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Nursing Standard (Royal College of...Pulse oximetry provides a non-invasive means to measure pulse rate and haemoglobin saturation. Philip Woodrow describes the nurse's role in its use. (Review)
Review
Pulse oximetry provides a non-invasive means to measure pulse rate and haemoglobin saturation. Philip Woodrow describes the nurse's role in its use.
Topics: Heart Rate; Hemoglobins; Humans; Oximetry; Pulse
PubMed: 10524107
DOI: 10.7748/ns1999.07.13.42.42.c2636 -
Neurological Research 1998The use of techniques to measure cerebral oxygen saturation is gradually gaining wide popularity. The main methods available today can mainly be classified as invasive... (Review)
Review
The use of techniques to measure cerebral oxygen saturation is gradually gaining wide popularity. The main methods available today can mainly be classified as invasive or noninvasive. The invasive technology uses the parenchyma probes, which measure oxygen and biochemical parameters, depending upon the type of probe used. The noninvasive techniques use near infrared spectroscopy for transcranial cerebral oximetry. At present there is no universally accepted indication for the use of either technique but with time and wider use they are expected to become better understood. We discuss our experience and the techniques used in cerebral oximetry.
Topics: Brain; Brain Chemistry; Humans; Oximetry; Oxygen; Spectroscopy, Near-Infrared
PubMed: 9584916
DOI: No ID Found -
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 -
Current Opinion in Critical Care Jun 2006Pulse oximetry is now a ubiquitous and essential tool of modern medicine, and while it is a relatively recent invention, the technology has rapidly matured since the... (Review)
Review
PURPOSE OF REVIEW
Pulse oximetry is now a ubiquitous and essential tool of modern medicine, and while it is a relatively recent invention, the technology has rapidly matured since the first commercially available oximeters were introduced in the 1970s. This review seeks to provide an overview of the basic physical operation of the probe and discuss its limitations, sources of error and some current advances in the use of multi-wavelength probes.
RECENT FINDINGS
New multi-wavelength oximeters and plethysmographic waveform analysis may expand the information that we can collect and use non-invasively. This includes distinguishing between haemoglobinopathies, monitoring volume status and volume loss, and potentially monitoring cardiac output non-invasively.
SUMMARY
The pulse oximeter, like any basic tool, must be used properly. There is considerable misunderstanding and lack of education among junior clinicians as to the use and interpretation of pulse oximeters. The introduction of the pulse oximeter has demonstrated a cost saving, although the cost-benefit of new multi-wavelength probes remains unproven.
Topics: Cost-Benefit Analysis; Humans; Monitoring, Physiologic; Oximetry; Plethysmography; Reproducibility of Results
PubMed: 16672788
DOI: 10.1097/01.ccx.0000224873.16700.78 -
Critical Care Nursing Clinics of North... Mar 1999Pulse oximetry is one of the most commonly applied technologies in acute and critical care. It has the potential to continuously monitor pulmonary function, avoid... (Review)
Review
Pulse oximetry is one of the most commonly applied technologies in acute and critical care. It has the potential to continuously monitor pulmonary function, avoid unnecessary blood gases, and alert clinicians to hypoxemic events that are not readily apparent by physical assessment. Due to these advantages, pulse oximetry has a firm place in health care. Unfortunately, pulse oximetry will not usually have a major impact on reducing hospital resources. In addition, oximetry has the potential to be misused owing to its widespread application. In order to obtain the maximum benefits from this technology, clinicians must be educated about the strengths and limitations of oximetry. If this education effectively changes clinicians' behavior, pulse oximetry will provide an excellent clinical advantage in patient assessment as well as moderate cost benefits.
Topics: Aged; Critical Care; Female; Humans; Male; Middle Aged; Monitoring, Physiologic; Oximetry; Oxyhemoglobins; Reproducibility of Results
PubMed: 10373826
DOI: No ID Found -
Topics in Companion Animal Medicine Aug 2013Respiratory dysfunction is common in veterinary patients and various techniques have been developed to rapidly and accurately monitor pulmonary gas exchange. Pulse... (Review)
Review
Respiratory dysfunction is common in veterinary patients and various techniques have been developed to rapidly and accurately monitor pulmonary gas exchange. Pulse oximetry and capnometry are tools that allow for continuous evaluation of pulmonary function. Methodology, indications, and limitations of pulse oximetry and capnometry are discussed in this article. Both techniques are useful for monitoring critically ill or anesthetized patients; however, limitations to their use exist which underscore the need for intermittent arterial blood gas analysis.
