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Pulse oximetry

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Pulse oximetry

ʻO ka oximetry pulse ʻole

Ke kumu

Ka nānā ʻana i ka saturation oxygen o ke kanaka

Pulse oximetryhe anoninvasiveala no ka nānā ʻana i ke kanakahoʻonaʻauao oxygen.ʻOiai ʻo kāna heluhelu ʻana i ka saturation oxygen peripheral (SpO2) ʻaʻole like ia me ka heluhelu makemake nui ʻia o ka saturation oxygen arterial (SaO2) maikinoea koko arterialka nānā ʻana, ua hoʻopili maikaʻi ʻia nā mea ʻelua i mea waiwai ke ʻano palekana, kūpono, noninvasive, inexpensive pulse oximetry no ke ana ʻana i ka saturation oxygen i loko.lāʻau lapaʻauhoʻohana.

Ma kāna ʻano noi maʻamau (transmissive), kau ʻia kahi mea ʻike ma kahi ʻāpana lahilahi o ke kino o ka mea maʻi, maʻamaumanamana limaa i ʻoleʻūpoʻo pepeiao, a ma ka hihia o kahikamaliʻi, ma ka wawae.Hāʻawi ka mea hana i ʻelua mau nalu o ka mālamalama ma o ka ʻāpana kino i kahi mea nānā kiʻi.He ana ia i ka hoʻololi ʻana o ka absorbance i kēlā me kēianā lōʻihi nalu, e ae ana e hooholo i kahoʻopaʻa ʻanama muli o ka puʻupuʻukoko kokokaawale, kaawalekoko venous, ka ʻili, ka iwi, ka ʻiʻo, ka momona, a (i ka nui o nā hihia) ka kui kui.[1]

ʻO ka Reflectance pulse oximetry kahi koho maʻamau i ka transmissive pulse oximetry.ʻAʻole koi kēia ʻano i kahi ʻāpana lahilahi o ke kino o ke kanaka a no laila ua kūpono i ka hoʻohana āpau e like me nā wāwae, ka lae, a me ka umauma, akā aia kekahi mau palena.ʻO ka Vasodilation a me ka hoʻoulu ʻana o ke koko venous i ke poʻo ma muli o ka hoʻihoʻi ʻana o ka venous i ka puʻuwai hiki ke hoʻohui i nā puʻuwai arterial a me venous i ka lae a alakaʻi i ka SpO spurious.2hopena.Loaʻa ia mau kūlana i ka wā e hana ana i ka anesthesia mehoʻokomo ʻana i ka endotracheala me ka ventila mechanical a i ole i na ma'i ma kaKe kūlana Trendelenburg.[2]

ʻIkepili

Moolelo[hoʻoponopono]

I ka makahiki 1935, ua hoʻokumu ke kauka Kelemania ʻo Karl Matthes (1905–1962) i ka pepeiao mua ʻelua-lōʻihi O.2mika saturation me nā kānana ʻulaʻula a me ka ʻōmaʻomaʻo (nā kānana ʻulaʻula a me ka infrared ma hope).ʻO kāna mika ka mea hana mua e ana iā O2hoʻopololei.[3]

Ua hana ʻia ka oximeter kumu eGlenn Allan Millikani ka makahiki 1940.[4]I ka makahiki 1949, ua hoʻohui ʻo Wood i kahi capsule kaomi e ʻoki i ke koko mai loko mai o ka pepeiao i mea e loaʻa ai ka O.2waiwai saturation ke lawe hou ia ke koko.Ua like ka manaʻo me ka pulse oximetry maʻamau i kēia lā, akā paʻakikī ke hoʻokō ma muli o ka paʻa ʻolenā paʻi kiʻia me nā kumu kukui;i kēia lā ʻaʻole hoʻohana ʻia kēia ʻano hana ma ke ʻano maʻi.I ka makahiki 1964, ua hōʻuluʻulu ʻo Shaw i ka oximeter pepeiao heluhelu piha mua, nāna i hoʻohana i ʻewalu mau nalu o ka mālamalama.

