Yordan Hristov Georgiev, Felix Neunhoeffer, Michael Hofbeck, Jörg Michel
{"title":"评估两种脉搏血氧仪在患有紫绀型和无紫绀型先天性心脏病婴儿中的准确性。","authors":"Yordan Hristov Georgiev, Felix Neunhoeffer, Michael Hofbeck, Jörg Michel","doi":"10.1111/pan.15017","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Peripherally measured oxygen saturation (SpO<sub>2</sub>) may often differ from arterial oxygen saturation (SaO<sub>2</sub>), measured by co-oximetry, especially within the lower range of oxygen saturations. This can potentially impact clinical decisions and therapy in children with congenital heart disease, as critical hypoxemia might remain unnoticed.</p><p><strong>Aims: </strong>Our aim was to investigate the accuracy of two different pulse oximeters compared to SaO<sub>2</sub> in infants with congenital heart diseases.</p><p><strong>Methods: </strong>Simultaneous recordings of SpO<sub>2</sub>, measured by two different pulse oximeters (Philips IntelliVue X3 Monitor and Nellcor™ OxiMax™), were compared to SaO<sub>2</sub> obtained by arterial blood gas analysis.</p><p><strong>Results: </strong>A total of 153 measurements were performed in 44 infants with arterial oxygen saturation between 70 and 100%. We divided the measurements into 3 subgroups: group 1-SaO<sub>2</sub> 70.0%-85.0%, group 2-SaO<sub>2</sub> 85.1%-94.0%, group 3-SaO<sub>2</sub> >94.1%. For Philipps, the median bias was 5.3 (IQR: 2.6-8.7) %, 2.3 (IQR: 0.9-6.0) % and 1.1 (IQR: -0.8-2.4) % in group 1, 2 and 3, respectively. For OxiMax™, the median bias was 2.7 (IQR: 0.5-5.1) %, 0.2 (IQR: -0.9-2.6) % and -0.5 (IQR: -1.3-0.6) % in group 1, 2 and 3, respectively. Regarding the accuracy of these oximeters, as evaluated with the Accuracy root mean squared index (Arms), it was 9.8 versus 4.5% in group 1, 4.5 versus 2.9% in group 2 and 2.4 versus 1.9% in group 3 for Philipps and OxiMax™, respectively.</p><p><strong>Conclusions: </strong>In lower range saturations between 70% and 85% the accuracy of both pulse oximeters exceeded the threshold of ≤3% recommended by the Food and Drug Administration (FDA). Therefore, peripheral pulse oximetry within the lower range of oxygen saturations should be interpreted with caution in infants with congenital heart diseases, taking into consideration its limitations. Direct co-oximetry should be the preferred method to support clinical decisions in children with cyanotic congenital heart diseases.</p>","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":" ","pages":"1267-1274"},"PeriodicalIF":1.7000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Assessment of accuracy of two pulse oximeters in infants with cyanotic and acyanotic congenital heart diseases.\",\"authors\":\"Yordan Hristov Georgiev, Felix Neunhoeffer, Michael Hofbeck, Jörg Michel\",\"doi\":\"10.1111/pan.15017\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Peripherally measured oxygen saturation (SpO<sub>2</sub>) may often differ from arterial oxygen saturation (SaO<sub>2</sub>), measured by co-oximetry, especially within the lower range of oxygen saturations. This can potentially impact clinical decisions and therapy in children with congenital heart disease, as critical hypoxemia might remain unnoticed.</p><p><strong>Aims: </strong>Our aim was to investigate the accuracy of two different pulse oximeters compared to SaO<sub>2</sub> in infants with congenital heart diseases.</p><p><strong>Methods: </strong>Simultaneous recordings of SpO<sub>2</sub>, measured by two different pulse oximeters (Philips IntelliVue X3 Monitor and Nellcor™ OxiMax™), were compared to SaO<sub>2</sub> obtained by arterial blood gas analysis.</p><p><strong>Results: </strong>A total of 153 measurements were performed in 44 infants with arterial oxygen saturation between 70 and 100%. We divided the measurements into 3 subgroups: group 1-SaO<sub>2</sub> 70.0%-85.0%, group 2-SaO<sub>2</sub> 85.1%-94.0%, group 3-SaO<sub>2</sub> >94.1%. For Philipps, the median bias was 5.3 (IQR: 2.6-8.7) %, 2.3 (IQR: 0.9-6.0) % and 1.1 (IQR: -0.8-2.4) % in group 1, 2 and 3, respectively. For OxiMax™, the median bias was 2.7 (IQR: 0.5-5.1) %, 0.2 (IQR: -0.9-2.6) % and -0.5 (IQR: -1.3-0.6) % in group 1, 2 and 3, respectively. Regarding the accuracy of these oximeters, as evaluated with the Accuracy root mean squared index (Arms), it was 9.8 versus 4.5% in group 1, 4.5 versus 2.9% in group 2 and 2.4 versus 1.9% in group 3 for Philipps and OxiMax™, respectively.