Pulse oximetry for the diagnosis and management of acute respiratory distress syndrome.
Pulse oximetry for the diagnosis and management of acute respiratory distress syndrome.
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DOI：
10.1016/s2213-2600(22)00058-3
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发表时间：
2022-11
影响因子：
76.2
通讯作者：
Ware, Lorraine B.
中科院分区：
文献类型：
--
作者：
Wick, Katherine D.;Matthay, Michael A.;Ware, Lorraine B.
急性呼吸窘迫综合征（ARDS）的诊断传统上需要使用动脉血计算动脉氧分压与吸入氧分数（PaO 2/FiO 2）的比率，这可能是昂贵的，并且在许多资源有限的环境中是不可能的。相比之下，脉搏血氧饱和度是连续可用的，准确的，廉价的，非侵入性的。基于脉搏血氧饱和度的指标，如脉搏血氧饱和度与FiO 2的比值（SpO 2/FiO 2），已在临床研究中得到验证，可用于ARDS患者的诊断和风险分层。SpO 2/FiO 2比值的局限性包括灌注状态差或氧饱和度高于97%时的准确性降低，以及皮肤色素沉着较深患者的准确性可能降低。脉搏血氧饱和度测定法在ARDS诊断和管理中的应用，包括正式采用SpO 2/FiO 2比值作为PaO 2/FiO 2的替代，以满足ARDS低氧血症的诊断标准，可以促进全球范围内对ARDS的早期认识，以推进临床实践和研究。
The diagnosis of acute respiratory distress syndrome (ARDS) traditionally requires calculation of the ratio of partial pressure of arterial oxygen to fraction of inspired oxygen (PaO2/FiO2) using arterial blood, which can be costly and is not possible in many resource-limited settings. By contrast, pulse oximetry is continuously available, accurate, inexpensive, and non-invasive. Pulse oximetry-based indices, such as the ratio of pulse-oximetric oxygen saturation to FiO2 (SpO2/FiO2), have been validated in clinical studies for the diagnosis and risk stratification of patients with ARDS. Limitations of the SpO2/FiO2 ratio include reduced accuracy in poor perfusion states or above oxygen saturations of 97%, and the potential for reduced accuracy in patients with darker skin pigmentation. Application of pulse oximetry to the diagnosis and management of ARDS, including formal adoption of the SpO2/FiO2 ratio as an alternative to PaO2/FiO2 to meet the diagnostic criterion for hypoxaemia in ARDS, could facilitate increased and earlier recognition of ARDS worldwide to advance both clinical practice and research.