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Agreement between pulse oximetry and arterial oxygen saturation measurement in critical care patients during COVID-19: a cross-sectional study

Some publications suggest that pulse oximetry measurement (SpO(2)) might overestimate arterial oxygen saturation (SaO(2)) measurement in COVID-19 patients. This study aims to evaluate the agreement between SpO(2) and SaO(2) among COVID-19 and non-COVID-19 patients. We conducted a multicenter, prospe...

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Autores principales: James, Arthur, Petit, Matthieu, Biancale, Flore, Bougle, Adrien, Degos, Vincent, Monsel, Antoine, Vieillard-Baron, Antoine, Constantin, Jean-Michel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Netherlands 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9859741/
https://www.ncbi.nlm.nih.gov/pubmed/36670340
http://dx.doi.org/10.1007/s10877-022-00959-2
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author James, Arthur
Petit, Matthieu
Biancale, Flore
Bougle, Adrien
Degos, Vincent
Monsel, Antoine
Vieillard-Baron, Antoine
Constantin, Jean-Michel
author_facet James, Arthur
Petit, Matthieu
Biancale, Flore
Bougle, Adrien
Degos, Vincent
Monsel, Antoine
Vieillard-Baron, Antoine
Constantin, Jean-Michel
author_sort James, Arthur
collection PubMed
description Some publications suggest that pulse oximetry measurement (SpO(2)) might overestimate arterial oxygen saturation (SaO(2)) measurement in COVID-19 patients. This study aims to evaluate the agreement between SpO(2) and SaO(2) among COVID-19 and non-COVID-19 patients. We conducted a multicenter, prospective study including consecutive intensive care patients from October 15, 2020, to March 4, 2021, and compared for each measurement the difference between SpO(2) and SaO(2), also called the systematic bias. The primary endpoint was the agreement between SpO(2) and SaO(2) measured with the Lin concordance coefficient and illustrated using the Bland and Altman method. Factors associated with systematic bias were then identified using a generalised estimating equation. The study included 105 patients, 66 COVID-19 positive and 39 COVID-19 negative, allowing for 1539 measurements. The median age was 66 [57; 72] years with median SOFA and SAPSII scores of, respectively, 4 [3; 6] and 37 [31; 47]. The median SpO(2) and SaO(2) among all measurements was respectively 97 [96–99] and 94 [92–96] with a systematic bias of 0.80 [− 0.6; 2.4]. This difference was, respectively, 0.80 [− 0.7; 2.5] and 0.90 [− 0.3; 2.0] among COVID-19 positive and negative patients. Overall agreement measured with the Lin correlation coefficient was 0.65 [0.63; 0.68] with 0.61 [0.57; 0.64] and 0.53 [0.45; 0.60] among the COVID-19 positive and negative groups, respectively. Factors independently associated with the variation of the SpO(2)-SaO(2) difference were the PaO(2)/FiO(2) ratio and need for mechanical ventilation. In our population, agreement between SpO(2) and SaO(2) is acceptable. During the COVID-19 pandemic, SaO(2) remains an efficient monitoring tool to characterise the level of hypoxemia and follow therapeutic interventions. As is already known about general intensive care unit patients, the greater hypoxemia, the weaker the correlation between SpO(2) and SaO(2). SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10877-022-00959-2.
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spelling pubmed-98597412023-01-23 Agreement between pulse oximetry and arterial oxygen saturation measurement in critical care patients during COVID-19: a cross-sectional study James, Arthur Petit, Matthieu Biancale, Flore Bougle, Adrien Degos, Vincent Monsel, Antoine Vieillard-Baron, Antoine Constantin, Jean-Michel J Clin Monit Comput Original Research Some publications suggest that pulse oximetry measurement (SpO(2)) might overestimate arterial oxygen saturation (SaO(2)) measurement in COVID-19 patients. This study aims to evaluate the agreement between SpO(2) and SaO(2) among COVID-19 and non-COVID-19 patients. We conducted a multicenter, prospective study including consecutive intensive care patients from October 15, 2020, to March 4, 2021, and compared for each measurement the difference between SpO(2) and SaO(2), also called the systematic bias. The primary endpoint was the agreement between SpO(2) and SaO(2) measured with the Lin concordance coefficient and illustrated using the Bland and Altman method. Factors associated with systematic bias were then identified using a generalised estimating equation. The study included 105 patients, 66 COVID-19 positive and 39 COVID-19 negative, allowing for 1539 measurements. The median age was 66 [57; 72] years with median SOFA and SAPSII scores of, respectively, 4 [3; 6] and 37 [31; 47]. The median SpO(2) and SaO(2) among all measurements was respectively 97 [96–99] and 94 [92–96] with a systematic bias of 0.80 [− 0.6; 2.4]. This difference was, respectively, 0.80 [− 0.7; 2.5] and 0.90 [− 0.3; 2.0] among COVID-19 positive and negative patients. Overall agreement measured with the Lin correlation coefficient was 0.65 [0.63; 0.68] with 0.61 [0.57; 0.64] and 0.53 [0.45; 0.60] among the COVID-19 positive and negative groups, respectively. Factors independently associated with the variation of the SpO(2)-SaO(2) difference were the PaO(2)/FiO(2) ratio and need for mechanical ventilation. In our population, agreement between SpO(2) and SaO(2) is acceptable. During the COVID-19 pandemic, SaO(2) remains an efficient monitoring tool to characterise the level of hypoxemia and follow therapeutic interventions. As is already known about general intensive care unit patients, the greater hypoxemia, the weaker the correlation between SpO(2) and SaO(2). SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10877-022-00959-2. Springer Netherlands 2023-01-21 2023 /pmc/articles/PMC9859741/ /pubmed/36670340 http://dx.doi.org/10.1007/s10877-022-00959-2 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Research
James, Arthur
Petit, Matthieu
Biancale, Flore
Bougle, Adrien
Degos, Vincent
Monsel, Antoine
Vieillard-Baron, Antoine
Constantin, Jean-Michel
Agreement between pulse oximetry and arterial oxygen saturation measurement in critical care patients during COVID-19: a cross-sectional study
title Agreement between pulse oximetry and arterial oxygen saturation measurement in critical care patients during COVID-19: a cross-sectional study
title_full Agreement between pulse oximetry and arterial oxygen saturation measurement in critical care patients during COVID-19: a cross-sectional study
title_fullStr Agreement between pulse oximetry and arterial oxygen saturation measurement in critical care patients during COVID-19: a cross-sectional study
title_full_unstemmed Agreement between pulse oximetry and arterial oxygen saturation measurement in critical care patients during COVID-19: a cross-sectional study
title_short Agreement between pulse oximetry and arterial oxygen saturation measurement in critical care patients during COVID-19: a cross-sectional study
title_sort agreement between pulse oximetry and arterial oxygen saturation measurement in critical care patients during covid-19: a cross-sectional study
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9859741/
https://www.ncbi.nlm.nih.gov/pubmed/36670340
http://dx.doi.org/10.1007/s10877-022-00959-2
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