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Anasthesiologie, Intensivmedizin,... Oct 2016Basic haemodynamic monitoring is an essential part of the anaesthesia work place. This includes Monitoring of ECG, blood pressure and pulse oximetry. For early... (Review)
Review
Basic haemodynamic monitoring is an essential part of the anaesthesia work place. This includes Monitoring of ECG, blood pressure and pulse oximetry. For early assessement of perioperative complications every patient should have a basic haemodynamic monitoring, independant of current health status or the type of anaesthesia applied. Knowledge of function, principles and limitations ais necessary for proper interpretation of the measured values. Here, we describe the function and application of ECG, non - invasive intermittent blood pressure and pulse oximetry in the perioperative setting.
Topics: Anesthesia; Blood Pressure Determination; Cardiovascular Diseases; Critical Care; Electrocardiography; Humans; Monitoring, Intraoperative; Oximetry
PubMed: 27764869
DOI: 10.1055/s-0041-110005 -
Minerva Pediatrics Dec 2022Blood oximetry provides a fundamental approach to blood gases for inpatients. Arterial blood gases (ABG) have been considered the gold standard for blood oximetry... (Review)
Review
Blood oximetry provides a fundamental approach to blood gases for inpatients. Arterial blood gases (ABG) have been considered the gold standard for blood oximetry assessment. Venous blood gas (VBG) evaluation is frequently available and provides a source of a more comfortable method for the assessment of blood oximetry in pediatric patients. Some data provided by the venous blood gas can be additive and offer insights apart from the arterial blood gas. The purpose of this review was to provide an assessment of the performance of VBG in pediatric patients. The study concludes that VBG are helpful tools in assessing oxygenation and ventilation in critically ill children and can be used as a marker of adequacy of systemic oxygen delivery. In the setting of systemic oxygen delivery decrease or oxygen extraction increase, the partial pressure of oxygen on the VBG will decrease. Thus, the partial pressure of oxygen and the corresponding venous saturation can be a marker of systemic oxygen delivery in a variety of illnesses. Simultaneous ABG and VBG comparison can actually lend great insight to not only the respiratory status of a patient but provide an assessment of the adequacy of cardiac output and systemic oxygen delivery.
Topics: Humans; Child; Gases; Blood Gas Analysis; Oximetry; Oxygen; Hypoxia; Inpatients
PubMed: 34530585
DOI: 10.23736/S2724-5276.21.06464-8 -
Early Human Development Mar 2022Partial oxygen saturation (SpO) increases within minutes during transition from the intrauterine to extrauterine life. This study aims to determine the postnatal course... (Observational Study)
Observational Study
BACKGROUND
Partial oxygen saturation (SpO) increases within minutes during transition from the intrauterine to extrauterine life. This study aims to determine the postnatal course of pulmonary regional oxygen saturation (rSO) measured by Near-Infrared Spectroscopy (NIRS).
METHODS
We conducted an observational study at the delivery room in infants above 35 weeks of gestation who did not need resuscitation and did not develop respiratory distress. Preductal pulse oximetry (Covidien NellcorTM) and right pulmonary apex oxygen saturation (raSO) and basal oxygen saturation (rbSO) (Covidien INVOSTM) were measured, starting from the postnatal third minute of life, until the 15th minute. The correlations between SpO and pulmonary rSO were analyzed.
RESULTS
Of the 110 infants included in the study, 87 were term and 23 were late preterms. The gestational age and birth weight were 38.5 ± 1.36 weeks and 3285 ± 508 g, respectively. Median (5th-95th percentile) raSO and rbSO were 79% (58-95%) and 78% (46-95%) at the third minute, respectively. The rSO values measured from both sides increased and reached a steady-state around postnatal 9 min, similar to SpO values. The pulmonary NIRS values were significantly higher for babies born by C-Section compared to babies born by vaginal delivery (p < 0.05).
CONCLUSION
We found that rSO measurements increased within minutes in the postnatal period in late preterm and term babies without respiratory distress and reached a plateau at the postnatal 9th minute. The normal values obtained from this preliminary study may be used to predict the prognosis of cases with respiratory distress.