Ua hoʻomohala ʻia ka Pulse oximetry i ka makahiki 1972, eTakuo Aoyagia me Michio Kishi, bioengineers, maNihon Kohdenme ka hoʻohana ʻana i ka ratio o ka ʻulaʻula a me ka infrared light absorption o nā ʻāpana pulsating ma ke kahua ana.ʻO Susumu Nakajima, he kauka lapaʻau, a me kāna mau hoa i hoʻāʻo mua i ka hāmeʻa i nā maʻi, e hōʻike ana iā ia ma 1975.[5]Ua kuaiia eBioxi ka makahiki 1980.[6][5][7]

Ma ka makahiki 1987, ʻo ka maʻamau o ka mālama ʻana i kahi maʻi anesthetic maʻamau i ka US ua komo pū me ka pulse oximetry.Mai ka lumi hana, hoʻolaha koke ka hoʻohana ʻana i ka pulse oximetry i loko o ka haukapila, mua ilumi ho'ōla, a laila ihale mālama kino.He waiwai koʻikoʻi ka Pulse oximetry i ka ʻāpana neonatal kahi e ulu ʻole ai ka poʻe maʻi me ka lawa ʻole o ka oxygenation, akā ʻoi aku ka nui o ka oxygen a me ka loli ʻana i ka ʻike o ka oxygen hiki ke alakaʻi i ka pōʻino a i ʻole ka makapō mai.retinopathy o ka wā mua(ROP).Eia kekahi, ʻo ka loaʻa ʻana o ke kinoea koko mai kahi maʻi neonatal he mea ʻeha ia i ka mea maʻi a he kumu nui o ka anemia neonatal.[8]Hiki i ka motion artifact ke lilo i palena koʻikoʻi i ka nānā ʻana i ka pulse oximetry e hopena i nā ʻōhua hoʻopunipuni pinepine a me ka nalowale o ka ʻikepili.ʻO kēia no ka mea i ka wā o ka neʻe a me ka peripheral haʻahaʻaperfusion, ʻAʻole hiki i ka nui o nā pulse oximeters ke hoʻokaʻawale i waena o ke koko arterial pulsating a me ka neʻe ʻana o ke koko venous, e alakaʻi ana i ka underestimation o ka saturation oxygen.ʻO nā haʻawina mua o ka hana o ka pulse oximetry i ka wā e neʻe ai ke kumuhana i hoʻomaopopo i nā nāwaliwali o nā ʻenehana pulse oximetry maʻamau i ka motion artifact.[9][10]

I ka makahiki 1995,Masimoua hoʻolauna ʻo Signal Extraction Technology (SET) hiki ke ana pololei i ka wā o ka neʻe ʻana o ka maʻi a me ka haʻahaʻa haʻahaʻa ma o ka hoʻokaʻawale ʻana i ka hōʻailona arterial mai ka venous a me nā hōʻailona ʻē aʻe.Mai ia manawa, ua hoʻomohala nā mea hana o ka pulse oximetry i nā algorithms hou e hōʻemi i kekahi mau ala hoʻopunipuni i ka wā o ka neʻe[11]e like me ka hoʻolōʻihi ʻana i nā manawa awelika a i ʻole nā ​​waiwai maloʻo ma ka pale, akā ʻaʻole lākou e ʻōlelo e ana i nā kūlana hoʻololi i ka wā o ka neʻe ʻana a me ka haʻahaʻa perfusion.No laila, aia nā ʻokoʻa koʻikoʻi i ka hana ʻana o nā oximeters pulse i nā kūlana paʻakikī.[12]I ka makahiki 1995, ua hoʻokomo ʻo Masimo i ka perfusion index, e helu ana i ka amplitude o ka peripheral.plethysmographʻano nalu.Ua hōʻike ʻia ka perfusion index e kōkua i nā kauka e wānana i ka nui o ka maʻi a me nā hopena hanu mua i nā neonates,[13][14][15]wānana i ke kahe ʻana o ka vena cava kiʻekiʻe haʻahaʻa i nā pēpē haʻahaʻa haʻahaʻa haʻahaʻa haʻahaʻa,[16]hāʻawi i kahi hōʻailona mua o ka sympathectomy ma hope o ka anesthesia epidural,[17]a hoʻomaikaʻi i ka ʻike ʻana i ka maʻi puʻuwai koʻikoʻi i nā keiki hānau hou.[18]

