Artificial acrylic finger nails may alter pulse oximetry measurement
Artificial acrylic finger nails may alter pulse oximetry measurement
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DOI：
10.1016/j.resuscitation.2006.11.018
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发表时间：
2007-07-01
期刊：
影响因子：
6.5
通讯作者：
Fiedler, Fritz
中科院分区：
文献类型：
--
作者：
Hinkelbein, Jochen;Koehler, Heike;Fiedler, Fritz
前言：在重症监护治疗中，脉搏血氧饱和度(SpO(2))监测是最常用的技术。然而，间歇性联合血氧仪仍是“黄金标准”(SAO(2))。据报道，除了亚克力指甲外，还有许多其他因素会干扰脉搏血氧仪。使用人工指甲的测量数据未被充分公布。材料和方法：在ICU机械通气危重病人中进行前瞻性临床实验试验。测量前将患者随机分为S组(S：西门子脉搏血氧仪)和P组(P：飞利浦脉搏血氧仪)。每例患者在标准位(SpO2)和侧位((SpO2)-S-N90)交替三次测定SpO2。作为参考测量，用血氧仪(CO血氧仪)测量血氧饱和度。此后，用相同的方法(SpO2)-S-A和(SpO2)-S-A90在丙烯酸指甲处获得SpO2。偏差计算公式为AS=(SpO2)-S-N-SaO2和AS=Aspo(2)-SaO2。用准确度(均值差)和精密度(标准差)来确定测量差异。结果：两组患者无钉固定的准确性和精密度与SaO2相当(N.S.)。用指甲指甲测量血氧饱和度，S组的偏差为-1.1%+/-3.14%(P=0.00522)，P组的偏差为+0.8%/-13.04%(N.S.)。结论：指甲压力值与脉搏血氧饱和度测定仪有关，可能会影响血氧饱和度测量的准确性。因此，摘除人造指甲有助于保证脉搏血氧饱和度测量的准确性和精确性。(C)2006年爱思唯尔爱尔兰有限公司版权保留。
Introduction: Pulse oximetry is the most common technique to monitor oxygen saturation (SpO(2)) during intensive care therapy. However, intermittent co-oximetry is still the "gold standard" (SaO(2)). Besides acrylic nails, numerous other factors have been reported to interfere with pulse oximetry. Data of measurements with artificial finger nails are not sufficiently published.Materials and methods: A prospective clinical-experimentat trial in mechanically ventilated and critically ill patients of an ICU was performed. Patients were randomly assigned to either group S (S: Siemens pulse oximeter) or group P (P: Philips pulse oximeter) prior to the measurements. SPO2 was determined in each patient three times alternately in standard (SPO2) and sideways position at the natural nail ((SPO2)-S-N90). For the reference measurements oxygen saturation was measured by means of a haemoximeter (co-oximetry). Thereafter, SPO2 was obtained at the acrylic finger nail in the same way (SPO2)-S-A and (SPO2)-S-A90). Bias was calculated as AS = (SPO2)-S-N-Sa02 and AS = ASpO(2) - SaO2. Accuracy (mean difference) and precision (standard deviation) were used to determine the measurement discrepancy. P < 0.05 was considered significant.Results: Accuracy and precision without acrylic nails applied were comparable to SaO2 in both groups (n.s.). With acrylic nails applied a bias of AS = -1.1 +/- 3.14% for group S (P = 0.00522) and a bias of AS = +0.8 +/- 13.04% for group P was calculated (n.s.).Conclusion: Acrylic finger nails may impair the measurement of oxygen saturation depending on the pulse oximeter used and may cause significant inaccuracy. Hence, removal of artificial acrylic finger nails may be helpful to assure an accurate and precise measurement with pulse oximetry. (C) 2006 Elsevier Ireland Ltd. All. rights reserved.