Topics: Female; Gestational Age; Humans; Infant; Infant, Newborn; Oximetry; Oxygen; Oxygen Saturation; Pregnancy; Spectroscopy, Near-Infrared
PubMed: 35144135
DOI: 10.1016/j.earlhumdev.2022.105552 -
Journal of Cardiac Surgery Dec 2022Patients who undergo cardiac surgery are at increased risk of stroke, postoperative cognitive decline, and delirium. These neurocognitive complications have led to... (Review)
Review
BACKGROUND
Patients who undergo cardiac surgery are at increased risk of stroke, postoperative cognitive decline, and delirium. These neurocognitive complications have led to increased costs, intensive care unit stays, morbidity, and mortality. As a result, there is a significant push to mitigate any neurological complications in cardiac surgery patients. Near-infrared spectroscopy to measure regional cerebral oxygen saturations has gained consideration due to its noninvasive and user-friendly nature. Cerebral oximetry desaturations during cardiac surgery have been linked to an array of adverse clinical outcomes. However, the most effective intraoperative interventions to protect this vulnerable patient population have yet to be ascertained.
AIM OF STUDY
To provide a comprehensive summary of the intraoperative management for cerebral oximetry desaturations during cardiac surgery. The review highlights clinical outcomes from cerebral oximetry use to quantify the importance of identifying cerebral desaturations during cardiac surgery. The review then interrogates possible interventions for cerebral oximetry desaturations in an effort to determine which interventions are most efficacious and to enlighten possible areas for further research.
METHODS
A narrative review of randomized controlled trials, observational studies, and systematic reviews with metanalyses was performed through August 2021.
RESULTS
There is significant heterogeneity among patient populations for which cerebral oximetry monitoring has been studied in cardiac surgery. Further, the definition of a clinically significant cerebral desaturation and the assessment of neurocognitive outcomes varied substantially across studies. As a result, metanalysis is challenging and few conclusions can be drawn. Cerebral oximetry use during cardiac surgery has not been associated with improvements in neurocognitive outcomes, morbidity, or mortality to date. The evidence to support a particular intervention for an acute desaturation is equivocal.
CONCLUSIONS
Future research is needed to quantify a clinically significant cerebral desaturation and to determine which interventions for an acute desaturation effectively improve clinical outcomes.
Topics: Humans; Oximetry; Cerebrovascular Circulation; Postoperative Complications; Cardiac Surgical Procedures; Nervous System Diseases; Oxygen
PubMed: 36423259
DOI: 10.1111/jocs.17232 -
Journal of Biophotonics Jun 2022The current technology for monitoring fetal wellbeing during child birth is cardiotocography. However, CTG has high false positive rates that lead to unnecessary... (Review)
Review
The current technology for monitoring fetal wellbeing during child birth is cardiotocography. However, CTG has high false positive rates that lead to unnecessary emergency Cesarean deliveries and false negatives that result in birth injuries. To curtail these issues, fetal pulse oximetery has been a topic of interest for many decades. Fetal pulse oximetry would yield the oxygen saturation of the fetus in utero and provide a more robust marker for clinicians to make decisions about performing emergency Cesarean deliveries. Here, we present a review of biomedical optical developments related to transabdominal fetal pulse oximetery in the biophotonics field and the challenges that must be overcome to make transabdominal pulse oximetry a clinical reality.
Topics: Cardiotocography; Cesarean Section; Delivery, Obstetric; Female; Fetal Monitoring; Humans; Oximetry; Oxygen; Pregnancy
PubMed: 35285153
DOI: 10.1002/jbio.202100343 -
Journal of Intensive Care Medicine Sep 2023Pulse oximetry is a noninvasive medical technique that measures the amount of oxygen in a person's blood by shining light through their skin. It is widely used in... (Review)
Review
Everything About Pulse Oximetry-Part 1: History, Principles, Advantages, Limitations, Inaccuracies, Cost Analysis, the Level of Knowledge About Pulse Oximeter Among Clinicians, and Pulse Oximetry Versus Tissue Oximetry.
