Impact of portable pulse oximetry on arterial blood gas analysis in an urban emergency department

1989 ◽  
Vol 18 (4) ◽  
pp. 458
Author(s):  
S Joseph ◽  
AL Kellermann ◽  
CA Cofer ◽  
BB Hackman
Keyword(s):  
Emergency Department ◽  
Pulse Oximetry ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Blood Gas ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Arterial Blood Gas Analysis ◽  
Urban Emergency Department

scholarly journals Optimization of choice of respiratory support the intensive care severe community-acquired pneumonia.

2018 ◽  
Vol 96 (2) ◽  
pp. 152-157
Author(s):  
Elena A. Borodulina ◽  
G. Yu. Chernogayeva ◽  
B. E. Borodulin ◽  
E. S. Vdoushkina ◽  
L. V. Povalyaeva ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Pulse Oximetry ◽  
Blood Gas Analysis ◽  
Community Acquired Pneumonia ◽  
Gas Analysis ◽  
Respiratory Support ◽  
Blood Gas ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Arterial Blood Gas Analysis

The purpose of study is the optimization of the choice of method of respiratory support in patients with severe community-acquired pneumonia (CAP) on admission to intensive care unit (ICU) on the basis of acid-alkaline indicators and arterial blood gas analysis. Material and methods. Depending on the method of the choice of respiratory support two groups of 350 people were formed. The first group (n = 350) - by the results of pulse oximetry (SatO2). The second group (n = 350) - in terms of acid-base and arterial blood gas analysis (pH, PO2, PCO2). To determine hypoxemia, pulse oximetry (heart monitor GOLDWAY G40), acid-alkali and gas composition of arterial blood (gas analyzer «MEDICA EasyStat») were used. In the ICU there were conducted three types of respiratory support: 1) oxygen therapy via orinasal mask 2) non-invasive mechanical ventilation (respirators «VENTimotion 2» and «Bipap Vision») 3) mechanical ventilation («Engstrom Carestation»). The criterion of effectiveness: recovery performance pulse oximetry, acid-base balance, and arterial blood gas analysis, the presence of positive clinical dynamics. Results. Choice of method of respiratory support in the gas composition of blood allowed to expand the indications for use NIV as a method of respiratory support in the treatment of patients with severe CAP, to ensure timely transfer and reduce the time finding patients on mechanical ventilation, to avoid damage due to hypoxia bodies - «target» with the development of multiple organ failure, and thus 4.3 times to reduce mortality and length of stay in the ICU of 1.7.

scholarly journals Triagem da síndrome hepatopulmonar: oximetria de pulso ou gasometria arterial?/ Hepatopulmonary syndrome screening: pulse oximetry or arterial gasometry?

2019 ◽  
Vol 64 (3) ◽  
pp. 184
Author(s):  
Cláudia Debona Mocelin ◽  
Marina Ribeiro Rocha ◽  
Mariana Poltronieri Pacheco
Keyword(s):  
Liver Transplantation ◽  
Pulse Oximetry ◽  
Hepatopulmonary Syndrome ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Blood Gas ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Arterial Blood Gas Analysis ◽  
Cirrhotic Patients

Objetivo: Avaliar se a realização rotineira da gasometria arterial em todos os pacientes cirróticos pode ser substituída pela oximetria de pulso isolada para a triagem de SHP. Material e métodos: Estudo observacional, individuado e transversal do tipo inquérito, por meio da análise dos prontuários dos pacientes do ambulatório de gastroenterologia e hepatologia do Hospital Santa Casa de Misericórdia de Vitória, localizado na cidade de Vitória - ES, e por meio da análise da gasometria arterial destes pacientes. Como critérios para o diagnóstico de cirrose, foram utilizados a história clínica, o exame físico, a análise laboratorial e pelo menos um exame de imagem.  Resultados: A amostra teve 75,4% de homens, com etiologia alcoólica sendo mais prevalente (53%). A idade média foi de 54 anos, não tendo correlação com a PaO2 (p = 0,754) e com a AaO2 (p = 0,574). A prevalência de pacientes Child A foi de 88,2% e Child B de 11,8%. A maioria (88,2%) dos pacientes apresentaram gradiente AaO2 ≥ 20 mmHg, compatível com critério diagnóstico gasométrico de SHP. Discussão: Não foi observada correlação significativa entre a oxigenação sanguínea medida pela gasometria arterial e pela oximetria de pulso. Pacientes com PaO2 < 60 mmHg apresentaram SatO2 mínima de 93% e mediana de 97%, DP 2,2, comparado com mínima de 85% e mediana de 87%, DP 3,9,  nos pacientes com níveis ≥ 60 mmHg (p = 0,827). Portanto, nota-se que a SatO2 medida pela oximetria de pulso não é um bom parâmetro para triagem de SHP nos pacientes cirróticos. Conclusões: A gasometria arterial é indispensável em todos os pacientes cirróticos para triagem da Síndrome Hepatopulmonar, independente da classe funcional, não podendo ser substituída pela oximetria de pulso. Tal conduta visa acelerar o diagnóstico dessa síndrome, considerando a inexistência de correlação entre os critérios diagnósticos gasométricos já estabelecidos e os valores obtidos na oximetria de pulso e no escore Child-Pugh. Tendo em vista que a Síndrome Hepatopulmonar é uma indicação de transplante hepático, seu diagnóstico precoce pode adiantar o processo, melhorando a resposta terapêutica e a sobrevida dos pacientes.Descritores: Síndrome hepatopulmonar, Cirrose hepática, Transplante de fígado, Oximetria, GasometriaABSTRACTObjective: To evaluate whether routine arterial blood gas analysis in all cirrhotic patients can be replaced by isolated pulse oximetry for HPS screening. Material and methods: Observational, individualized and cross-sectional study, by analyzing the medical records of patients from the gastroenterology and hepatology outpatient clinic of the Santa Casa de Misericórdia de Vitória Hospital, located in the city of Vitória - ES, and by analyzing the laboratory results of the arterial blood gases of these patients. The criteria for the diagnosis of cirrhosis were clinical history, physical examination, laboratory analysis and at least one imaging exam. Results: A total of 75.4% of the sample consisted of males, with alcoholic etiology being more prevalent (53%). The mean age was 54 years, with no correlation with PaO 2 (p = 0.754) and AaO 2 (p = 0.574). The prevalence of Child A patients was 88.2% and of Child B was 11.8%. The majority (88.2%) of the patients presented a AaO2 gradient ≥ 20 mmHg, compatible with HPS gasometric diagnostic criteria.  Discussion: No significant correlation was observed between blood oxygenation as measured by arterial blood gas and pulse oximetry. Patients with PaO2 <60 mmHg had a minimum SatO2 of 93% and a median of 97%, SD 2.2, compared with a minimum of 85% and a median of 87%, SD 3.9, in patients with levels ≥ 60 mmHg (p = 0.827). Therefore, it is noted that SatO2 measured by pulse oximetry is not a good parameter for screening for SHP in cirrhotic patients. Conclusion: Arterial blood gas analysis is indispensable in all cirrhotic patients in screening for Hepatopulmonary Syndrome, regardless of functional class, and cannot be replaced by pulse oximetry. Such conduct aims to accelerate the diagnosis of this syndrome, considering the inexistence of correlation between the already established gasometric diagnostic criteria and the values obtained in pulse oximetry and Child- Pugh score. Since the existence of Hepatopulmonary Syndrome is an indication for liver transplantation, early diagnosis may accelerate the process, improving therapeutic response and survival in patients.Keywords: Hepatopulmonary syndrome, Liver cirrhosisc Liver transplantation, Oximetry, Gasometry

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