The Predictive Value of Pulse Oximeters for Pulse Improvement after Angiography in Infants and Children
Mohammad-Reza Alipour1, Mazyar Rastegar2, Mehdi Ghaderian3
1Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, IR Iran.
Insights
Pulse oximetry effectively detects pulse recovery in children after angiography. This non-invasive tool confirms pulse presence and aids in monitoring recovery, potentially guiding treatment decisions.
Area of Science:
- Pediatric Cardiology
- Medical Imaging
- Vascular Access
Background:
- Pulse oximetry provides vital information on pulse presence and waveform characteristics, especially when direct arterial access is challenging.
- Its utility in post-procedural monitoring, particularly after angiography, warrants further investigation.
Purpose of the Study:
- To evaluate the predictive accuracy of pulse oximeters in identifying improved arterial pulses in pediatric patients following angiography.
- To assess the temporal trends of pulse recovery using pulse oximetry post-angiography.
Main Methods:
- A multi-center, cross-sectional study involving 467 pediatric patients (4 days to 12 years) undergoing angiography.
- Pulse oximetry was utilized to detect pulse curves at 1, 6, and 12 hours post-angiography in cases where palpable pulses were absent in lower extremities.
- Data collected from January 2012 to January 2016.
Main Results:
- Pulse oximetry successfully displayed pulse curves in 319 patients immediately post-angiography.
- A significant correlation was observed between palpable pulses at 6 and 12 hours post-angiography (P < 0.0001).
- High odds of pulse improvement were noted at 12 hours post-catheter angiography: 91.6% (arterial), 100% (venous), and 95.9% (both paths).
Conclusions:
- Pulse oximetry is a valuable tool for immediate post-angiography pulse assessment and monitoring recovery up to 12 hours.
- Findings suggest that pulse oximetry can guide therapeutic decisions, potentially allowing the use of heparin alone instead of thrombolytic agents.
Background:
Information from pulse oximeter waves confirms the presence of a pulse and helps obtain waves from tissue when the supplying artery is not readily accessible.
Objectives:
This study determined the predictive value of pulse oximeters for detecting improved arterial pulses after angiography.
Patients And Methods:
This cross-sectional, multi-center study included 467 4-day-old to 12-year-old patients and was conducted from January 2012 to January 2016. Angiographies were performed on 12-year-old or younger children for various medical reasons using venous, arterial, or both types of paths. The posterior malleolar or dorsalis pedis were palpated in punctured lower extremities. In the absence of a pulse, pulse oximetry was performed to identify pulse curves at 1 hour, 6 hours, and 12 hours after each angiography.
Results:
Pulse oximetry displayed the pulses of 319 patients immediately following each angiography. Of these, 262 patients had palpable pulses at 6 hours after angiography (P < 0.0001), while 57 patients had no palpable pulse. Of these 57 patients, 15 had no palpable pulse at 12 hours after angiography (P < 0.0001). The odds of pulse improvement in children 6 hours after catheter angiography were 76% for the arterial path, 90% for the venous path, and 83.2% for both paths. At 12 hours after catheter angiography, these values increased to 91.6% for the arterial path, 100% for the venous path, and 95.9% for both paths.
Conclusions:
The pulse oximeter can display the pulse curve immediately (1 hour) after angiography and indicate pulse improvement at 12 hours maximally following an angiography. In this case, heparin alone may be used instead of thrombolytic agents.
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