Comber J T, Lopez B L
Department of Emergency Medicine, Abington Memorial Hospital, PA, USA.
Am J Emerg Med. 1996 Jan;14(1):16-8. doi: 10.1016/S0735-6757(96)90005-4.
This prospective study was done to evaluate the accuracy of pulse oximetry as an indicator of hypoxemia in sickle cell anemia patients presenting to the ED in acute vasoocclusive crisis. Thirteen patients (age older than 18 years) presenting in crisis, with pulse oximetry readings less than 95% had arterial blood gas (ABG) analysis performed. The mean pulse oximetry reading was 91.4% +/- 3.2% (SD); the mean ABG oxygen saturation (ABG O2 sat) was 95.3% +/- 1.4% (SD). The mean O2 sat difference (ABG O2 sat minus pulse oximetry) was 4.5% (P < .001 versus a control group of ED patients receiving ABG and pulse oximetry). Pulse oximetry correlated with ABG O2 sat (r = 0.889, P < .001) and O2 sat difference (r = -0.927, P < .001). No correlation existed between complete blood count, reticulocyte count, historical and physical examination findings, and O2 sat or O2 sat difference. By linear regression, ABG O2 sat = 0.44 (pulse oximetry) + 55.6. This study suggests that pulse oximetry underestimates oxygenation in sickle cell anemia patients presenting in painful crisis.
本前瞻性研究旨在评估脉搏血氧饱和度测定法作为急诊科急性血管阻塞性危机中镰状细胞贫血患者低氧血症指标的准确性。13例处于危机状态、脉搏血氧饱和度读数低于95%的患者（年龄大于18岁）接受了动脉血气（ABG）分析。脉搏血氧饱和度的平均读数为91.4%±3.2%（标准差）；动脉血气氧饱和度（ABG O2 sat）的平均值为95.3%±1.4%（标准差）。平均氧饱和度差异（ABG O2 sat减去脉搏血氧饱和度）为4.5%（与接受ABG和脉搏血氧饱和度测定的急诊科患者对照组相比，P <.001）。脉搏血氧饱和度与ABG O2 sat相关（r = 0.889，P <.001），与氧饱和度差异相关（r = -0.927，P <.001）。全血细胞计数、网织红细胞计数、病史和体格检查结果与氧饱和度或氧饱和度差异之间无相关性。通过线性回归分析，ABG O2 sat = 0.44（脉搏血氧饱和度）+ 55.6。本研究表明，脉搏血氧饱和度测定法低估了处于疼痛危机中的镰状细胞贫血患者的氧合情况。
