of approximately 3.15% from the results achieved by blood gas analysis. If COHb resulted in values higher than 10%, the bias remained approximately the same (3.43%/precision 2.362%). When different blood gas analyzers in our department were tested with the same patient sample, a mean error of 2.4% was found. This is only 1% lower compared to the mean error of pulse CO oximetry. Therefore, pulse CO oximetry represents a reliable measurement technique that is easy to handle and could facilitate the early diagnosis of CO intoxication in pre-hospital rescue conditions.
血液气体分析（BGA）对碳氧血红蛋白（COHb）的侵入性测量被认为是诊断吸入性损伤和一氧化碳（CO）中毒的标准诊断程序。BGA 与 COHb 测试的主要缺点是在院前救援条件下不可用。使用脉冲 CO 血氧仪（Rad57，Masimo 公司，美国）进行的非侵入性 SpCO 分析代表了一种易于操作的设备，可方便诊断 CO 中毒。在 2006 年 1 月至 2008 年 8 月期间，我们烧伤中心收治的 20 名 CO 中毒患者被纳入本研究。第一天进行血液气体分析，包括 COHb 测试，每小时进行一次。同时，使用 Rad57 脉冲 CO 血氧仪测定 SpCO。患者根据血液气体分析的参数接受吸入性氧气治疗，或如果 COHb > 10%，则接受高压氧治疗。5 名年轻健康志愿者作为对照组。志愿者的 SpCO 与他们的 COHb 水平交叉检查，通过血液气体分析测量。脉搏 CO 血氧仪的结果显示，与血液气体分析结果相比，平均误差约为 3.15%。如果 COHb 导致的数值高于 10%，则偏差保持不变（3.43%/精度 2.362%）。当我们部门的不同血液气体分析仪对同一患者样本进行测试时，发现平均误差为 2.4%。这仅比脉搏 CO 血氧仪的平均误差低 1%。因此，脉搏 CO 血氧仪是一种可靠的测量技术，易于操作，可在院前救援条件下方便地早期诊断 CO 中毒。
