Division of Neonatology, Children's Hospital of Philadelphia and University of Pennsylvania, Philadelphia, PA; Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada.
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada.
J Pediatr. 2014 Oct;165(4):666-71.e2. doi: 10.1016/j.jpeds.2014.05.028. Epub 2014 Jun 25.
To compare oxygen saturations as displayed to caregivers on offset pulse oximeters in the 2 groups of the Canadian Oxygen Trial.
In 5 double-blind randomized trials of oxygen saturation targeting, displayed saturations between 88% and 92% were offset by 3% above or below the true values but returned to true values below 84% and above 96%. During the transition, displayed values remained static at 96% in the lower and at 84% in the higher target group during a 3% change in true saturations. In contrast, displayed values changed rapidly from 88% to 84% in the lower and from 92% to 96% in the higher target group during a 1% change in true saturations. We plotted the distributions of median displayed saturations on days with >12 hours of supplemental oxygen in 1075 Canadian Oxygen Trial participants to reconstruct what caregivers observed at the bedside.
The oximeter masking algorithm was associated with an increase in both stability and instability of displayed saturations that occurred during the transition between offset and true displayed values at opposite ends of the 2 target ranges. Caregivers maintained saturations at lower displayed values in the higher than in the lower target group. This differential management reduced the separation between the median true saturations in the 2 groups by approximately 3.5%.
The design of the oximeter masking algorithm may have contributed to the smaller-than-expected separation between true saturations in the 2 study groups of recent saturation targeting trials in extremely preterm infants.
比较加拿大氧试验（Canadian Oxygen Trial）2 组中，偏移脉冲血氧计向护理人员显示的氧饱和度。
在 5 项针对氧饱和度目标的双盲随机试验中，显示饱和度在 88%至 92%之间，偏移量为真实值上下 3%，但低于 84%和高于 96%时则返回真实值。在过渡期间，在真实饱和度变化 3%的情况下，显示值在低值组中保持在 96%不变，在高值组中保持在 84%不变。相比之下，在真实饱和度变化 1%的情况下，显示值在低值组中从 88%快速变为 84%，在高值组中从 92%快速变为 96%。我们在 1075 名加拿大氧试验参与者中，绘制了>12 小时补充氧时的中位数显示饱和度分布，以重建护理人员在床边观察到的情况。
氧饱和度计掩蔽算法与在 2 个目标范围的偏移和真实显示值的末端之间的过渡期间显示饱和度的稳定性和不稳定性增加有关。护理人员在高目标组中维持的显示值低于低值组。这种差异管理使 2 组之间的中位数真实饱和度之间的分离减少了约 3.5%。
氧饱和度计掩蔽算法的设计可能导致了最近在极早产儿饱和度目标试验中，2 个研究组之间的真实饱和度的分离小于预期。