Topics: Animals; Capnography; Monitoring, Physiologic; Oximetry; Respiration Disorders
PubMed: 24183001
DOI: 10.1053/j.tcam.2013.06.006 -
International Anesthesiology Clinics 1989We now have the technology through reflectance spectrophotometry to evaluate and display continuously mixed venous oxygen saturation SvO2 through use of a modified... (Review)
Review
We now have the technology through reflectance spectrophotometry to evaluate and display continuously mixed venous oxygen saturation SvO2 through use of a modified pulmonary artery catheter. Adding this method of assessing the balance of oxygen supply and demand to our standard armamentarium of hemodynamic monitoring may improve our ability to diagnose and treat cardiovascular aberrations at an earlier stage than was previously possible. Through analysis of the Fick equation, it can be seen that SvO2 depends upon the cardiac output, the arterial oxygen saturation, the hemoglobin level, and the rate of oxygen consumption. These are, in turn, affected by a great number of factors (see Fig 8). As seen in the variety of patient care examples cited above, the usefulness of SvO2 monitoring continues to grow. It appears that there are no intrinsic risks associated with SvO2 monitoring beyond those of customary PA monitoring. This new technology provides us with online information not previously available, at an associated cost that needs to be further examined.
Topics: Anesthesiology; Humans; Monitoring, Physiologic; Oximetry; Veins
PubMed: 2670771
DOI: 10.1097/00004311-198902730-00007 -
Anaesthesia Dec 2007Global Oximetry (GO) is an initiative launched recently in Uganda, India, the Philippines and Vietnam. The overall aims are to promote oximetry utilisation and reduce... (Review)
Review
Global Oximetry (GO) is an initiative launched recently in Uganda, India, the Philippines and Vietnam. The overall aims are to promote oximetry utilisation and reduce oximetry costs in lower income countries. Research objectives include studying the feasibility of cost reduction; overcoming non-cost barriers to global oximetry including issues of prioritization; education and guidelines; servicing and access to parts. Promotional objectives include creating new policy, influencing oximetry design, and setting new global standards for safer monitoring.
Topics: Costs and Cost Analysis; Developing Countries; Humans; International Cooperation; Monitoring, Intraoperative; Oximetry
PubMed: 17937720
DOI: 10.1111/j.1365-2044.2007.05305.x -
Journal of Perioperative Practice Oct 2006Pulse oximetry has emerged as a very common and useful method to measure oxygen saturation since it was first described by Takuo Aoyagi in 1974. It measures the oxygen... (Review)
Review
Pulse oximetry has emerged as a very common and useful method to measure oxygen saturation since it was first described by Takuo Aoyagi in 1974. It measures the oxygen saturation of haemoglobin in the arterial blood and the pulse rate. It is an indirect indicator of cardiac output. It also gives an audible signal varying in pitch depending on the oxygen saturation. It displays a plethysmographic image and also gives a digital readout. The following is an overview of the device and an examination of its applications.
Topics: Diagnostic Errors; Equipment Design; Humans; Oximetry; Reproducibility of Results
PubMed: 17069399
DOI: 10.1177/175045890601601005 -
High Altitude Medicine & Biology 2011Pulse oximetry is a valuable, noninvasive, diagnostic tool for the evaluation of ill individuals at high altitude and is also being increasingly used to monitor the... (Review)
Review
Pulse oximetry is a valuable, noninvasive, diagnostic tool for the evaluation of ill individuals at high altitude and is also being increasingly used to monitor the well-being of individuals traveling on high altitude expeditions. Although the devices are simple to use, data output may be inaccurate or hard to interpret in certain situations, which could lead to inappropriate clinical decisions. The purpose of this review is to consider such issues in greater detail. After examining the operating principles of pulse oximetry, we describe the available devices and the potential uses of oximetry at high altitude. We then consider the pitfalls of pulse oximetry in this environment and provide recommendations about how to deal with these issues. Device users should recognize that oxygen saturation changes rapidly in response to small changes in oxygen tensions at high altitude and that device accuracy declines with arterial oxygen saturations of less than 80%. The normal oxygen saturation at a given elevation may not be known with certainty and should be viewed as a range of values, rather than a specific number. For these reasons, clinical decisions should not be based on small differences in saturation over time or among individuals. Effort should also be made to minimize factors that cause measurement errors, including cold extremities, excess ambient light, and ill-fitting oximeter probes. Attention to these and other issues will help the users of these devices to apply them in appropriate situations and to minimize erroneous clinical decisions.
Topics: Altitude; Altitude Sickness; Brain Edema; Humans; Hypertension, Pulmonary; Hypoxia; Oximetry
PubMed: 21718156
DOI: 10.1089/ham.2011.0013