Carter B G, Carlin J B, Tibballs J, Mead H, Hochmann M, Osborne A
Paediatric Intensive Care Unit, Royal Children's Hospital, Parkville, Melbourne, Victoria, Australia.
Crit Care Med. 1998 Jun;26(6):1128-33. doi: 10.1097/00003246-199806000-00040.
To evaluate the performance of two pulse oximeters in the measurement of arterial hemoglobin saturation in hypoxemic children.
Prospective, repeated-measures observational study.
A 16-bed pediatric intensive care unit in a children's tertiary hospital.
Sixty-six patients with arterial saturation of <90%.
Three arterial blood samples were taken from each subject during a 48-hr period. Pulse oximeter measurements of arterial saturation were compared with arterial saturation determined by cooximetry.
Arterial saturation was measured using one or both pulse oximeters (SpO2) and compared with the arterial hemoglobin saturation determined by cooximetry (SaO2). Sixty-two subjects were studied, using the Ohmeda pulse oximeter giving 185 data points (78 with saturations <75% [defined by the average of pulse oximeter and cooximeter]); 53 subjects were studied, using the Hewlett-Packard pulse oximeter yielding 155 data points (60 with saturations <75%). SpO2 ranged from 24% to 94%. Bias and precision of the Ohmeda pulse oximeter were -2.8% and 4.8% >75% and -0.8% and 8.0% <75%. Bias and precision of the Hewlett-Packard pulse oximeter were -0.5% and 5.1% >75% and 0.4% and 4.6% <75%. Intrapatient regression coefficient (r) for the differences between pulse oximeter and cooximeter was 0.58 for the Ohmeda and 0.59 for the Hewlett-Packard. Regression coefficients for predicting change in cooximeter value given a change in the Ohmeda pulse oximeter were 0.59 and 0.71 <75% and >75%, respectively. Similar coefficients for the Hewlett-Packard pulse oximeter were 0.50 and 0.70, respectively.
The performance of the Ohmeda pulse oximeter deteriorated below an SpO2 of 75%. The Hewlett-Packard pulse oximeter performed consistently above and below an SpO2 of 75%. The ability of both pulse oximeters to reliably predict change in SaO2 based on change in pulse oximetry was limited. We recommend measurement of PaO2 or SaO2 for important clinical decisions.
评估两种脉搏血氧仪在测量低氧血症儿童动脉血红蛋白饱和度方面的性能。
前瞻性、重复测量观察性研究。
一家儿童三级医院的16张床位的儿科重症监护病房。
66例动脉血氧饱和度<90%的患者。
在48小时内从每个受试者采集三份动脉血样本。将脉搏血氧仪测量的动脉血氧饱和度与通过比色法测定的动脉血氧饱和度进行比较。
使用一台或两台脉搏血氧仪（SpO2）测量动脉血氧饱和度，并与通过比色法测定的动脉血红蛋白饱和度（SaO2）进行比较。对62名受试者进行了研究，使用Ohmeda脉搏血氧仪获得了185个数据点（78个饱和度<75%[由脉搏血氧仪和比色法的平均值定义]）；对53名受试者进行了研究，使用惠普脉搏血氧仪获得了155个数据点（60个饱和度<75%）。SpO2范围为24%至94%。Ohmeda脉搏血氧仪在饱和度>75%时的偏差和精密度分别为-2.8%和4.8%，在饱和度<75%时为-0.8%和8.0%。惠普脉搏血氧仪在饱和度>75%时的偏差和精密度分别为-0.5%和5.1%，在饱和度<75%时为0.4%和4.6%。Ohmeda脉搏血氧仪与比色法之间差异的患者内回归系数（r）为0.58，惠普脉搏血氧仪为0.59。当Ohmeda脉搏血氧仪发生变化时，预测比色法值变化的回归系数在饱和度<75%和>75%时分别为0.59和0.71。惠普脉搏血氧仪的类似系数分别为0.50和0.70。
Ohmeda脉搏血氧仪在SpO2低于75%时性能下降。惠普脉搏血氧仪在SpO2高于和低于75%时表现一致。两种脉搏血氧仪根据脉搏血氧测定法的变化可靠预测SaO2变化的能力有限。我们建议在做出重要临床决策时测量PaO2或SaO2。
