Gerlif C, Nielsen M D, Thøgersen C, Andersen L I
Thorax-karkirurgisk afdeling T, Odense Universitetshospital.
Ugeskr Laeger. 1995 Jul 3;157(27):3897-900.
The aim of the present study was to evaluate the validity of pulse oximetry screening for prehypoxaemia, to assess the agreement between pulse- and haem-oximetry and to elucidate any influence of peripheral temperature on pulse oximeter measurements. A consecutive prospective study was undertaken in 91 cardiac surgery patients still in treatment with controlled mechanical ventilation in the early postoperative period. We examined arterial oxygen tension (paO2), arterial oxygen saturation (SaO2) and pulse oximeter saturation (SpO2) from 657 arterial blood samples. The sensitivity of the pulse oximeter was 0.83, the specificity 0.73, and the diagnostic specificity was 0.10, at the chosen level of screening. The pulse oximeter showed a tendency to underestimate the oxygen saturation by 0.85%. The agreement between pulse- and haem-oxymetry was found to be good. The authors conclude that the pulse oximeter is acceptable for respiratory screening in postoperative cardiac surgery. The low specificity and the low diagnostic specificity results in frequent false alarms. Low peripheral temperature (down to 25%) do not influence the validity of either methods.
本研究的目的是评估脉搏血氧饱和度测定法筛查低氧血症前期的有效性,评估脉搏血氧饱和度测定法与血气血氧饱和度测定法之间的一致性,并阐明外周温度对脉搏血氧饱和度测定仪测量结果的任何影响。对91例术后早期仍在接受控制性机械通气治疗的心脏手术患者进行了一项连续前瞻性研究。我们从657份动脉血样本中检测了动脉血氧分压(paO2)、动脉血氧饱和度(SaO2)和脉搏血氧饱和度测定仪测得的饱和度(SpO2)。在选定的筛查水平下,脉搏血氧饱和度测定仪的敏感性为0.83,特异性为0.73,诊断特异性为0.10。脉搏血氧饱和度测定仪显示有低估血氧饱和度0.85%的趋势。发现脉搏血氧饱和度测定法与血气血氧饱和度测定法之间的一致性良好。作者得出结论,脉搏血氧饱和度测定仪可用于心脏手术后的呼吸筛查。低特异性和低诊断特异性导致频繁出现误报。低外周温度(低至25%)不会影响这两种方法的有效性。