Pulse oximetry is a noninvasive medical technique that measures the amount of oxygen in a person's blood by shining light through their skin. It is widely used in medical care and is considered as important as the 4 traditional vital signs. In this article, it was aimed to review all aspects of pulse oximetry in detail. The international and national reliable sources were used in the literature review for critical data analysis. A total of 13 articles including 9 reviews, 1 comparative clinical research, 1 cost-saving quality improvement project, 1 cross-sectional and multicenter descriptive study, and 1 questionnaire study were used for the preparation of this part of the review. The history, principles, advantages, limitations inaccuracies, cost analysis, the level of knowledge about pulse oximeter among clinicians, and pulse oximetry versus tissue oximetry were all reviewed in detail. The device has a significant impact on modern medicine, allowing continuous monitoring of hemoglobin oxygen saturation in arterial blood. Oximeters are valuable in managing oxygen levels in respiratory and nonrespiratory diseases and have become an essential tool in hospital settings. Detecting low levels of oxygen saturation early can alert patients to seek medical attention promptly. It is crucial to comprehend the working and limitations of pulse oximetry technology to ensure patient safety.
Topics: Humans; Cross-Sectional Studies; Oximetry; Oxygen; Pulmonary Gas Exchange; Costs and Cost Analysis; Multicenter Studies as Topic
PubMed: 37437083
DOI: 10.1177/08850666231185752 -
Korean Journal of Anesthesiology Oct 2022Cerebral oximetry using near-infrared spectroscopy (NIRS) is used for monitoring cerebral oxygen saturation during cardiac surgery and is correlated with clinical... (Observational Study)
Observational Study
BACKGROUND
Cerebral oximetry using near-infrared spectroscopy (NIRS) is used for monitoring cerebral oxygen saturation during cardiac surgery and is correlated with clinical outcomes. Our goal was to explore cerebral and somatic NIRS in liver resections as a predictor of post-operative complications.
METHODS
Prospective observational and non-interventional study from a tertiary care university hospital including adult patients undergoing liver resection monitored using NIRS at four sites before and during surgery. Those sites were: frontotemporal left and right zones, right thigh, and right arm. Anesthesiologists and surgeons were blinded to oximetry values. Correlations were assessed between baseline oximetry values and cerebro-somatic desaturation load (threshold of 80% from baseline) values with peri-operative events and complications.
RESULTS
Ninety patients were distributed equally among gender with a mean age of 59.7 ± 13.1 years. Lower baseline cerebral and/or somatic values were associated with increased risk of delirium, respiratory failure, surgical and renal complications, blood transfusions, and length of stay in the intensive care unit and in the hospital (P < 0.05). The severity of somatic desaturation below 80% was the only parameter associated with blood losses (P = 0.030) and length of hospital stay (P = 0.047).
CONCLUSIONS
Cerebral and somatic desaturation does occur in liver resection and can be used simultaneously during liver surgery. Both baseline cerebral and somatic NIRS values are correlated with complications and outcomes. However, thigh desaturation appears more sensitive than cerebral NIRS values in predicting some of these complications.
Topics: Adult; Aged; Cardiac Surgical Procedures; Cerebrovascular Circulation; Humans; Liver; Middle Aged; Oximetry; Spectroscopy, Near-Infrared
PubMed: 35045594
DOI: 10.4097/kja.21414 -
A & a Case Reports Jun 2016The safety of anesthesia was dramatically improved by the introduction of pulse oximetry. This technology was rapidly adopted by anesthesiologists and made a standard of... (Review)
Review
The safety of anesthesia was dramatically improved by the introduction of pulse oximetry. This technology was rapidly adopted by anesthesiologists and made a standard of practice in many countries. In 2007, during development of the Surgical Safety Checklist, the World Health Organization recommended a pulse oximeter as a monitor for all patients undergoing anesthesia. However, clinicians in low- and middle-income countries lack access to basic anesthesia equipment, including pulse oximeters. The Lifebox Foundation was formed to determine how a suitable oximeter could be made available to anesthesia providers in these countries. Almost 11,000 oximeters have been delivered in 90 countries, with education courses completed in over 50 countries.
