在评估急性哮喘时，动脉血气分析还是血氧饱和度？
Arterial blood gas analysis or oxygen saturation in the assessment of acute asthma?
作者信息
Carruthers D M, Harrison B D
机构信息
Department of Respiratory Medicine, West Norwich Hospital, UK.
出版信息
Thorax. 1995 Feb;50(2):186-8. doi: 10.1136/thx.50.2.186.
BACKGROUND
A study was undertaken to determine if arterial blood gas estimation is always necessary in the assessment of patients presenting to hospital with acute severe asthma, or whether oxygen saturation as measured by pulse oximetry is a reliable screening test for predicting those in respiratory failure.
METHODS
A prospective study was conducted in a specialist respiratory medical unit. Arterial blood gas tensions and pulse oximetry were measured in 89 consecutive patients admitted with acute severe asthma. Respiratory failure was defined as PaO2 < 8.0 kPa or PaCO2 > 6 kPa.
RESULTS
When oxygen saturation was 92% or higher (72 patients) respiratory failure was found in three (4.2%) cases. In the 82 patients with a saturation of 90% or higher six patients (7.3%) had respiratory failure.
CONCLUSIONS
In the initial assessment of acute severe asthma an oxygen saturation of > 92% suggests that respiratory failure is unlikely and therefore arterial blood gas measurement is unnecessary. This study is only relevant to the assessment of asthmatic patients at presentation. Other parameters of severity must be continually assessed in all asthmatic patients admitted to hospital irrespective of the initial SaO2, and blood gases measured when clinically indicated.
背景
开展了一项研究，以确定在评估因急性重度哮喘入院的患者时，动脉血气分析是否始终必要，或者通过脉搏血氧饱和度测定法测得的血氧饱和度是否是预测呼吸衰竭患者的可靠筛查测试。
方法
在一个专业呼吸内科病房进行了一项前瞻性研究。对89例因急性重度哮喘入院的连续患者进行了动脉血气张力和脉搏血氧饱和度测定。呼吸衰竭定义为动脉血氧分压（PaO2）<8.0千帕或动脉血二氧化碳分压（PaCO2）>6千帕。
结果
当血氧饱和度为92%或更高时（72例患者），3例（4.2%）出现呼吸衰竭。在血氧饱和度为90%或更高的82例患者中，6例（7.3%）出现呼吸衰竭。
结论
在急性重度哮喘的初始评估中，血氧饱和度>92%表明呼吸衰竭的可能性不大，因此无需进行动脉血气测定。本研究仅适用于哮喘患者就诊时的评估。对于所有入院的哮喘患者，无论初始血氧饱和度如何，都必须持续评估其他严重程度参数，并在临床指征明确时进行血气测定。
Zotero 插件