scholarly journals Comparison of Pocket Pulse Oximeter and Standard Pulse Oximeter With ABG Analysis in Critically Ill Patients

2021 ◽  
Author(s):  
Jeswanth Reddy N. ◽  
Kiran H. S. ◽  
B. J. Subhash Chandra ◽  
Basavana Gowdappa H.
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Pulse Oximeter ◽  
Therapeutic Interventions ◽  
Monitoring Device ◽  
Pearson’S Correlation ◽  
Arterial Blood ◽  
Standard Pulse ◽  
Pearson's Correlation ◽  
At Home

Background: Pulse oximetry (SpO2) is a standard monitoring device in patients presenting to EMDs and intensive care units (ICUs). Pocket pulse oximeters (PPOs) are used widely in wards, EMDs, and small hospitals/clinics. These inexpensive PPOs also guide therapeutic interventions. Few studies have evaluated the accuracy of SpO2 in patients presenting to critical care areas vis-à-vis devices like PPO and standard pulse oximeter (SPO). This study becomes extremely relevant in view of the ongoing crisis of the COVID-19 pandemic wherein SpO2 monitoring is very important in hospitals, quarantine centers, small clinics, or even at home.  Methods: Patients presenting to critical areas who underwent arterial blood gases (ABG) analysis on the recommendation of the treating physician between November 2016 and October 2018 were included in this study. Along with the ABG analysis, a simultaneous assessment of SpO2 was done with a single PPO and SPO and all values were noted. Statistical analysis was done using the SPSS v.21.0 for Windows.  Results: The study included 300 patients. We compared the O2 saturations of ABG, SPO, and PPO with respect to sex, different age groups, and at different levels of ABG pCO2, HCO3, and pH in all patients. All parameters were compared using the Pearson’s correlation test; the results showed that ABG O2 saturations were closer to the SPO than the PPO but the differences were not statistically significant as the Pearson’s correlation values for all parameters were >0.8. We also compared the parameters by Bland Altman Plot and all observations were outside 95% CI (confidence interval), which means that there was a good agreement between O2 saturations by all three methods, that is, ABG, SPO, and PPO; however, ABG O2 saturations were closer to SPO than PPO but this difference was not statistically significant. Hence, we conclude that the PPO is a useful tool for reliable monitoring of O2 saturations.  Conclusion: This study highlights that inexpensive and noninvasive PPO can be used as a standard monitoring device with reliability in critically ill patients presenting to EMDs, ICUs, and small hospitals/clinics, quarantine centers, and even at home.

Interpretation of Noninvasive and Invasive Information

2017 ◽  
Author(s):  
Borzoo Farhang ◽  
Erik P Anderson ◽  
Mark P Hamlin
Keyword(s):  
Critically Ill ◽  
Hemodynamic Monitoring ◽  
Critically Ill Patients ◽  
Pulse Contour Analysis ◽  
Pulse Contour ◽  
Response To Therapy ◽  
Contour Analysis ◽  
Central Venous ◽  
Arterial Blood ◽  
Pulmonary Arterial

Traditional, static measures of resuscitation, such as vital signs, central venous pressure, and pulmonary arterial pressure, provide momentary glimpses evolving hemodynamic states. In patients with shock, these measures of resuscitation are poor indicators of response to therapy. As a result, dynamic assessments of cardiovascular status are now used in critically ill patients to facilitate resuscitation. Some of these approaches focus on fluid responsiveness. These assessments allow care to be tailored to each patient’s response to interventions. An evolving aspect of hemodynamic monitoring is evaluation of the adequacy of tissue perfusion and oxygen delivery. In this review, we consider the use of arterial, central venous, and pulmonary arterial blood pressure monitoring; echocardiography; transesophageal Doppler technology; pulse contour analysis; bioimpedance and bioreactance; and partial rebreathing monitoring modalities to assess hemodynamic status in critically ill patients.  This review contains 22 figures, 5 tables, and 38 references. Key words: echocardiography, esophageal Doppler technology, invasive and noninvasive hemodynamic monitoring, pulse contour analysis, shock 

Abstract 339: Capillary Transmitted Light Intensity for the Monitoring of Tissue Perfusion: CLIP Study

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Naoto Morimura ◽  
Tetsuya Sakamoto ◽  
Kyoko Matsumori ◽  
Kohei Takahashi ◽  
Tomoki Doi ◽  
...  
Keyword(s):  
Light Intensity ◽  
Blood Lactate ◽  
Critically Ill Patients ◽  
Pulse Oximeter ◽  
Predictive Value ◽  
Lactate Level ◽  
Tissue Perfusion ◽  
Blood Lactate Level ◽  
Arterial Blood ◽  
Arterial Blood Lactate

