Hemoglobin oxygen saturation discrepancy using various methods in patients with sickle cell vaso-occlusive painful crisis
Hemoglobin oxygen saturation discrepancy using various methods in patients with sickle cell vaso-occlusive painful crisis
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DOI：
10.1111/j.1600-0609.2004.00396.x
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发表时间：
2005-04-01
影响因子：
3.1
通讯作者：
Mattana, J
中科院分区：
文献类型：
--
作者：
Ahmed, S;Siddiqui, AK;Mattana, J
目的：评价不同方法测量镰状细胞病（SCD）成人缺氧患者疼痛性血管闭塞危象期间氧合血红蛋白（O（2）Hb）饱和度的一致性，并将这些结果与对照组进行比较。患者和方法：在18例成人血管闭塞危象期间的SCD患者和12例各种心肺诊断的非SCD患者中，通过脉搏血氧饱和度（SpO（2））、一氧化碳血氧饱和度[SO2（功能性氧合血红蛋白饱和度）和FO（2）Hb（氧合血红蛋白分数）]和使用正常O（2）Hb解离曲线计算（SaO（2））同时测定血红蛋白氧饱和度。使用Bland和Altman提出的方法评价两组中各种方法的一致性。结果：SCD患者各种方法之间的平均差异均明显大于对照组。SCD组的一致性限度（LOA）也比对照组宽。SCD患者SpO（2）和SO（2）以及SpO（2）和FO（2）Hb之间的平均偏倚为-3.1 +/- 4.4（LOA：-11.9至5.7）和2 +/- 4.1（LOA：-6.2至10.2），而对照组为-1.4 +/- 1.4（LOA：-4.2至1.4）和1.2 +/- 1.5（LOA：-1.9至4.3）。SCD患者SpO（2）和SaO（2）之间的平均偏倚为-4.5 +/-4（LOA：-12.5至3.5），而对照组为-0.1 +/-2.1（LOA：-4.3至4.1）。SCD患者各种方法的LOA宽度范围为9.8至17.6，而对照组为1.3至8.4。结论：血管闭塞危象时SCD患者O（2）Hb饱和度的不同测量方法存在差异。这些患者的脉搏血氧测定值异常应谨慎解释，并辅以动脉血气分析和一氧化碳血氧测定。
Objective: To evaluate agreement among various methods for measuring oxyhemoglobin (O(2)Hb) saturation in adult hypoxic patients with sickle cell disease (SCD) during painful vaso-occlusive crisis and to compare those results with a control group. Patients and methods: The hemoglobin oxygen saturation was determined simultaneously by pulse oximetry (SpO(2)), co-oximetry [SO2 (functional oxyhemoglobin saturation) and FO(2)Hb (oxyhemoglobin fraction)] and by calculation (SaO(2)) using a normal O(2)Hb dissociation curve in 18 adult patients with SCD during vaso-occlusive crisis and 12 non-SCD patients with various cardiopulmonary diagnoses. The method proposed by Bland and Altman was used to evaluate agreement of various methods in each of the two groups. Results: Mean differences between various methods in patients with SCD were significantly larger than the control group. Limits of agreement (LOA) were also wider in the SCD group than in the control group. Mean bias between SpO(2) and SO2, and SpO(2) and FO(2)Hb in patients with SCD were -3.1 +/- 4.4 (LOA: -11.9 to 5.7) and 2 +/- 4.1 (LOA: -6.2 to 10.2) respectively, compared with -1.4 +/- 1.4 (LOA: -4.2 to 1.4) and 1.2 +/- 1.5 (LOA: -1.9 to 4.3) in the control group. A mean bias of -4.5 +/- 4 (LOA: -12.5 to 3.5) between SpO(2) and SaO(2) was noted in patients with SCD compared with -0.1 +/- 2.1 (LOA: -4.3 to 4.1) in the control group. The width of LOA for various methods in patients with SCD ranged from 9.8 to 17.6 compared with 1.3 to 8.4 in the control group. Conclusion: Patients with SCD during vaso-occlusive crisis have discrepancies in O(2)Hb saturation measurements by various methods. Abnormal pulse oximetry values in these patients should be interpreted cautiously and supplemented by arterial blood gas analysis and co-oximetry.