脉冲氧计,COVID-19和ICU设置中的种族差异
Carmen A T Reep1, Lucas M Fleuren1, Leo Heunks1,2
1Department of Intensive Care, Erasmus Medical Center, Rotterdam, the Netherlands.
Critical care explorations
|August 22, 2024
概括
种族显著影响脉冲氧计的可靠性,增加了黑人和西班牙裔或拉丁裔患者隐藏的低氧症的风险,特别是那些患有COVID-19的患者. 需要进一步的研究来理解和解决这些差异.
科学领域:
- 医疗器械 医疗器械
- 健康差异 在健康上的差异
- 临床诊断 临床诊断 临床诊断
背景情况:
- 脉冲氧计是监测氧和度的关键工具,但其准确性可能因不同种族群体而异.
- 以前的研究表明脉冲氧计读数的潜在偏差,特别是在较深的皮肤色调中.
- 了解这些差异对于公平的患者护理至关重要.
研究的目的:
- 评估比赛对脉冲氧计衍生的氧和 (SpO2) 的可靠性的影响.
- 调查SpO2精度是否受到SpO2范围,COVID-19诊断和重症监护室 (ICU) 入院的影响.
- 为了确定不同种族群体和临床环境中隐藏的低氧血症的风险.
主要方法:
- 一项回顾性队列研究利用了来自国家COVID队列协作 (N3C) 数据库的数据,其中包括来自80个美国机构的8万多名患者.
- 在各种种族群体中分析了SpO2和动脉氧和度 (SaO2) 测量之间的一致性.
- 采用了通用后勤混合效应模型来评估影响隐性低血风险的因素,并考虑了医院级随机效应.
主要成果:
- 在所有种族群体中观察到SpO2和SaO2之间的差异,在黑人患者中发现了最显著的偏差.
- 黑人患者在所有SPO2范围和临床情景中表现出更高的隐性低氧化率.
- 黑人和西班牙裔或拉丁裔患者,以及被诊断为COVID-19的患者中,隐性低氧症的风险增加.
结论:
- 种族是影响脉冲氧计可靠性的重要因素.
- 黑人和西班牙裔或拉丁裔患者,以及因COVID-19住院的人,面临更高的未检测到的低氧化血的风险.
- 需要进一步的研究,以阐明脉冲氧计精度的这些种族差异的原因,并开发有效的干预措施.
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