Background: We developed a new device for quantifying capillary refill time (CRT) by applying the pulse oximeter principle, and reported the excellent correlation between quantitative CRT (Q-CRT) and tissue hypoperfusion status as represented by arterial blood lactate levels in critically ill patients in the pilot study. Methods: Diagnostic accuracy study was undergone in ICU of a tertiary emergency medical center. While the pulse oxygen saturation sensor was placed on the finger of the patients, transmitted light intensity was measured with a pulse oximeter (OLV-3100, Nihon Kohden Corp., Japan) before start and during compression of the finger. Correlation between delta Ab, defined as the absorbance of light intensity of infra-red (A-ir) minus that of red (A-r), and arterial blood lactate level was analyzed. Results: The delta Ab was analyzed a total of 69 waveforms in 23 patients. The sensitivity, specificity, positive predictive value, and negative predictive value of the delta Ab less than 0.06 for predicting a lactate level more than 2.0 mmol/l were 100%, 93%, 89%, 100%, respectively. Conclusions: The delta Ab was well correlated to high level of blood lactate level in critically ill patients. Further study will confirm to place the delta Ab as one of non-invasive predictors of tissue perfusion status.

scholarly journals Association of Serum Calprotectin Concentrations with Mortality in Critically Ill and Septic Patients

Diagnostics ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. 990
Author(s):  
Theresa H. Wirtz ◽  
Lukas Buendgens ◽  
Ralf Weiskirchen ◽  
Sven H. Loosen ◽  
Nina Haehnsen ◽  
...  
Keyword(s):  
Overall Survival ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
University Hospital ◽  
Therapeutic Interventions ◽  
Neutrophil Granulocytes ◽  
Icu Patients ◽  
Long Term Outcome ◽  
Icu Admission

Background: Calprotectin is present in the cytosol of neutrophil granulocytes and released upon activation. Fecal calprotectin is applied in the clinical management of inflammatory bowel disease whereas serum calprotectin has been discussed as a biomarker in inflammatory disorders. However, its long-term prognostic relevance in critical illness remains unclear. Our aim was to investigate serum calprotectin concentrations as a prognostic biomarker in critically ill and septic patients. Methods: Serum calprotectin concentrations were analyzed in 165 critically ill patients (108 with sepsis, 57 without sepsis) included in our observational study. Patients were enrolled upon admission to the medical intensive care unit (ICU) of the RWTH Aachen University Hospital. Calprotectin concentrations were compared to 24 healthy controls and correlated with clinical parameters, therapeutic interventions, and survival. Results: Serum calprotectin concentrations were significantly increased in ICU patients as well as in septic patients compared to respective controls (p < 0.001 for ICU patients and p = 0.001 for septic patients). Lower calprotectin concentrations were measured in patients with comorbidities i.e., coronary artery disease. Calprotectin concentrations strongly correlated with the C-reactive protein (p < 0.001) and were closely associated to parameters of mechanical ventilation (i.a. inspiratory oxygen fraction, FiO2; p < 0.001). The overall survival was significantly impaired in septic patients with high baseline calprotectin concentrations (p = 0.036). However, patients with increasing calprotectin serum concentrations within the first week of ICU admission showed an improved overall survival (p = 0.009). Conclusions: In summary, serum calprotectin concentrations are significantly increased in critically ill patients with sepsis. High calprotectin concentrations at ICU admission predict long-term mortality risk, whereas increasing calprotectin concentrations are associated with a favorable long-term outcome.

scholarly journals Increased heme catabolism in critically ill patients: correlation among exhaled carbon monoxide, arterial carboxyhemoglobin, and serum bilirubin IXα concentrations

2006 ◽  
Vol 290 (1) ◽  
pp. L114-L119 ◽  
Author(s):  
Hiroshi Morimatsu ◽  
Toru Takahashi ◽  
Kyoichiro Maeshima ◽  
Kazuyoshi Inoue ◽  
Tomoko Kawakami ◽  
...  
Keyword(s):  
Carbon Monoxide ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Linear Regression Analysis ◽  
Multivariate Linear Regression Analysis ◽  
Arterial Blood ◽  
Exhaled Air ◽  
Co Concentration ◽  
Exhaled Carbon Monoxide ◽  
Co Concentrations

