Jensen L A, Onyskiw J E, Prasad N G
Faculty of Nursing, University of Alberta, Edmonton, Canada.
Heart Lung. 1998 Nov-Dec;27(6):387-408. doi: 10.1016/s0147-9563(98)90086-3.
The purposes of the study were to: (1) describe the aggregate strength of the relationship of arterial oxygen saturation as measured by pulse oximetry with the standard of arterial blood gas analysis as measured by co-oximetry, (2) examine how various factors affect this relationship, and (3) describe an aggregate estimate of the bias and precision between oxygen saturation as measured by pulse oximetry and the standard in vitro measures.
A meta-analysis was conducted.
Seventy-four studies from 1976 to 1994 met the inclusion criteria of: (1) adult study population, (2) quantitative analysis of empirical data, and (3) bivariate correlations or bias and precision estimates between pulse oximeter and co-oximeter values.
There were a total of 169 oximeter trials on 41 oximeter models from 25 different manufacturers. Studies were conducted in various settings with a variety of subjects, with most being healthy adult volunteers. The weighted mean r, based on 39 studies (62 oximeter trials) for which the r statistic and number of data points were available, was 0.895 (var [r] = 0.014). Based on 23 studies (82 oximeter trials) for which bias and precision estimates and number of data points were available, the mean absolute bias and precision were 1.999 and 0.233, respectively. Several factors were found to affect the accuracy of pulse oximetry.
Pulse oximeters were found to be accurate within 2% (+/- 1 SD) or 5% (+/- 2 SD) of in vitro oximetry in the range of 70% to 100% Sao2. In comparing ear and finger probes, readings from finger probes were more accurate. Pulse oximeters may fail to record accurately the true Sao2 during severe or rapid desaturation, hypotension, hypothermia, dyshemoglobinemia, and low perfusion states.
本研究的目的是：（1）描述通过脉搏血氧饱和度测定法测得的动脉血氧饱和度与通过共血氧测定法测得的动脉血气分析标准之间关系的总体强度；（2）研究各种因素如何影响这种关系；（3）描述通过脉搏血氧饱和度测定法测得的血氧饱和度与体外标准测量值之间偏差和精密度的总体估计。
进行了一项荟萃分析。
1976年至1994年的74项研究符合以下纳入标准：（1）成年研究人群；（2）对实证数据进行定量分析；（3）脉搏血氧仪和共血氧仪值之间的双变量相关性或偏差及精密度估计。
共有来自25个不同制造商的41种血氧仪型号的169次血氧仪试验。研究在各种环境中对各种受试者进行，大多数是健康成年志愿者。基于39项研究（62次血氧仪试验）（可获得r统计量和数据点数量）的加权平均r为0.895（var[r]=0.014）。基于23项研究（82次血氧仪试验）（可获得偏差和精密度估计以及数据点数量），平均绝对偏差和精密度分别为1.999和0.233。发现几个因素会影响脉搏血氧测定法的准确性。
发现在70%至100%的动脉血氧饱和度（Sao2）范围内，脉搏血氧仪在体外血氧测定的2%（±1标准差）或5%（±*2标准差）范围内是准确的。在比较耳部和手指探头时，手指探头的读数更准确。在严重或快速去饱和、低血压、体温过低、血红蛋白异常血症和低灌注状态下，脉搏血氧仪可能无法准确记录真实的Sao2。