Ua hoʻohālikelike nā pepa i paʻi ʻia i ka ʻenehana unuhi hōʻailona me nā ʻenehana pulse oximetry ʻē aʻe a ua hōʻike i nā hopena maikaʻi mau no ka ʻenehana unuhi hōʻailona.[9][12][19]Ua hōʻike pū ʻia ka hana ʻenehana hōʻiliʻili pulse oximetry e unuhi i ke kōkua ʻana i nā kauka e hoʻomaikaʻi i nā hopena maʻi.I loko o kahi noiʻi, ua hoʻemi ʻia ka retinopathy o ka prematurity (pōʻino o ka maka) e 58% i nā neonates haʻahaʻa haʻahaʻa haʻahaʻa ma ke kikowaena me ka hoʻohana ʻana i ka ʻenehana hōʻailona hōʻailona, ​​ʻoiai ʻaʻohe emi o ka retinopathy o prematurity ma kahi kikowaena ʻē aʻe me nā kauka like e hoʻohana ana i ka protocol like. akā me ka ʻenehana unuhi ʻole hōʻailona.[20]Ua hōʻike ʻia nā haʻawina ʻē aʻe i ka hopena o ka ʻenehana hōʻiliʻili pulse oximetry i ka liʻiliʻi o nā ana kinoea koko, ʻoi aku ka wikiwiki o ka manawa wean oxygen, ka hoʻohana haʻahaʻa haʻahaʻa, a me ka lōʻihi o ka noho ʻana.[21]ʻO ke ana-ma o ka neʻe a me ka haʻahaʻa haʻahaʻa haʻahaʻa hiki ke hoʻohana ʻia i nā wahi i nānā ʻole ʻia e like me ka papahele ākea, kahi i hoʻopilikia ai nā mea hoʻopunipuni wahaheʻe i ka pulse oximetry maʻamau.Ma ke ʻano he hōʻike o kēia, ua paʻi ʻia kahi noiʻi ʻāina ma 2010 e hōʻike ana i nā kauka ma Dartmouth-Hitchcock Medical Center me ka hoʻohana ʻana i ka ʻenehana hōʻiliʻili ʻenehana pulse oximetry ma ka papahele ākea hiki ke hoʻemi i ka hoʻoulu ʻana o ka hui pane wikiwiki, nā hoʻololi ICU, a me nā lā ICU.[22]I ka makahiki 2020, ua hōʻike ʻia kahi noiʻi retrospective e pili ana i ke kula hoʻokahi ma mua o ʻumi mau makahiki o ka hoʻohana ʻana i ka pulse oximetry me ka ʻenehana hōʻiliʻili hōʻailona, ​​i hui pū ʻia me kahi ʻōnaehana nānā maʻi, ʻaʻohe make maʻi a ʻaʻohe mea maʻi i hōʻeha ʻia e ka opioid-induced respiratory depression. ʻoiai e hoʻohana mau ana ka nānā ʻana.[23]

I ka makahiki 2007, ua hoʻokomo ʻo Masimo i ke ana mua o kaplth variability index(PVI), ka mea i hōʻike ʻia e nā haʻawina hoʻomaʻamaʻa he nui i kahi ala hou no ka loiloi maʻalahi, noninvasive no ka hiki o ka mea maʻi ke pane i ka hoʻokele wai.[24][25][26]He mea koʻikoʻi nā pae wai kūpono i ka hōʻemi ʻana i nā pilikia postoperative a me ka hoʻomaikaʻi ʻana i nā hopena o ka maʻi: ʻo ka nui o ka wai i haʻahaʻa loa (under-hydration) a i ʻole kiʻekiʻe loa (over-hydration) ua hōʻike ʻia e hōʻemi i ka hoʻōla ʻana i ka ʻeha a hoʻonui i ka pilikia o ka maʻi a i ʻole nā ​​pilikia naʻau.[27]ʻO ka mea i hala koke nei, ua helu ka National Health Service ma United Kingdom a me ka French Anesthesia and Critical Care Society i ka nānā ʻana i ka PVI ma ke ʻano he ʻāpana o kā lākou manaʻo i manaʻo ʻia no ka hoʻokele wai intra-operative.[28][29]

