Wax David B, Rubin Philip, Neustein Steven
Department of Anesthesiology, Mount Sinai School of Medicine, 1 Gustave L. Levy Place, Box 1010, New York, NY 10029, USA.
Anesth Analg. 2009 Dec;109(6):1847-9. doi: 10.1213/ANE.0b013e3181bbc446.
New reflectance pulse oximetry probes placed on the forehead may be an improvement over transmittance probes placed on a finger, toe, or earlobe in patients with compromised perfusion. We compared the reliability and accuracy of the 2 types of probes in patients undergoing vascular surgery.
Patients with peripheral vascular disease undergoing vascular surgery under general anesthesia were monitored with both a transmittance earlobe probe and a reflectance forehead probe. Spo(2) was recorded continuously from both probes, and arterial blood gas samples were analyzed when clinically indicated. The average values from both probes over each minute were compared using Bland-Altman analysis.
Twenty patients were included yielding a total of 3993 1-min averaged data pairs. Neither probe failed to report a value for more than 1 min. A Bland-Altman plot showed the limits of agreement between the probes of -4.0% to +2.6%. Twenty-eight arterial blood samples were analyzed for 14 patients and Sao(2) closely matched both Spo(2) probe values at the time of sampling. Compared with Sao(2), analysis demonstrated limits of agreement of -4.7% to 6.1% for ear and -3.3% to 3.4% for forehead sites.
The new reflectance forehead Spo(2) probe tested has acceptable agreement with the older transmittance probe placed on the earlobe for pulse oximetry within typical ranges of Spo(2) in patients undergoing vascular surgery.
对于灌注受损的患者，置于前额的新型反射式脉搏血氧饱和度探头可能比置于手指、脚趾或耳垂的透射式探头有所改进。我们比较了这两种类型探头在接受血管手术患者中的可靠性和准确性。
对全身麻醉下接受血管手术的外周血管疾病患者，同时使用透射式耳垂探头和反射式前额探头进行监测。连续记录两个探头的SpO₂，临床指征明确时分析动脉血气样本。使用Bland-Altman分析比较两个探头每分钟的平均值。
纳入20例患者，共产生3993对1分钟平均数据。两个探头均未出现超过1分钟无读数的情况。Bland-Altman图显示两个探头之间的一致性界限为-4.0%至+2.6%。对14例患者的28份动脉血样本进行分析，采样时SaO₂与两个SpO₂探头值密切匹配。与SaO₂相比，分析显示耳垂部位的一致性界限为-4.7%至6.1%，前额部位为-3.3%至3.4%。
在接受血管手术患者的典型SpO₂范围内，测试的新型反射式前额SpO₂探头与置于耳垂的老式透射式探头在脉搏血氧饱和度测量方面具有可接受的一致性。
