Comment on 'Pulse oximetry' by Jubran

Autor: Aikaterini Maliaga, Stavroula Boulia, Charalampos Martinos, Ilias Andrianakis
Rok vydání: 2007
Předmět:
Zdroj: Intensive Care Medicine. 33:740-740
ISSN: 1432-1238
0342-4642
DOI: 10.1007/s00134-007-0529-y
Popis: Dear Sir: Refering to the Physiological Note of Amal Jurban “Pulse Oximetry” which was published in the issue of Intensive Care Medicine of July 24th 2004, we would like to make two additional statements. One very useful clinical application of pulse oximetry which has not been mentioned in the article above is that the cyclical respiratory induced changes in the amplitude of the pulse oximeter waveform can be used to detect normotensive hypovolemia. According to several studies [1, 2], systolic pressure variation and its dDown component have been shown to be sensitive factors in estimating intravascular volume in patients undergoing mechanical ventilation. Therefore respiratory-induced waveform variability of the pulse oximetric signal is a useful measurement in the detection of mild hypovolemia. Furthermore, as far as limitations of pulse oximetry are concerned, an important question which evokes is what happens with increasing bilirubin concentrations. According to several studies [3] hyperbilirubinemia does not interfere with hemoglobin saturation measured by pulse oximetry, while others [4] suggest that a bilirubin concentration below 17mg/dl is a safe limit above which measurements exceed normal values. The later stands for multiwavelength oximeters because in severe jaundice the O2Hb values are not identical with the real blood concentration of this hemoglobin deritive. In this situation pulse oximetry is more valid.
Databáze: OpenAIRE
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