I ka makahiki 2011, ua ʻōlelo kekahi pūʻulu hana akamai i ka nānā ʻana i nā keiki hou me ka pulse oximetry e hoʻonui i ka ʻikemaʻi puʻuwai koʻikoʻi(CCHD).[30]Ua haʻi ka pūʻulu hana CCHD i nā hopena o nā haʻawina nui ʻelua o 59,876 mau kumuhana i hoʻohana wale i ka ʻenehana hōʻiliʻili hōʻailona no ka hoʻonui ʻana i ka ʻike ʻana o CCHD me ka liʻiliʻi o nā hopena hoʻopunipuni.[31][32]Manaʻo ka pūʻulu hana CCHD e hana ʻia ka nānā ʻana i nā keiki hou me ka neʻe ʻana o ka pulse oximetry i hoʻopaʻa ʻia ma nā kūlana perfusion haʻahaʻa.I ka makahiki 2011, ua hoʻohui ke Kakauolelo o ka Ola Ola a me nā lawelawe kanaka o ʻAmelika i ka pulse oximetry i ka papa hoʻomaʻamaʻa like ʻole.[33]Ma mua o ka hōʻike ʻana no ka nānā ʻana me ka hoʻohana ʻana i ka ʻenehana hōʻiliʻili hōʻailona, ​​ʻoi aku ka liʻiliʻi o 1% o nā keiki hānau hou ma ʻAmelika Hui Pū ʻIa.I kēia lā,ʻO ka Newborn FoundationUa kākau ʻo ia ma kahi kokoke i ka nānā ʻana i ke ao holoʻokoʻa ma ʻAmelika Hui Pū ʻIa a ke hoʻonui wikiwiki nei ka nānā ʻana o ka honua.[34]I ka makahiki 2014, ua hōʻike ʻia ke kolu o ka noiʻi nui o nā keiki hānau hou he 122,738 i hoʻohana wale i ka ʻenehana hōʻailona hōʻailona like, nā hopena maikaʻi e like me nā haʻawina nui ʻelua.[35]

Ua hoʻomohala ʻia ka pulse oximetry kiʻekiʻe (HRPO) no ka nānā ʻana a me ka hoʻāʻo ʻana i ka apnea hiamoe ma ka home i nā poʻe maʻi hiki ʻole ke hana.polysomnography.[36][37]Hoʻopaʻa a hoʻopaʻa ia i nā mea ʻeluaka helu pulupulua me SpO2 i 1 kekona manawa a ua hōʻike ʻia i loko o hoʻokahi haʻawina e kōkua i ka ʻike ʻana i ka hanu pilikia ʻole o ka hiamoe i nā maʻi maʻi.[38]

Hana[hoʻoponopono]

ʻO ke ʻano o ka hoʻoheheʻe ʻana o ka hemoglobin oxygenated (HbO2) a me ka hemoglobin deoxygenated (Hb) no nā lōʻihi hawewe ʻulaʻula a me ka infrared.

ʻO ka ʻaoʻao i loko o kahi oximeter pulse

Hōʻike ka nānā ʻana o ke koko-oxygen i ka pākēneka o ke koko i hoʻopiha ʻia me ka oxygen.ʻOi aku ke kikoʻī, ana ia i ka pākēneka ohemoglobin, ka pūmua i loko o ke koko e lawe ana i ka oxygen, hoʻouka ʻia.ʻO nā pae maʻamau e ʻae ʻia no nā maʻi me ka ʻole o ka pulmonary pathology mai 95 a 99 pakeneka.No ka ma'i hanu lumi lumi ea ma kahi a kokokeʻilikai kai, he kuhi o ka pO arterial2hiki ke hana ʻia mai ke koko-oxygen monitor"saturation o ka oxygen peripheral"(SpO2) heluhelu.

