Aust Hansjörg, Kranke Peter, Eberhart Leopold H J, Afshari Arash, Weber Frank, Brieskorn Melanie, Heine Julian, Arndt Christian, Rüsch Dirk
Department of Anaesthesia and Intensive Care, University Hospital Giessen-Marburg, Marburg Campus, Baldingerstrasse, 35033, Marburg, Germany,
J Clin Monit Comput. 2015 Jun;29(3):415-26. doi: 10.1007/s10877-014-9620-4. Epub 2014 Sep 25.
In Germany it is common practice to use pulse oximetry and supplementary oxygen only on request in patients breathing spontaneously transferred to the post-anaesthesia care unit (PACU) following surgery under general anaesthesia. The main aim was to study the influence of medical training and clinical experience on assessing SpO(2) and detecting hypoxaemia in these patients. The second aim was to do a preliminary assessment whether this practice can be found in countries other than Germany. Anaesthetists, nurses and medical students estimated SpO(2) in patients breathing room air at the end of transfer to the PACU following surgery (including all major surgical fields) under general anaesthesia. Estimated SpO(2) was compared to SpO(2) measured by pulse oximetry. A survey was carried out among European anaesthesists concerning the use of pulse oximetry and supplementary oxygen during patient transfer to the PACU. Hypoxaemia (SpO(2) < 90 %) occurred in 154 (13.5 %) out of 1,138 patients. Anaesthetists, nurses, and medical students identified only 25, 23, and 21 patients of those as being hypoxaemic, respectively. Clinical experience did not improve detection of hypoxaemia both in anaesthetists (p = 0.63) and nurses (p = 0.18). Use of pulse oximetry and supplemental oxygen during patient transfer to the PACU in European countries differs to a large extent. It seems to be applied only on request in many hospitals. Considering the uncertainty about deleterious effects of transient, short lasting hypoxaemia routine use of pulse oximetry is advocated for patient transfer to the PACU.
在德国，对于在全身麻醉手术后自主呼吸并转入麻醉后护理单元（PACU）的患者，通常仅在有需求时才使用脉搏血氧饱和度测定法和补充氧气。主要目的是研究医学培训和临床经验对评估这些患者的SpO₂及检测低氧血症的影响。第二个目的是初步评估除德国外的其他国家是否也存在这种做法。麻醉医生、护士和医学生对全身麻醉手术后（包括所有主要手术领域）转入PACU的患者在呼吸室内空气时的SpO₂进行了估计。将估计的SpO₂与通过脉搏血氧饱和度测定法测得的SpO₂进行比较。针对欧洲麻醉医生开展了一项关于在患者转入PACU期间使用脉搏血氧饱和度测定法和补充氧气的调查。1138例患者中有154例（13.5%）出现低氧血症（SpO₂<90%）。麻醉医生、护士和医学生分别仅识别出其中25例、23例和21例为低氧血症患者。临床经验并未提高麻醉医生（p = 0.63）和护士（p = 0.18）对低氧血症的检测能力。在欧洲国家，患者转入PACU期间脉搏血氧饱和度测定法和补充氧气的使用情况差异很大。在许多医院似乎仅在有需求时才使用。考虑到短暂、持续时间短的低氧血症的有害影响存在不确定性，主张在患者转入PACU时常规使用脉搏血氧饱和度测定法。
