Rationale and limitations of the SpO2/FiO2 as a possible substitute for PaO2/FiO2 in different preclinical and clinical scenarios.
Rationale and limitations of the SpO2/FiO2 as a possible substitute for PaO2/FiO2 in different preclinical and clinical scenarios.
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DOI：
10.5935/0103-507x.20220013-pt
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发表时间：
2022-01
影响因子：
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通讯作者：
Silva, Pedro Leme
中科院分区：
文献类型：
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作者：
Carvalho, Eduardo Butturini de;Leite, Thiago Ravache Sobreira;Sacramento, Raquel Ferreira de Magalhaes;Nascimento, Paulo Roberto Loureiro do;Samary, Cynthia Dos Santos;Rocco, Patricia Rieken Macedo;Silva, Pedro Leme
虽然动脉血气分析得出的PaO2/FiO2仍然是诊断急性呼吸衰竭的金标准，但SpO2/FiO2已被研究作为潜在的替代品。目前的叙述性综述介绍了SpO2/FiO2作为PaO2/FiO2的可能替代品并用作诊断和预后标记物的临床前和临床文献的状态；概述了脉搏血氧仪及其局限性，并评估了SpO2/FiO2作为COVID-19患者PaO2/FiO2替代指标的实用性。总体而言，根据最小搜索策略，发现49项SpO2/FiO2和PaO2/FiO2的比较研究。大多数是针对新生儿进行的，一些是针对急性呼吸窘迫综合征的成年人进行的，少数是在其他临床情况下进行的（包括极少数针对COVID-19患者）。有一些证据表明，SpO2/FiO2标准可以替代PaO2/FiO2在不同的临床情况。急性呼吸衰竭患者应避免不必要的侵入性手术，这一事实加强了这一点。不可否认，脉搏血氧仪正变得越来越普遍，并且可以提供无成本的监测。因此，用SpO2/FiO2代替PaO2/FiO2可以使资源有限的机构客观诊断急性呼吸衰竭。
Although the PaO2/FiO2 derived from arterial blood gas analysis remains the gold standard for the diagnosis of acute respiratory failure, the SpO2/FiO2 has been investigated as a potential substitute. The current narrative review presents the state of the preclinical and clinical literature on the SpO2/FiO2 as a possible substitute for PaO2/FiO2 and for use as a diagnostic and prognostic marker; provides an overview of pulse oximetry and its limitations, and assesses the utility of SpO2/FiO2 as a surrogate for PaO2/FiO2 in COVID-19 patients. Overall, 49 studies comparing SpO2/FiO2 and PaO2/FiO2 were found according to a minimal search strategy. Most were conducted on neonates, some were conducted on adults with acute respiratory distress syndrome, and a few were conducted in other clinical scenarios (including a very few on COVID-19 patients). There is some evidence that the SpO2/FiO2 criteria can be a surrogate for PaO2/FiO2 in different clinical scenarios. This is reinforced by the fact that unnecessary invasive procedures should be avoided in patients with acute respiratory failure. It is undeniable that pulse oximeters are becoming increasingly widespread and can provide costless monitoring. Hence, replacing PaO2/FiO2 with SpO2/FiO2may allow resourcelimited facilities to objectively diagnose acute respiratory failure.