Hypoxaemia definition in childhood based on arterial oxygen saturation obtained with a pulse oximeter: a retrospective study.

IF 3.2 3区 医学 Q1 PEDIATRICS
Nicole Beydon, Bamodi Simaga, Hayat Hammiche, Benjamin Dudoignon, Jessica Taytard, Plamen Bokov, Christophe Delclaux
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Abstract

Objective: Using normal pulse oximetry (SpO2) values as basis, an oxygen saturation <98% could reflect hypoxaemia in childhood. The objectives were to define the level of SpO2 associated with hypoxaemia, the prevalence of SpO2 <98% in children suffering from chronic diseases referred to pulmonary function testing units.

Setting: Two university paediatric hospitals.

Design and patients: We retrospectively selected arterialised blood gas (ABG) analyses and SpO2 recordings, and further recorded pulmonary function test (PFT) indices (z-scores of forced expiratory volume at 1 s (FEV1), forced vital capacity (FVC), FEV1/FVC and total lung capacity) of visits with SpO2<98% (Radical-7 pulse oximeter, Masimo).

Results: The Bland-Altman analysis of saturations (n=1188) showed that SpO2 overestimated arterialised saturation (bias: +1.3%, precision: ±1.1%). The 20 ABGs with SpO2≤95% showed hypoxaemia (z-score of arterialised pressure of O2<-1.96), while 48/74 (65%) ABGs with SpO2 of 96% or 97% showed hypoxaemia. Three thousand eight hundred twenty-four PFTs were recorded in 2641 children (1186 girls, 1455 boys) with a mean age (±SD) of 12.3±3.5 years. The prevalence of SpO2<98% was 114/2641 children (4.3%, 95% CI 3.6 to 5.2), showing that hypoxaemia was mainly observed in chronic obstructive diseases (96 children). Twelve children had SpO2≤95% and all had ventilatory defects (based on international definitions of PFT).

Conclusions: An oxygen saturation ≤95%, using the Masimo oximeter, is indicative of hypoxaemia and PFT abnormalities, while oxygen saturation of 96% or 97% indicates possible hypoxaemia. Thus, chronic respiratory insufficiency can confidently be diagnosed if repeated SpO2 is ≤95% using the Masimo oximeter.

根据脉搏血氧计获得的动脉氧饱和度来定义儿童低氧血症:一项回顾性研究。
目的:以正常脉搏血氧饱和度(SpO2)值为基础,分析血氧饱和度与低氧血症的相关性,探讨SpO2的患病率。设计和患者:我们回顾性选择动脉化血气(ABG)分析和SpO2记录,并进一步记录SpO2患者的肺功能试验(PFT)指数(1秒用力呼气量(FEV1)、用力肺活量(FVC)、FEV1/FVC和总肺活量的z评分)。结果:Bland-Altman饱和度分析(n=1188)显示,SpO2高估了动脉化饱和度(偏差:+1.3%,精度:±1.1%)。SpO2≤95%的20例abg为低氧血症(O22动脉化压z-score为96%或97%)。2641名儿童(1186名女孩,1455名男孩)共记录了3824例pft,平均年龄(±SD)为12.3±3.5岁。SpO22患病率≤95%,且均存在通气缺陷(基于国际上对PFT的定义)。结论:Masimo血氧计血氧饱和度≤95%提示低氧血症和PFT异常,96%或97%提示可能存在低氧血症。因此,使用Masimo血氧计,如果重复SpO2≤95%,则可以确定诊断为慢性呼吸功能不全。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
5.80
自引率
3.80%
发文量
291
审稿时长
3-6 weeks
期刊介绍: Archives of Disease in Childhood is an international peer review journal that aims to keep paediatricians and others up to date with advances in the diagnosis and treatment of childhood diseases as well as advocacy issues such as child protection. It focuses on all aspects of child health and disease from the perinatal period (in the Fetal and Neonatal edition) through to adolescence. ADC includes original research reports, commentaries, reviews of clinical and policy issues, and evidence reports. Areas covered include: community child health, public health, epidemiology, acute paediatrics, advocacy, and ethics.
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