Cov ntiv tes Clip Oximetry Probe puas tuaj yeem siv hauv pob ntseg?
Tso lus
Lub ntsiab lus ntawm lub
Blood oxygen probes are widely used to assess oxygen saturation (SpO 2) to guide patient care and monitor response to treatment. However, improper placement of the oximetry probe can affect the oximetry of healthy and normal oxygen content outpatient patients. One study evaluated how treatment decisions were influenced by an SpO 2 value, obtained by placing a finger-clip-on blood oxygen probe on the auricle of 46 patients undergoing the trial, compared with an arterial blood gas (ABG) (SaO 2) analysis measured from the finger. There was no statistical difference between finger probe saturation and SaO 2, with a mean difference of -0.66% (P>{{0}}.05). Muaj qhov sib txawv tseem ceeb hauv pob ntseg saturation (-4.29 feem pua ; P <0.001). Kev tshuaj xyuas cov neeg mob hypoxic (SaO 2<90%) showed significant differences between ABG SaO 2 and finger and ear SpO 2. The study provides evidence that placing finger clip blood oxygen probes on the ear is unsafe clinical practice and may lead to poor patient management.
Ntshav oxygen sojntsuam yog ib qho kev tsis ncaj, tsis muaj kev cuam tshuam, raug thiab nyab xeeb rau kev ntsuas cov pa oxygen saturation (SpO 2). Nws yog dav siv los sau cov kev soj ntsuam soj ntsuam nyob rau hauv ntau yam ntawm cov neeg mob sab nraud thiab nyob rau hauv cov chaw kho mob. Ntau qhov kev kho mob tau coj los ntawm kev ntsuas oxygen saturation, xws li thaum lub sij hawm ntsuam xyuas thiab cov lus teb rau kev cuam tshuam xws li kev kho cov pa oxygen thiab tsis muaj qhov cua (NIV). Tsis ntev los no, cov ntshav oxygen soj ntsuam tau siv los saib xyuas tus mob ntawm COVID-19 cov neeg mob thaum nyob hauv tsev kho mob.
Kev sojntsuam oximetry yog tsim los sau SpO 2 los ntawm kev ntsuas qhov nqus ntawm oxygenated hemoglobin (HbO 2) thiab deoxygenated hemoglobin (Hb) rau cov wavelengths ntawm lub teeb. Lub oximeter sojntsuam muaj lub teeb-emitting diodes (leds) uas project ob wavelengths ntawm lub teeb -- liab (660 nm) thiab infrared (940 nm) -- los ntawm ib sab ntawm lub sojntsuam mus rau ib tug photodetector nyob rau lwm yam . Lub pulsating arterial ntshav thaum lub plawv contraction xa oxygenated hemoglobin (HbO 2) rau cov ntaub so ntswg, uas ua rau kom nqus tau ntau infrared lub teeb, yog li lub teeb tsawg dua mus txog lub photodetector. Yog li ntawd, cov qib ntawm oxygen saturation nyob rau hauv cov ntshav txiav txim siab qhov degree ntawm lub teeb haum. Cov txiaj ntsig tau ua tiav thiab kev nyeem ntawv digital ntawm cov txiaj ntsig oximetry tau tshwm sim ntawm lub vijtsam oximeter li SpO2.
Qhov tseeb ntawm oximeter nyob ntawm qhov sib txawv ntawm SpO 2 ntsuas los ntawm oximeter thiab cov pa oxygen saturation ntsuas los ntawm concurrent arterial blood gas (ABG) sampling (SaO 2). Cov chaw tsim khoom thov qhov tseeb ntawm 2 feem pua ntawm cov qauv sib txawv (SD) ntawm 2-3 feem pua rau qhov sib txawv, tab sis muaj pov thawj tias qhov ntsuas qhov yuam kev feem ntau ze rau 3-4 feem pua. Nws kuj tseem nyob ntawm qhov kev cia siab txuas ntxiv ntawm lub wavelength ntawm lub teeb tawm, tab sis kev hloov pauv ua haujlwm (xws li kev puas tsuaj los ntawm kev hnav lossis ntxuav cov leds) tuaj yeem hloov pauv tus nqi ntawm lub teeb nqus, uas yuav cuam tshuam rau qhov raug kwv yees ntawm SpO 2. Yog li, qhov sib txawv nruab nrab ntawm SaO 2 thiab SpO 2 yuav loj dua thaum SpO 2 poob qis dua 80 feem pua vim qhov tsis raug ntawm kev ntsuas ntsuas thiab ntsuas ntshav oxygen saturation.
Qhov tseeb ntawm kev nyeem ntawv oxygen saturation yog cuam tshuam los ntawm arterial pulse zog, lub cev txav, xim cuam tshuam, venous pulsation, thiab ntau yam ntawm lub cev. Kev ntsuas saturation kuj hloov pauv ntau nrog kev hloov pauv hauv qhov cua cuam tshuam nrog kev hnoos, hais lus, ua pa tuav, thiab ua haujlwm lub cev. Txawm hais tias ua tau yooj yim, kev sojntsuam oximetry yuav tsum muaj kev cob qhia kev kho mob kom ntseeg tau tias tau txais kev nyeem ntawv raug. Muaj pov thawj tias cov kws kho mob tsis yog ib txwm paub txog cov kev txwv ntawm cov ntshav oxygen probes thiab cov khoom siv dag zog thiab cov teeb liab tsis zoo tuaj yeem ua rau kev nyeem ntawv tsis raug. Vim yog cov xwm txheej no, qhov ntsuas saturation yuav tsum tau soj ntsuam rau ob peb feeb los txiav txim siab tus nqi ntsuas ntau zaus, tsis yog tso siab rau thawj tus nqi muab.
Vim hais tias cov ntshav-oxygen sojntsuam ntsuas tus nqi ntawm lub teeb kis los ntawm cov ntaub so ntswg, txhua lub teeb ci ncaj qha ci rau ntawm lub sensor muaj peev xwm tsim cov ntawv nyeem tsis raug. Yog hais tias lub sensor tsis raug siv los yog siv rau cov ntaub so ntswg qhov chaw uas tsis tau teev tseg los ntawm cov chaw tsim khoom, xws li kev siv ntiv tes clip oximetry sojntsuam ntawm pob ntseg, optical shunt yuav tshwm sim qhov twg lub teeb ncav cuag lub ntes thiab tsis infuse cov ntaub so ntswg los ntawm cov ntshav. . Cov nyhuv ntawm qhov ntsuas SpO 2 yuav nyob ntawm seb qhov wavelengths ntawm lub teeb yuav raug kho qhov muag shunt, nrog rau cov teeb pom kev sab nraud, uas tuaj yeem nce lossis txo tus nqi tseeb. Vim li no, oximetry probes yuav tsum tau siv tsuas yog qhov chaw uas lawv tsim.
lus qhia
Kev ntsuas ntawm SpO 2 yuav tsum tau kuaj xyuas kom raug los ntawm kev ntsuas qhov pom ntawm photoelectric plethysmography waveform ntawm cov khoom siv oximetry uas siv cov kev sojntsuam hauv qhov chaw tsim nyog. Kev txo qis peripheral ncig, raws li kev txiav txim siab los ntawm lub zog tsis zoo ntawm lub zog, yuav tsum suav tias yog kev ntsuas kev txwv, uas yuav ua rau qhov tsis raug SpO 2 nyeem. Hauv cov xwm txheej no, yuav tsum tau txiav txim siab lwm qhov kev sojntsuam oximetry uas tsim nyog, xws li pob ntseg clip / forehead clamp oximetry sojntsuam lossis ntsuas ntshav roj.
