Scriven A J, Cobbe S M
Department of Medical Cardiology, Royal Infirmary, Glasgow.
Br Heart J. 1994 Aug;72(2):133-5. doi: 10.1136/hrt.72.2.133.
To establish the incidence and severity of arterial oxygen desaturation during transoesophageal echocardiography performed under light intravenous sedation; to determine which patients are at greatest risk; and to assess the effects of supplementary oxygen treatment.
Prospective study of 150 patients referred for transoesophageal echocardiography.
Echocardiography laboratory in a tertiary cardiothoracic referral centre.
Transcutaneous arterial oxygen saturation.
During transoesophageal echocardiography mean (SD) arterial oxygen saturation (SaO2) fell in 144 of 150 patients (96%) from 95.4%(2.6%) to 90.7%(6.3%) (p < 0.001). Significant hypoxaemia, defined as SaO2 < 90%, was found in 27 of 150 patients (18%); in this group SaO2 fell from 92.9%(3.5%) to 81.8%(9.6%) (p < 0.001), but rose rapidly on oxygen to 95.5%(2.4%) (p < 0.001). Two patients became profoundly hypoxaemic with SaO2 values of 35% and 74%. The principal risk factors for hypoxaemia during transoesophageal echocardiography were mitral valve disease, severe mitral regurgitation, and New York Heart Association symptomatic class III or IV.
Transcutaneous oximetry and supplementary oxygen should be available routinely during transoesophageal echocardiography.
确定在轻度静脉镇静下进行经食管超声心动图检查时动脉血氧饱和度降低的发生率和严重程度；确定哪些患者风险最高；并评估补充氧气治疗的效果。
对150例接受经食管超声心动图检查的患者进行前瞻性研究。
一家三级心胸转诊中心的超声心动图实验室。
经皮动脉血氧饱和度。
在经食管超声心动图检查期间，150例患者中有144例（96%）的平均（标准差）动脉血氧饱和度（SaO2）从95.4%（2.6%）降至90.7%（6.3%）（p<0.001）。150例患者中有27例（18%）出现严重低氧血症，定义为SaO2<90%；在该组中，SaO2从92.9%（3.5%）降至81.8%（9.6%）（p<0.001），但吸氧后迅速升至95.5%（2.4%）（p<0.001）。两名患者出现严重低氧血症，SaO2值分别为35%和74%。经食管超声心动图检查期间低氧血症的主要危险因素是二尖瓣疾病、严重二尖瓣反流以及纽约心脏协会症状分级为III或IV级。
在经食管超声心动图检查期间应常规进行经皮血氧测定并提供补充氧气。