</p><p><strong>Conclusions: </strong>In lower range saturations between 70% and 85% the accuracy of both pulse oximeters exceeded the threshold of ≤3% recommended by the Food and Drug Administration (FDA). Therefore, peripheral pulse oximetry within the lower range of oxygen saturations should be interpreted with caution in infants with congenital heart diseases, taking into consideration its limitations. Direct co-oximetry should be the preferred method to support clinical decisions in children with cyanotic congenital heart diseases.</p>\",\"PeriodicalId\":19745,\"journal\":{\"name\":\"Pediatric Anesthesia\",\"volume\":\" \",\"pages\":\"1267-1274\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2024-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Pediatric Anesthesia\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1111/pan.15017\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/10/4 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"ANESTHESIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pediatric Anesthesia","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/pan.15017","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/10/4 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}
Assessment of accuracy of two pulse oximeters in infants with cyanotic and acyanotic congenital heart diseases.
Background: Peripherally measured oxygen saturation (SpO2) may often differ from arterial oxygen saturation (SaO2), measured by co-oximetry, especially within the lower range of oxygen saturations. This can potentially impact clinical decisions and therapy in children with congenital heart disease, as critical hypoxemia might remain unnoticed.
Aims: Our aim was to investigate the accuracy of two different pulse oximeters compared to SaO2 in infants with congenital heart diseases.
Methods: Simultaneous recordings of SpO2, measured by two different pulse oximeters (Philips IntelliVue X3 Monitor and Nellcor™ OxiMax™), were compared to SaO2 obtained by arterial blood gas analysis.
Results: A total of 153 measurements were performed in 44 infants with arterial oxygen saturation between 70 and 100%. We divided the measurements into 3 subgroups: group 1-SaO2 70.0%-85.0%, group 2-SaO2 85.1%-94.0%, group 3-SaO2 >94.1%. For Philipps, the median bias was 5.3 (IQR: 2.6-8.7) %, 2.3 (IQR: 0.9-6.0) % and 1.1 (IQR: -0.8-2.4) % in group 1, 2 and 3, respectively. For OxiMax™, the median bias was 2.7 (IQR: 0.5-5.1) %, 0.2 (IQR: -0.9-2.6) % and -0.5 (IQR: -1.3-0.6) % in group 1, 2 and 3, respectively. Regarding the accuracy of these oximeters, as evaluated with the Accuracy root mean squared index (Arms), it was 9.8 versus 4.5% in group 1, 4.5 versus 2.9% in group 2 and 2.4 versus 1.9% in group 3 for Philipps and OxiMax™, respectively.
Conclusions: In lower range saturations between 70% and 85% the accuracy of both pulse oximeters exceeded the threshold of ≤3% recommended by the Food and Drug Administration (FDA). Therefore, peripheral pulse oximetry within the lower range of oxygen saturations should be interpreted with caution in infants with congenital heart diseases, taking into consideration its limitations. Direct co-oximetry should be the preferred method to support clinical decisions in children with cyanotic congenital heart diseases.
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Devoted to the dissemination of research of interest and importance to practising anesthetists everywhere, the scientific and clinical content of Pediatric Anesthesia covers a wide selection of medical disciplines in all areas relevant to paediatric anaesthesia, pain management and peri-operative medicine. The International Editorial Board is supported by the Editorial Advisory Board and a team of Senior Advisors, to ensure that the journal is publishing the best work from the front line of research in the field. The journal publishes high-quality, relevant scientific and clinical research papers, reviews, commentaries, pro-con debates, historical vignettes, correspondence, case presentations and book reviews.
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