Pulse Oximetry and Arterial Saturation Difference in Pediatric COVID-19 Patients: Retrospective Analysis by Race*
Pulse Oximetry and Arterial Saturation Difference in Pediatric COVID-19 Patients: Retrospective Analysis by Race*
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儿科 COVID-19 患者的脉搏血氧饱和度和动脉饱和度差异：按种族进行回顾性分析*
DOI：
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发表时间：
2023
影响因子：
4.1
通讯作者：
Sebastián Acosta
中科院分区：
文献类型：
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作者：
F. Savorgnan;Adel M. Hassan;Nirica M. Borges;Sebastián Acosta
目的：在血液实验室检查中，脉搏血氧饱和度（Spo 2）可能会高估动脉血氧饱和度（Sao 2）。本研究旨在评估Spo 2-Sao 2与种族相关的差异（即，患者自我报告为黑人或白色）、隐匿性低氧血症和住院时间（LOS）。设计：在儿童COVID-19患者中进行的单中心回顾性研究。我们使用多变量线性回归来研究种族和血氧测量之间的关系，以及隐匿性低氧血症和LOS之间的关系。根据批准的比较，使用Spo 2和Sao 2数据定义血氧测定偏倚。隐性低氧血症定义为Spo 2大于92%，Sao 2小于88%。单位：第四儿科医院。患者：2020年5月至2021年12月期间在德克萨斯州儿童医院住院的儿科COVID-19患者。干预措施：无。测量和主要结果：分析中有2713例患者具有完整的生理数据。其中61%为黑人，39%为白色。与白色患者相比，黑人患者的血氧测定偏倚更大（p < 0.001），并且该偏倚随着氧饱和度降低而增加（p < 0.001）。黑人和白色人的隐性低氧血症患病率分别为12%和4%（p < 0.001）。一旦控制了支持水平（重症监护、呼吸、循环），LOS与血氧测定偏倚或隐匿性低氧血症无关。结论：我们发现，在诊断为COVID-19的症状性住院儿科患者中，Spo 2相对于Sao 2的测量存在血氧测定偏倚。此外，种族与血氧测定偏倚增加有关。然而，我们没有发现血氧测定偏差与该患者队列中医院LOS之间的关系。
Objectives: Pulse oximetry (Spo2) may overestimate arterial oxygen saturation (Sao2) in blood laboratory testing. This study aimed to assess Spo2–Sao2 difference in relation to race (i.e., patient self-reporting as Black or White), occult hypoxemia, and length of stay (LOS) in pediatric patients with COVID-19. Design: Single-center retrospective study in pediatric COVID-19 patients. We used multivariable linear regressions to examine the association between race and oximetry measurements and between occult hypoxemia and LOS. Oximetry bias was defined using Spo2 and Sao2 data according to approved comparisons. Occult hypoxemia was defined as Spo2 greater than 92% and Sao2 less than 88%. Setting: Quaternary pediatric hospital. Patients: Pediatric COVID-19 patients admitted to Texas Children’s Hospital between May 2020 and December 2021. Interventions: None. Measurements and Main Results: There were 2713 patients with complete physiological data in the analysis. Of the total, 61% were Black, and 39% were White. Oximetry bias was greater in Black compared with White patients (p < 0.001), and this bias increased as the oxygen saturations decreased (p < 0.001). Black and White patients had a 12% and 4% prevalence of occult hypoxemia, respectively (p < 0.001). LOS was not associated with oximetry bias or occult hypoxemia once controlled for the level of support (intensive care, respiratory, circulatory). Conclusions: We found an oximetry bias in the measurement of Spo2 with respect to Sao2 in symptomatic hospitalized pediatric patients with the diagnosis of COVID-19. Furthermore, race is related to an increased oximetry bias. However, we did not find a relationship between oximetry bias and the LOS in the hospital in this cohort of patients.