在新生儿和小婴儿中,SPO2通过氧储量指数减少的早期预警
Eva Wittenmeier1, Irene Schmidtmann2, Pascal Heese1
1Department of Anesthesiology, University Medical Centre of the Johannes Gutenberg University, Mainz, Germany.
Paediatric anaesthesia
|August 8, 2023
概括
氧气储备指数 (ORI) 提供了一些早期警告婴儿氧气不和,但缺乏足够的敏感性和对PaO2.2的一致性. 因此,ORI不建议作为可靠的早期预警指标,这儿科人口.
科学领域:
- 麻醉学 麻醉学
- 儿科重症监护 儿科重症监护
- 生物医学工程 生物医学工程
背景情况:
- 持续监测患者的氧化量对于安全麻醉至关重要,特别是在新生儿和婴儿.
- 氧气储备指数 (ORI) 是一种新的参数,旨在通过与动脉氧气部分压力 (PaO2) 的关系来评估氧化.
- 早期发现低氧化血症对于预防儿科麻醉期间的不良事件至关重要.
研究的目的:
- 评估ORI提供的临床相关性和预警时间,以评估新生儿和小婴儿即将发生的SpO2 (脉冲氧计血红蛋白和) 降低.
- 评估ORI警报在婴儿全身麻醉期间检测SpO2下降的灵敏度.
- 为了确定ORI和PaO2测量与血液气体分析在这个儿科队列之间的一致性.
主要方法:
- 在全身麻醉期间,在2岁以下的婴儿中持续测量ORI和SpO2.
- 计算不同ORI警报设置的警告时间和灵敏度,以检测SPO2下降.
- 评估ORI和PaO2与血液气体分析结果的一致性.
主要成果:
- 在麻醉期间,ORI为SpO2降低提供了84秒的中位警告时间,灵敏度为55%.
- 在麻醉诱导期间,预警时间为63秒,灵敏度为56%.
- ORI和PaO2间隔之间的一致性很差 (kappa = 0.00),婴儿的体重和身高与ORI的正确PaO2分类相关.
结论:
- 虽然ORI为新生儿和小婴儿的SpO2下降提供了早期警告,但其灵敏度和与PaO2的一致性不足以进行临床建议.
- 该研究表明,ORI在目前的形式中可能不是可靠的早期预警指标,用于检测这个脆弱的年龄组的低氧症.
- 可能需要进一步的研究来完善ORI算法或探索其与儿童麻醉的其他监测参数结合的实用性.
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