The Use of Pulse Oximetry to Determine Hypoxemia in Acute Exacerbations of COPD
| Autor: | Susana, Garcia-Gutierrez, Anette, Unzurrunzaga, Inmaculada, Arostegui, Jose María, Quintana, Esther, Pulido, Maria Soledad, Gallardo, Cristóbal, Esteban, Jose M, Quintana |
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| Rok vydání: | 2015 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty Logistic regression Hypoxemia Cohort Studies Pulmonary Disease Chronic Obstructive Predictive Value of Tests Internal medicine medicine Humans Oximetry Hypoxia Aged Oxygen saturation (medicine) Aged 80 and over COPD medicine.diagnostic_test business.industry Emergency department Middle Aged medicine.disease respiratory tract diseases Pulse oximetry Cross-Sectional Studies Logistic Models ROC Curve Respiratory failure Spain Anesthesia Cardiology Arterial blood Female medicine.symptom Emergency Service Hospital Respiratory Insufficiency business |
| Zdroj: | COPD: Journal of Chronic Obstructive Pulmonary Disease. 12:613-620 |
| ISSN: | 1541-2563 1541-2555 |
| DOI: | 10.3109/15412555.2014.995291 |
| Popis: | There is little evidence that the guideline-recommended oxygen saturation of 92% is the best cut-off point for detecting hypoxemia in COPD exacerbations.To detect and validate pulse oximetry oxygen saturation cut-off values likely to detect hypoxemia in patients with aeCOPD, to explore the correlation between oxygen saturation measured by pulse oximetry and hypoxemia or hypercapnic respiratory failure.Cross-sectional study nested in the IRYSS-COPD study with 2,181 episodes of aeCOPD recruited between 2008 and 2010 in 16 hospitals belonging to the Spanish Public Health System. Data collected include determination of oxygen saturation by pulse oximetry upon arrival in the emergency department (ED), first arterial blood gasometry values, sociodemographic information, background medical history and clinical variables upon ED arrival. Logistic regression models were performed using as the dependent variables hypoxemia (PaO260 mmHg) and hypercapnic respiratory failure (PaO260 mmHg and PaCO245). Optimal cut-off points were calculated.The correlation coefficient between oxygen saturation and pO2 measured by arterial blood gasometry was 0.89. The area under the curve (AUC) for the hypoxemia model was 0.97 (0.96-0.98) and the optimal cut-off point for hypoxemia was an oxygen saturation of 90%. The AUC for hypercapnic respiratory failure was 0.90 (0.87-0.92) and the optimal cut-off point was an oxygen saturation of 88%.Our results support current recommendations for ordering blood gasometry based on pulse oximetry oxygen saturation cut-offs for hypoxemia. We also provide easy to use formulae to calculate pO2 from oxygen saturation measured by pulse oximetry. |
| Databáze: | OpenAIRE |
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