It has been reported that exhaled carbon monoxide (CO) concentrations and arterial carboxyhemoglobin (CO-Hb) concentration in blood may be increased in critically ill patients. However, there was no study that examined correlation among amount of CO in exhaled air, CO-Hb concentrations in erythrocytes, and bilirubin IXα (BR) in serum, i.e., the three major indexes of heme catabolism, within the same subject. Here, we examined CO concentrations in exhaled air, CO-Hb concentrations in arterial blood, and BR levels in serum in 29 critically ill patients. Measurements of exhaled CO, arterial CO-Hb, and serum total BR have been done in the intensive care unit. As control, exhaled CO concentration was also measured in eight healthy volunteers. A median exhaled CO concentration was significantly higher in critically ill patients compared with control. There was significant correlation between CO and CO-Hb and CO and total BR level. We also found CO concentrations correlated with indirect BR but not direct BR. Multivariate linear regression analysis for amount of exhaled CO concentrations also showed significant correlation with CO-Hb and total BR, despite the fact that respiratory variables of study subjects were markedly heterogeneous. We found no correlation among exhaled CO, patients’ severity, and degree of inflammation, but we found a strong trend of a higher exhaled CO concentration in survivors than in nonsurvivors. These findings suggest there is an increased heme breakdown in critically ill patients and that exhaled CO concentration, arterial CO-Hb, and serum total BR concentrations may be useful markers in critically ill conditions.

CORRELATION OF VENOUS BLOOD GAS AND PULSE OXIMETRY WITH ARTERIAL BLOOD GAS IN CRITICALLY ILL PATIENTS

2021 ◽  
pp. 1-3
Author(s):  
Sritam Mohanty ◽  
Rangaraj Setlur ◽  
Jyoti Kumar Sinha
Keyword(s):  
Pulse Oximetry ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Venous Blood ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Blood Gas ◽  
Gold Standard Method ◽  
Arterial Blood Gas ◽  
Arterial Blood

Introduction: Arterial blood gas (ABG) analysis is the gold standard method and frequently performed intervention to evaluate acid-base status along with adequacy of ventilation and oxygenation among patients with predominantly critical / acute diseases. Aims And Objectives: The aim of this study is to evaluate the correlation of VBG analysis and pulse oximetry (SpO2) with ABG analysis in critically ill patients. Materials And Methods:Intensive Care Unit (ICU), Command Hospital (Eastern Command), Kolkata, Adult patients requiring arterial blood gas analysis, JAN 2018 –JUNE 2019, 100 critically ill patients and Age – 18yrs and older, Sex – Either sex. Conclusion: In this study population of critically ill patients, pH and pCO2 on VBG analysis correlated with pH and pCO2 on ABG analysis. The SpO2 correlated well with pO2 on ABG analysis

scholarly journals Chloride in intensive care units: a key electrolyte

F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 1930 ◽  
Author(s):  
Ghassan Bandak ◽  
Kianoush B. Kashani
Keyword(s):  
Intensive Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Kidney Injury ◽  
Chloride Content ◽  
Patient Admission ◽  
Critically Ill Patient ◽  
The Past ◽  
Arterial Blood ◽  
Clinical Investigations

Over the past few years, chloride has joined the league of essential electrolytes for critically ill patients. Dyschloremia can occur secondary to various etiologic factors before and during patient admission in the intensive care unit. Some cases are disease-related; others, treatment-related. Chloride abnormalities were shown in animal models to have adverse effects on arterial blood pressure, renal blood flow, and inflammatory markers, which have led to several clinical investigations. Hyperchloremia was studied in several settings and correlated to different outcomes, including death and acute kidney injury. Baseline hypochloremia, to a much lesser extent, has been studied and associated with similar outcomes. The chloride content of resuscitation fluids was also a subject of clinical research. In this review, we describe the effect of dyschloremia on outcomes in critically ill patients. We review the major studies assessing the chloride content of resuscitation fluids in the critically ill patient.

A Practical Approach to Understanding Acid–Base Abnormalities in Critical Illness

2011 ◽  
Vol 24 (1) ◽  
pp. 17-26 ◽  
Author(s):  
Amy L. Dzierba ◽  
Prasad Abraham
Keyword(s):  
Critical Illness ◽  
Problem Solving ◽  
Critically Ill ◽  
Therapeutic Interventions ◽  
Practical Approach ◽  
Blood Gas ◽  
Acid Base ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Base Disorder

Acid−base disorders are common in the critically ill. Arterial blood gas (ABG) analysis is frequently used to identify and manage acid−base disturbances. Using a systematic problem-solving approach to acid−base disturbances will facilitate the identification and assess the progression and severity of the metabolic and respiratory abnormality. The intent of this review is to examine acid−base physiology and regulation, provide a method to evaluate a patient’s acid−base disorder, and provide therapeutic interventions.

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