Topics: Anesthesiology; Global Health; Humans; Oximetry; Patient Safety; Societies, Medical; World Health Organization
PubMed: 27301049
DOI: 10.1213/XAA.0000000000000335 -
Sleep Medicine Reviews Jun 2016Overnight polysomnography is the gold standard tool for the diagnosis of obstructive sleep apnea syndrome (OSAS) in habitually snoring children, but it is expensive and... (Review)
Review
Overnight polysomnography is the gold standard tool for the diagnosis of obstructive sleep apnea syndrome (OSAS) in habitually snoring children, but it is expensive and not always available. Nocturnal oximetry has been proposed as an abbreviated and low-cost testing modality for the diagnosis of OSAS. In this systematic review, 25 original articles were evaluated to: (i) summarize reference values of nocturnal oximetry parameters in healthy children; (ii) identify abnormal oximetry patterns that predict OSAS in habitually snoring children; (iii) delineate abnormalities in oximetry that can predict responses to treatment interventions for OSAS and potential complications. Nocturnal SpO2 drops <90%, more than two clusters of desaturation events (≥4%) and oxyhemoglobin desaturation (≥4%) index (ODI4) >2.2 episodes/h are unusual in children without OSAS. At least three clusters of desaturation events, and at least three SpO2 drops below 90% in a nocturnal oximetry recording are indicative of moderate-to-severe OSAS. An ODI4 >2 episodes/h combined with OSAS symptoms also exhibits high positive predictive value for apnea-hypopnea index >1 episode/h. Children without clusters of desaturation events have low risk of major respiratory complications following adenotonsillectomy. Thus, nocturnal oximetry emerges as a valuable tool that can facilitate treatment decisions when polysomnography is not available.
Topics: Child; Humans; Hypoxia; Oximetry; Sleep Apnea, Obstructive; Snoring; Tonsillectomy
PubMed: 26146027
DOI: 10.1016/j.smrv.2015.05.008 -
Journal of Plastic, Reconstructive &... Sep 2022Prompt diagnosis and intervention are essential for acute limb ischaemia after trauma. Guidelines for diagnosis are changing with new evidence. Pulse oximetry may be a...
Prompt diagnosis and intervention are essential for acute limb ischaemia after trauma. Guidelines for diagnosis are changing with new evidence. Pulse oximetry may be a useful adjunct. We aim to assess the value of pulse oximetry and other common tests for diagnosing vascular injury. Electronic medical records of patients with limb injuries were identified. Patient demographics, the mechanism of injury, comorbidities, the results of diagnostic tests or examinations, and the end outcome were extracted. Receiver Operator Characteristics (ROC) curves were used to calculate cut-offs with optimum sensitivity and specificity for pulse oximetry. Performance characteristics to predict vascular injury for all documented tests were calculated and compared. SpO2 values were significantly different in the group with and without vascular disruption (p = 0.034). Using a cut-off of 96% calculated from ROC curve analysis, SpO had a sensitivity of 78% and a specificity of 90%. For the other techniques, abnormal pulse oximetry waveform, absent distal pulses, and capillary refill over 2 s were significantly different between the two groups. Abnormal pulse oximetry waveform had the highest specificity (100%) while SpO2 was the most sensitive (78%). We suggest that pulse oximetry is a useful adjunct for patients with limb trauma, an abnormal waveform or SpO2 value below 96% suggests vascular disruption is present. Capillary refill over 2 s and absent distal pulses can also be used; if either are positive, this suggests vascular disruption. No test or examination was shown to be able to exclude vascular injury.
Topics: Humans; Ischemia; Oximetry; Oxygen; Peripheral Vascular Diseases; Sensitivity and Specificity; Vascular System Injuries
PubMed: 35787992
DOI: 10.1016/j.bjps.2022.04.080