Hoʻohana ʻia kahi oximeter pulse maʻamau i ka mīkini uila a me kahi pālua liʻiliʻinā diodes māmā(LED) e kū pono ana i kahiphotodiodema kahi ʻāpana translucent o ke kino o ka mea maʻi, maʻamau ka manamana lima a i ʻole ka pepeiao.Hoʻokahi LED he ʻulaʻula, melōʻihi naluo 660 nm, a o kekahiinfraredme ka loa hawewe o 940 nm.ʻOkoʻa loa ka ʻai ʻana o ka māmā ma kēia mau nalu nalu ma waena o ke koko i hoʻopiha ʻia me ka oxygen a me ke koko nele i ka oxygen.Hoʻomoʻa ʻia ka hemoglobin oxygen i nā kukui infrared hou aʻe a hiki i ke kukui ʻulaʻula ke hele.ʻO ka hemoglobin deoxygenated e hiki ai i nā kukui infrared ke hele a komo i nā kukui ʻulaʻula hou aʻe.Hoʻokaʻawale nā ​​LED ma o kā lākou pōʻai o kekahi, a laila ʻo kekahi, a laila ʻelua ma kahi o kanakolu manawa i kēlā me kēia kekona e hiki ai i ka photodiode ke pane i ke kukui ʻulaʻula a me ka infrared e hoʻokaʻawale a hoʻoponopono hoʻi no ka baseline kukui ambient.[39]

Ana ʻia ka nui o ke kukui i hoʻouna ʻia (ma nā huaʻōlelo ʻē aʻe, ʻaʻole i komo ʻia) a hana ʻia nā hōʻailona maʻamau no kēlā me kēia nalu.Ke loli nei kēia mau hōʻailona i ka manawa no ka mea e piʻi ana ka nui o ke koko ʻaʻa i kēia manawa (ʻoiaʻiʻo pulses) me kēlā me kēia puʻuwai.Ma ka unuhi ʻana i ka māmā liʻiliʻi i hoʻouna ʻia mai ke kukui i hoʻouna ʻia i kēlā me kēia nalu, hoʻoponopono ʻia nā hopena o nā ʻiʻo ʻē aʻe, e hana ana i kahi hōʻailona mau no ke koko arterial pulsatile.[40]ʻO ka lakio o ke ana kukui ʻulaʻula me ke ana kukui infrared e helu ʻia e ka mea hana (e hōʻike ana i ka ratio o ka hemoglobin oxygenated i ka hemoglobin deoxygenated), a laila hoʻololi ʻia kēia ratio i SpO2e ka mea hana ma o apapa ʻimi[40]ma muli o kaKānāwai Beer–Lambert.[39]Hoʻohana ʻia ka hoʻokaʻawale hōʻailona i nā kumu ʻē aʻe: he plethysmograph waveform ("pleth wave") e hōʻike ana i ka hōʻailona pulsatile e hōʻike pinepine ʻia no kahi hōʻailona ʻike o nā pulses a me ka maikaʻi o ka hōʻailona.[41]a me ka lakio helu ma waena o ka pulsatile a me ka baseline absorbance (“hua kuhikuhi perfusion") hiki ke hoʻohana ʻia e loiloi i ka perfusion.[25]

Hōʻike[hoʻoponopono]

Hoʻopili ʻia kahi ʻimi pulse oximeter i ka manamana lima o ke kanaka

ʻO kahi oximeter pulse he amea lapaʻaue nānā pono ʻole i ka saturation oxygen o ka mea maʻikoko(e kūʻē i ke ana ʻana i ka saturation oxygen pololei ma o kahi laʻana koko) a me nā loli i ka nui o ke koko i loko o ka ʻili, e hana ana i kahiphotoplethysmogramhiki ke hana hou ʻia i lokonā ana ʻē aʻe.[41]Hiki ke hoʻokomo ʻia ka pulse oximeter i loko o kahi nānā maʻi multiparameter.Hōʻike ka hapa nui o nā mea nānā i ka pulse rate.Loaʻa nō hoʻi nā oximeter pulse hiki ke hoʻohana ʻia i ka pākaukau no ka lawe ʻana a i ʻole ka nānā ʻana i ke koko-oxygen home.

