Welsh Emma J, Carr Robin
Population Health Research Institute, St George's, University of London, Cranmer Terrace, London, UK, SW17 0RE.
Cochrane Database Syst Rev. 2015 Sep 27;2015(9):CD011584. doi: 10.1002/14651858.CD011584.pub2.
We became aware through talking with people with asthma that some are using pulse oximeters to monitor their own blood oxygen levels during an asthma attack. Pulse oximeters are marketed by some suppliers as essential equipment for the home medicine cabinet. We wanted to find out if reliable evidence is available on use of pulse oximeters to self monitor asthma exacerbations at home. We decided to include only trials that used pulse oximeters as part of a personalised asthma action plan because it is important that decisions are made on the basis of symptoms as well as oxygen saturation, and that patients have a clear protocol to follow when their asthma worsens.
To determine whether pulse oximeters used as part of a personalised asthma action plan for people with asthma are safer and more effective than a personalised asthma action plan alone.
We searched the Cochrane Airways Group Specialised Register (CAGR), which includes reports identified through systematic searches of bibliographic databases including the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Allied and Complementary Medicine Database (AMED) and PsycINFO, and by handsearching. We also searched ClinicalTrials.gov and the World Health Organization (WHO) trials portal.
We planned to include randomised controlled trials (RCTs). Participants would have included adults, children or both with a diagnosis of asthma. We planned to include trials in which investigators compared participants who used pulse oximeters to monitor oxygen levels at home during an asthma exacerbation as part of a personalised asthma action plan (PAAP) versus those who used a PAAP without a pulse oximeter. We planned to include studies involving people receiving any treatment regimen provided that no medicine was included as part of the randomisation schedule.
We planned to use standard methods as recommended by The Cochrane Collaboration.
We found no studies and no evidence to support or refute the use of home pulse oximetry in self management of asthma; therefore, we can make no recommendations about use of a pulse oximeter as part of a PAAP.
AUTHORS' CONCLUSIONS: We found no reliable data to support or refute patient use of pulse oximeters to monitor oxygen saturation levels when experiencing an asthma attack. People should not use a pulse oximeter without seeking advice from a qualified healthcare professional.We identified no compelling rationale for home monitoring of oxygen levels in isolation for most people with asthma. Some people have a reduced perception of the severity of their own breathlessness when exposed to hypoxia. If trials on self monitoring of oxygen levels in the blood by pulse oximeter at home by people with asthma are conducted, the pulse oximeter must be given as part of a personalised asthma action plan.
通过与哮喘患者交流，我们了解到一些患者在哮喘发作期间使用脉搏血氧仪自行监测血氧水平。一些供应商将脉搏血氧仪作为家庭药箱的必备设备进行销售。我们想查明是否有关于使用脉搏血氧仪在家中自我监测哮喘加重情况的可靠证据。我们决定仅纳入将脉搏血氧仪作为个性化哮喘行动计划一部分的试验，因为基于症状以及血氧饱和度做出决策很重要，而且患者在哮喘恶化时有明确的方案可遵循。
确定作为哮喘患者个性化哮喘行动计划一部分使用的脉搏血氧仪是否比单独的个性化哮喘行动计划更安全、更有效。
我们检索了Cochrane气道组专业注册库（CAGR），其中包括通过对包括Cochrane对照试验中心注册库（CENTRAL）、MEDLINE、EMBASE、护理及相关健康文献累积索引（CINAHL）、补充和替代医学数据库（AMED）以及PsycINFO在内的文献数据库进行系统检索以及手工检索所识别的报告。我们还检索了ClinicalTrials.gov和世界卫生组织（WHO）试验平台。
我们计划纳入随机对照试验（RCT）。参与者将包括诊断为哮喘的成人、儿童或两者皆有。我们计划纳入这样的试验，即研究者比较作为个性化哮喘行动计划（PAAP）一部分在哮喘加重期间在家中使用脉搏血氧仪监测氧水平的参与者与使用无脉搏血氧仪的PAAP的参与者。我们计划纳入涉及接受任何治疗方案的人群的研究，前提是随机分组方案中不包括任何药物。
我们计划使用Cochrane协作网推荐的标准方法。
我们未找到任何研究，也没有证据支持或反驳在家中使用脉搏血氧仪进行哮喘自我管理；因此，我们无法就将脉搏血氧仪作为PAAP的一部分使用给出建议。
我们未找到可靠数据支持或反驳患者在哮喘发作时使用脉搏血氧仪监测血氧饱和度水平。人们在未咨询合格医疗保健专业人员的情况下不应使用脉搏血氧仪。我们未发现大多数哮喘患者单独在家监测氧水平有令人信服的理由。一些人在缺氧时对自身呼吸急促严重程度的感知会降低。如果开展关于哮喘患者在家中通过脉搏血氧仪自我监测血液中氧水平的试验，脉搏血氧仪必须作为个性化哮喘行动计划的一部分提供。
