Nicole Beydon, Bamodi Simaga, Hayat Hammiche, Benjamin Dudoignon, Jessica Taytard, Plamen Bokov, Christophe Delclaux
{"title":"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。","authors":"Nicole Beydon, Bamodi Simaga, Hayat Hammiche, Benjamin Dudoignon, Jessica Taytard, Plamen Bokov, Christophe Delclaux","doi":"10.1136/archdischild-2025-328723","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Using normal pulse oximetry (SpO<sub>2</sub>) values as basis, an oxygen saturation <98% could reflect hypoxaemia in childhood. The objectives were to define the level of SpO<sub>2</sub> associated with hypoxaemia, the prevalence of SpO<sub>2</sub> <98% in children suffering from chronic diseases referred to pulmonary function testing units.</p><p><strong>Setting: </strong>Two university paediatric hospitals.</p><p><strong>Design and patients: </strong>We retrospectively selected arterialised blood gas (ABG) analyses and SpO<sub>2</sub> recordings, and further recorded pulmonary function test (PFT) indices (z-scores of forced expiratory volume at 1 s (FEV<sub>1</sub>), forced vital capacity (FVC), FEV<sub>1</sub>/FVC and total lung capacity) of visits with SpO<sub>2</sub><98% (Radical-7 pulse oximeter, Masimo).</p><p><strong>Results: </strong>The Bland-Altman analysis of saturations (n=1188) showed that SpO<sub>2</sub> overestimated arterialised saturation (bias: +1.3%, precision: ±1.1%). The 20 ABGs with SpO<sub>2</sub>≤95% showed hypoxaemia (z-score of arterialised pressure of O<sub>2</sub><-1.96), while 48/74 (65%) ABGs with SpO<sub>2</sub> 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 SpO<sub>2</sub><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 SpO<sub>2</sub>≤95% and all had ventilatory defects (based on international definitions of PFT).</p><p><strong>Conclusions: </strong>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 SpO<sub>2</sub> is ≤95% using the Masimo oximeter.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":3.2000,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Hypoxaemia definition in childhood based on arterial oxygen saturation obtained with a pulse oximeter: a retrospective study.\",\"authors\":\"Nicole Beydon, Bamodi Simaga, Hayat Hammiche, Benjamin Dudoignon, Jessica Taytard, Plamen Bokov, Christophe Delclaux\",\"doi\":\"10.1136/archdischild-2025-328723\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Using normal pulse oximetry (SpO<sub>2</sub>) values as basis, an oxygen saturation <98% could reflect hypoxaemia in childhood. The objectives were to define the level of SpO<sub>2</sub> associated with hypoxaemia, the prevalence of SpO<sub>2</sub> <98% in children suffering from chronic diseases referred to pulmonary function testing units.</p><p><strong>Setting: </strong>Two university paediatric hospitals.</p><p><strong>Design and patients: </strong>We retrospectively selected arterialised blood gas (ABG) analyses and SpO<sub>2</sub> recordings, and further recorded pulmonary function test (PFT) indices (z-scores of forced expiratory volume at 1 s (FEV<sub>1</sub>), forced vital capacity (FVC), FEV<sub>1</sub>/FVC and total lung capacity) of visits with SpO<sub>2</sub><98% (Radical-7 pulse oximeter, Masimo).</p><p><strong>Results: </strong>The Bland-Altman analysis of saturations (n=1188) showed that SpO<sub>2</sub> overestimated arterialised saturation (bias: +1.3%, precision: ±1.1%). The 20 ABGs with SpO<sub>2</sub>≤95% showed hypoxaemia (z-score of arterialised pressure of O<sub>2</sub><-1.96), while 48/74 (65%) ABGs with SpO<sub>2</sub> 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 SpO<sub>2</sub><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 SpO<sub>2</sub>≤95% and all had ventilatory defects (based on international definitions of PFT).</p><p><strong>Conclusions: </strong>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 SpO<sub>2</sub> is ≤95% using the Masimo oximeter.</p>\",\"PeriodicalId\":8150,\"journal\":{\"name\":\"Archives of Disease in Childhood\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.2000,\"publicationDate\":\"2025-07-30\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Archives of Disease in Childhood\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1136/archdischild-2025-328723\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PEDIATRICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archives of Disease in Childhood","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1136/archdischild-2025-328723","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PEDIATRICS","Score":null,"Total":0}
Hypoxaemia definition in childhood based on arterial oxygen saturation obtained with a pulse oximeter: a retrospective study.
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.
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.