Department of General Practice, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht.
Department of Public Health, Healthcare Innovation and Evaluation and Medical Humanities, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht.
Br J Gen Pract. 2023 Apr 27;73(730):e356-e363. doi: 10.3399/BJGP.2022.0224. Print 2023 May.
Pulse oximetry as a home or remote monitoring tool accelerated during the pandemic for patients with COVID-19, but evidence on its use is lacking.
To assess the feasibility of home monitoring by pulse oximetry of patients aged ≥40 years with cardiovascular comorbidity and moderate-to-severe COVID-19.
A primary care-based, open, pilot randomised controlled trial, with nested process evaluation, was undertaken in the Netherlands.
From November 2020 to June 2021, eligible patients presenting to one of 14 participating Dutch general practices were randomly allocated to regular measurement of peripheral oxygen saturation (at least three SpO measurements per day for 14 days) with a validated pulse oximeter or usual care.
All 41 participants (21 intervention, 20 usual care) completed the 45-day follow-up period. Overall, the intervention group performed 97.6% of protocolised measurements; the median daily measurement per participant was 2.7 (interquartile range 1-4). Hypoxemia (SpO <94%) was reported in 10 participants (in 52 measurements); of those, six consulted the GP as instructed. Participants reported a high feeling of safety (0-100 visual analogue scale): 71.8 for the intervention group versus 59.8 for the control ( = 0.09). Primary care consultations were similar across groups: 50 for the intervention versus 51 for the control. Eleven visits by 10 participants were made to the emergency department (eight from the intervention group versus three from usual care), of which six participants were hospitalised (five intervention versus one usual care). No participants were admitted to the intensive care unit or died during follow-up.
Home monitoring of patients with moderate-to-severe COVID-19 by pulse oximetry appeared feasible; adherence was high, patients reported a high feeling of safety, while the number of primary care consultations remained similar to usual care.
脉搏血氧仪作为 COVID-19 患者的家庭或远程监测工具，在大流行期间得到了加速应用，但关于其使用的证据尚缺乏。
评估脉搏血氧仪在家中监测≥40 岁合并心血管合并症和中重度 COVID-19 患者的可行性。
在荷兰开展了一项基于初级保健的开放型试点随机对照试验，其中嵌套了过程评估。
2020 年 11 月至 2021 年 6 月，符合条件的患者从 14 家参与荷兰常规实践的患者中随机分配到使用经过验证的脉搏血氧仪进行外周血氧饱和度的常规测量（14 天内每天至少测量 3 次 SpO ）或常规护理。
所有 41 名参与者（21 名干预组，20 名常规护理组）完成了 45 天的随访期。总体而言，干预组完成了 97.6%的方案化测量；每位参与者的中位数每日测量次数为 2.7（四分位间距 1-4）。报告有 10 名参与者（52 次测量）出现低氧血症（SpO <94%）；其中 6 名按指示咨询了 GP。参与者报告了很高的安全感（0-100 视觉模拟量表）：干预组为 71.8，对照组为 59.8（ = 0.09）。两组的初级保健咨询相似：干预组为 50 次，对照组为 51 次。10 名参与者中有 11 名前往急诊室（8 名来自干预组，3 名来自常规护理组），其中 6 名患者住院（5 名干预组，1 名常规护理组）。在随访期间，没有参与者被收治到重症监护病房或死亡。
使用脉搏血氧仪在家中监测中度至重度 COVID-19 患者似乎是可行的；依从性很高，患者报告安全感很高，而初级保健咨询次数与常规护理相似。
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