Pono[hoʻoponopono]

He mea maʻalahi ka Pulse oximetry nononinvasiveana mau o ka oxygen saturation koko.ʻO ka ʻokoʻa, pono e hoʻoholo ʻia ke kiʻekiʻe o ke kinoea koko ma ke keʻena keʻena ma kahi laʻana koko i huki ʻia.He mea pono ka Pulse oximetry ma nā wahi a pau o ka mea maʻioxygenationʻaʻole paʻa, ʻo ia hoʻimālama koʻikoʻi, hana, ho'ōla, pilikia a me ka hoʻonohonoho hale maʻi,nā pailakai nā mokulele i hoʻopaʻa ʻole ʻia, no ka loiloi ʻana i ka oxygenation o kēlā me kēia maʻi, a me ka hoʻoholo ʻana i ka pono o ka ponooxygen.ʻOiai ua hoʻohana ʻia ka pulse oximeter e nānā i ka oxygenation, ʻaʻole hiki iā ia ke hoʻoholo i ka metabolism o ka oxygen, a i ʻole ka nui o ka oxygen e hoʻohana ʻia e ka mea maʻi.No kēia kumu, pono e anakalapona kalapona(CO2) pae.Hiki ke hoʻohana ʻia no ka ʻike ʻana i nā mea ʻino i ka ventila.Eia naʻe, ka hoʻohana ʻana i ka pulse oximeter e ʻikehypoventilationimpaired me ka hoʻohana 'ana i ka oxygen supplemental, no ka mea, aia wale nō i ka manawa e hanu ai ka poʻe maʻi i ka ea lumi e hiki ke ʻike pono ʻia nā abnormalities o ka hana hanu me kona hoʻohana ʻana.No laila, ʻaʻole pono ka hoʻohana maʻamau o ka oxygen supplemental inā hiki i ka mea maʻi ke mālama i ka oxygenation kūpono i loko o ka ea lumi, no ka mea hiki ke hopena i ka hypoventilation hele me ka ʻike ʻole ʻia.[42]

Ma muli o ko lākou maʻalahi o ka hoʻohana ʻana a me ka hiki ke hāʻawi i nā koina saturation oxygen mau a me ka koke, he mea koʻikoʻi ka pulse oximeterslāʻau ulia pōpilikiaa he mea maikaʻi nō hoʻi no nā poʻe maʻi me nā pilikia hanu a i ʻole naʻau, ʻoi akuCOPD, a i ʻole no ka ʻike ʻana i kekahipilikia moee like meapneaahypopnea.[43]He mea pono nā oximeters pulse hiki ke hoʻohana ʻia i ka pākaukau no nā pailaka e hana ana i kahi mokulele ʻaʻole kaomi ma luna o 10,000 kapuaʻi (3,000 m) a i ʻole 12,500 kapuaʻi (3,800 m) ma US[44]kahi e pono ai ka oxygen hou.He mea pono nō hoʻi nā oximeter pulse hikiwawe no nā piʻi mauna a me nā mea pāʻani e emi ana ke kiʻekiʻe o ka oxygenkiʻekiʻea i ʻole me ka hoʻoikaika kino.Hoʻohana kekahi mau pulse oximeters i nā lako polokalamu e kahakaha ana i ka oxygen koko a me ka pulse o ka mea maʻi, e lilo ana i mea hoʻomanaʻo e nānā i ke kiʻekiʻe o ka oxygen koko.

ʻO ka holomua o ka hoʻohui hou ʻana i kēia manawa ua hiki i nā poʻe maʻi ke nānā mau ʻia ko lākou koko oxygen saturation me ka ʻole o ka hoʻopaʻa ʻana i ke kelepona me ka nānā ʻana i ka haukapila, me ka ʻole o ka mōhai ʻana i ka kahe o ka ʻikepili maʻi i nā mea nānā moe a me nā ʻōnaehana kiaʻi maʻi.Hāʻawi ʻo Masimo Radius PPG, i hoʻolauna ʻia ma 2019, hāʻawi i ka tetherless pulse oximetry me ka hoʻohana ʻana i ka ʻenehana hōʻailona hōʻailona Masimo, e ʻae ana i ka poʻe maʻi e neʻe me ka ʻoluʻolu a me ka hoʻomau mau ʻana a me ka hilinaʻi.[45]Hiki nō hoʻi iā Radius PPG ke hoʻohana i ka Bluetooth paʻa e kaʻana pololei i ka ʻikepili maʻi me kahi atamai a i ʻole nā ​​​​mea akamai ʻē aʻe.[46]

