评估 COVID-19 患者无声低氧血症的预测因素和频率，以及脉搏血氧仪与动脉血气水平之间的差距：一项横断面研究。

Health Care Science Pub Date : 2024-06-17 DOI:10.1002/hcs2.98

Mohammad Javad Fallahi, Fatemehsadat Pezeshkian, Keivan Ranjbar, Rojan Javaheri, Reza Shahriarirad

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引用次数: 0

摘要

背景：无声低氧血症是指患者在氧气饱和度低得惊人的情况下没有呼吸困难。它可能导致患者病情迅速恶化，死亡率升高，因此及时发现并确定预测因素可显著改善预后。本研究旨在记录 COVID-19 患者无声低氧血症的证据及其临床特征：方法：本研究共纳入 78 名确诊感染 COVID-19 的住院非插管患者。用脉搏血氧仪（PO）测量他们的血氧饱和度，并采集动脉血气（ABG）。记录了人口统计学和临床特征。采用博格量表评估呼吸困难状况，得分低于 2 分且血氧饱和度低于 94% 的患者被标记为沉默性缺氧。利用单变量分析评估变量之间的相关性及其几率比（OR）和 95% 置信区间（CI）：20名参与者（25.6%）出现了静默性低氧血症。PO 和 ABG 方法之间的平均差异为 4.36 ± 3.43。根据回归分析，呼吸困难和呼吸频率与 PO 和 ABG 之间的氧气饱和度差异有显著的统计学相关性（OR：2.05；p = 0.026；95% CI：0.248-3.847 和 OR：0.144；p = 0.048，95% CI：0.001-0.286）。此外，博格量表（OR：0.29；P = 0.009；95% CI：0.116-0.740）与静默性低氧血症有显著的反向相关性：无声低氧血症可能是影响部分 COVID-19 患者的并发症之一。结论：无声低氧血症可能是影响部分 COVID-19 患者的并发症，对年轻人和患有潜在神经或精神疾病的患者应给予更多关注。此外，呼吸频率、脉搏血氧计和动脉血气中的氧气水平也应一并考虑。

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Evaluation of the predictors and frequency of silent hypoxemia in COVID-19 patients and the gap between pulse oximeter and arterial blood gas levels: A cross-sectional study

Background

Silent hypoxemia is when patients do not experience breathing difficulty in the presence of alarmingly low O₂ saturation. It could cause rapid deterioration and higher mortality rates among patients, so prompt detection and identifying predictive factors could result in significantly better outcomes. This study aims to document the evidence of silent hypoxemia in patients with COVID-19 and its clinical features.

Methods

A total of 78 hospitalized, nonintubated patients with confirmed COVID-19 infection were included in this study. Their O₂ saturation was measured with a pulse oximeter (PO), and arterial blood gas (ABG) was taken. Demographic and clinical features were recorded. The Borg scale was used to evaluate dyspnea status, and patients with a score of less than two accompanied by O₂ saturation of less than 94% were labeled as silent hypoxic. Univariate analysis was utilized to evaluate the correlation between variables and their odds ratio (OR) and 95% confidence interval (CI).

Results

Silent hypoxemia was observed in 20 (25.6%) of the participants. The average difference between the PO and ABG methods was 4.36 ± 3.43. Based on regression analysis, dyspnea and respiratory rate demonstrated a statistically significant correlation with the O₂ saturation difference between PO and ABG (OR: 2.05; p = 0.026; 95% CI: 0.248–3.847 and OR: 0.144; p = 0.048, 95% CI: 0.001–0.286). Furthermore, the Borg scale (OR: 0.29; p = 0.009; 95% CI: 0.116–0.740) had a significant reverse correlation with silent hypoxia.

Conclusions

Silent hypoxemia can be a possible complication that affects some COVID-19 patients. Further care should be bestowed upon the younger population and those with underlying neurological or mental illnesses. Furthermore, the respiratory rate, pulse oximeter, and arterial blood gas O₂ levels should be considered alongside each other.

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