Susana Garcia-Gutierrez1, Anette Unzurrunzaga1, Inmaculada Arostegui2, Jose María Quintana1, Esther Pulido3, Maria Soledad Gallardo3, Cristóbal Esteban4. 1. a Unidad de Investigación, Hospital Galdakao-Usansolo (Osakidetza)-Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC) , Galdakao , Bizkaia , Spain. 2. b Departamento de Matemática Aplicada y Estadística e Investigación Operativa-Universidad del País Vasco UPV/EHU-Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Leioa , Bizkaia. 3. c Servicio de Urgencias , Hospital Galdakao-Usansolo , Galdakao , Bizkaia , Spain. 4. d Servicio de Respiratorio - Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Hospital Galdakao-Usansolo (Osakidetza) , Galdakao , Bizkaia , Spain.
Abstract
BACKGROUND: There is little evidence that the guideline-recommended oxygen saturation of 92% is the best cut-off point for detecting hypoxemia in COPD exacerbations. OBJECTIVE: 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. METHODOLOGY: 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 (PaO2 < 60 mmHg) and hypercapnic respiratory failure (PaO2 < 60 mmHg and PaCO2 > 45). Optimal cut-off points were calculated. RESULTS: 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%. CONCLUSIONS: 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.
BACKGROUND: There is little evidence that the guideline-recommended oxygen saturation of 92% is the best cut-off point for detecting hypoxemia in COPD exacerbations. OBJECTIVE: 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. METHODOLOGY: 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 (PaO2 < 60 mmHg) and hypercapnic respiratory failure (PaO2 < 60 mmHg and PaCO2 > 45). Optimal cut-off points were calculated. RESULTS: 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%. CONCLUSIONS: 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.
Authors: Kristian Brat; Marek Plutinsky; Karel Hejduk; Michal Svoboda; Patrice Popelkova; Jaromir Zatloukal; Eva Volakova; Miroslava Fecaninova; Lucie Heribanova; Vladimir Koblizek Journal: Int J Chron Obstruct Pulmon Dis Date: 2018-03-26
Authors: Joren Buekers; Jan Theunis; Patrick De Boever; Anouk W Vaes; Maud Koopman; Eefje Vm Janssen; Emiel Fm Wouters; Martijn A Spruit; Jean-Marie Aerts Journal: JMIR Mhealth Uhealth Date: 2019-06-06 Impact factor: 4.773