Nā palena[hoʻoponopono]

ʻO ka Pulse oximetry e ana wale i ka saturation hemoglobin, ʻaʻoleventilaa ʻaʻole ia he ana piha o ka lawa ʻana o ka hanu.ʻAʻole ia he pani nokinoea kokonānā ʻia i loko o kahi keʻena hana, no ka mea ʻaʻole ia e hōʻike i ka hemahema kumu, nā pae kalapona kalapona, ke kokopH, a i ʻolebicarbonate(HCO3−) hoʻopaʻa ʻana.Hiki ke ana ʻia ka metabolism o ka oxygen e ka nānā ʻana i ka CO i pau2, akā ʻaʻole hāʻawi nā helu saturation i ka ʻike e pili ana i ka ʻike oxygen koko.Lawe ʻia ka hapa nui o ka oxygen i loko o ke koko e ka hemoglobin;i ka anemia ko'iko'i, li'ili'i ka hemoglobin i ke koko, 'a'ole hiki ke lawe i ka oxygen e like me ka saturated.

Hiki ke kumu o ka heluhelu haʻahaʻa hewa ʻolehypoperfusionhoʻohana ʻia no ka nānā ʻana (pinepine ma muli o ke anuanu o kahi lālā, a maivasoconstrictionlua i ka hoohana ana ivasopressornā ʻelele);ʻaʻole pono ka noi sensor;nui loacallousedʻili;a i ʻole ka neʻe ʻana (e like me ka haʻalulu), ʻoi loa i ka wā hypoperfusion.No ka hōʻoia ʻana i ka pololei, pono e hoʻihoʻi ka mea ʻike i kahi puʻupuʻu paʻa a / a i ʻole ka nalu pulse.ʻOkoʻa nā ʻenehana Pulse oximetry i ko lākou hiki ke hāʻawi i ka ʻikepili pololei i ka wā o ka neʻe a me ka perfusion haʻahaʻa.[12][9]

ʻAʻole ʻo Pulse oximetry kahi ana piha o ka lawa o ka oxygen kaʻe.Inā lawa ʻolekahe kokoʻaʻole lawa ka hemoglobin i loko o ke koko (anemia), hiki ke pilikia nā kikohypoxiaʻoiai ke kiʻekiʻe o ka oxygen saturation arterial.

No ka mea e ana ana ka pulse oximetry i ka pākēneka o ka hemoglobin i hoʻopaʻa ʻia, e loaʻa ana kahi heluhelu hoʻopunipuni kiʻekiʻe a haʻahaʻa haʻahaʻa ke hoʻopaʻa ʻia ka hemoglobin i kahi mea ʻē aʻe ma waho o ka oxygen:

  • ʻOi aku ka pili o ka Hemoglobin i ka carbon monoxide ma mua o ka oxygen, a hiki ke loaʻa kahi heluhelu kiʻekiʻe ʻoiai he hypoxemic maoli ka mea maʻi.Ma na hihia okalapona monoxide, hiki i kēia hemahema ke hoʻopaneʻe i ka ʻike ʻana ohypoxia(ka haʻahaʻa o ka oxygen cellular level).
  • ʻO ka make ʻana o ka cyanidehāʻawi i kahi heluhelu kiʻekiʻe no ka mea e hōʻemi ana i ka lawe ʻana o ka oxygen mai ke koko arterial.I kēia hihia, ʻaʻole wahaheʻe ka heluhelu ʻana, no ka mea, ʻoi aku ka kiʻekiʻe o ka oxygen koko i ka wā mua o ka make cyanide.[pono ka wehewehe]
  • Methemoglobinemiake kumu o ka heluhelu pulse oximetry ma waena o 80s.
  • Hiki i ka COPD [ʻoi aku ka maʻi bronchitis maʻi maʻi] ke kumu i ka heluhelu wahaheʻe.[47]

ʻO kahi ala noninvasive e hiki ai ke ana mau i nā dyshemoglobins ʻo ia ka pulseCO-oximeter, i kūkulu ʻia ma 2005 e Masimo.[48]Me ka hoʻohana ʻana i nā lōʻihi nalu hou,[49]Hāʻawi ia i nā kauka i kahi ala e ana i nā dyshemoglobins, carboxyhemoglobin, a me methemoglobin me ka hemoglobin holoʻokoʻa.[50]

Hoʻonui hoʻohana[hoʻoponopono]

Wahi a kahi hōʻike e iData Research ʻo ka US pulse oximetry nānā mākaʻikaʻi no nā lako a me nā mea ʻike ma luna o 700 miliona USD ma 2011.[51]

I ka makahiki 2008, ʻoi aku ma mua o ka hapalua o nā mea hana lapaʻau nui e hoʻopuka ana ma ka honuaKinahe mau mea hana o ka pulse oximeters.[52]

ʻIke mua o COVID-19[hoʻoponopono]

Hoʻohana ʻia nā Pulse oximeters e kōkua i ka ʻike mua ʻana oCOVID-19nā maʻi, kahi e hiki ai ke ʻike mua ʻole ʻia ka haʻahaʻa o ka oxygen saturation a me ka hypoxia.ʻO ka New York TimesUa hōʻike ʻia "ua māhele ʻia nā luna olakino inā pono e ʻōlelo ʻia ka nānā ʻana i ka home me ka pulse oximeter ma kahi ākea i ka wā Covid-19.Hōʻike nā haʻawina o ka hilinaʻi i nā hopena like ʻole, a ʻaʻohe alakaʻi i ke koho ʻana i kekahi.Akā ke aʻo nei nā kauka he nui i nā mea maʻi e kiʻi i hoʻokahi, e hoʻolilo iā ia i ke ala hele o ka maʻi maʻi.[53]

ana i loaa[hoʻoponopono]

E nana no hoi:Photoplethysmogram

Ma muli o ka hoʻololi ʻana i ka nui o ke koko ma ka ʻili, aplethysmographicHiki ke ʻike ʻia ka ʻokoʻa ma ka hōʻailona māmā i loaʻa (transmittance) e ka mea ʻike ma kahi oximeter.Hiki ke wehewehe ʻia ke ʻano like ʻole ahana manawa, hiki ke hoʻokaʻawale ʻia i loko o kahi ʻāpana DC (ka waiwai kiʻekiʻe)[a]a me kahi ʻāpana AC (peak minus awāwa).[54]ʻO ka ratio o ka ʻāpana AC i ka ʻāpana DC, i hōʻike ʻia ma ke ʻano he pākēneka, ʻike ʻia ʻo ia ka(pilipili)perfusionkuhikuhi(Pi) no ka pulse, a loaʻa maʻamau ka laulā o 0.02% a 20%.[55]He ana mua i kapaia kapulse oximetry plethysmographic(POP) e ana wale i ka mea "AC", a ua lawe lima ia mai na pixels kiai.[56][25]

Helu helu hoʻololi(PVI) kahi ana o ka hoʻololi ʻana o ka index perfusion, e kū ana i ka wā o ka hanu ʻana.Ma ka makemakika ua helu ʻia e like me (Pimax- Pimin)/Pimax× 100%, kahi i loaʻa ai ka nui a me ka liʻiliʻi loa o nā koina Pi mai hoʻokahi a i ʻole ka nui o ka hanu hanu.[54]Ua hōʻike ʻia he hōʻailona pono, noninvasive no ka pane mau ʻana o ka wai no nā poʻe maʻi e hoʻokele ana i ka wai.[25] Pulse oximetry plethysmographic waveform amplitude(ΔPOP) he ʻano hana like ma mua no ka hoʻohana ʻana ma ka POP i lawe lima ʻia, i helu ʻia e like me (POPmax- POPmin)/(POPmax+ POPmin)*2.[56]

E nana hoi [hoʻoponopono]

memo[hoʻoponopono]

  1. ^ʻO kēia wehewehe ʻana i hoʻohana ʻia e Masimo he ʻokoʻa ia mai ke kumu waiwai i hoʻohana ʻia i ka hana hōʻailona;ʻo ia ka manaʻo e ana i ka hoʻopaʻa ʻana o ke koko arterial pulsatile ma luna o ka pae kumu.

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Ka manawa hoʻouna: Jun-04-2020