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Oximetry garaaca wadnaha

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Oximetry garaaca wadnaha

Oximetry garaaca wadnaha ee aan tetherless

Ujeedo

La socoshada qoyaanka ogsijiinta ee qofka

Oximetry garaaca wadnahawaaaan duullaan lahaynhabka lagula socdo qofkabuuxinta ogsijiinta.In kasta oo ay akhrinayso saturation oksijiinta durugsan (SpO2) had iyo jeer la mid ma aha akhrinta aadka loo jecel yahay ee saturation oxygen halbowlaha (SaO2) kagaaska dhiigga halbowlahaFalanqaynta, labaduba waxay si fiican ugu xidhan yihiin si badbaado leh, ku habboon, aan fiicneyn, habka oximetry garaaca wadnaha ee aan qaali ahayn ay qiimo u leedahay cabbirka saturation oxygencaafimaadisticmaal.

Habka arjigeeda ugu caansan (gudbiyeedka), qalabka dareemayaasha ayaa la dhigayaa qayb dhuuban oo ka mid ah jirka bukaanka, badanaafaraha farahaamadhegta, ama haddii ay dhacdo adhallaan, cagta oo dhan.Qalabku wuxuu sii maraa laba mawjadaha iftiinka ee qaybta jidhka ilaa sawirqaade.Waxay cabbirtaa nuugista isbeddelka mid kasta oo ka mid ahdhererka hirarka, taas oo u oggolaanaysa inay go'aamisonuugistagaraacid awgeeddhiig halbowleedkeligiis, marka laga reebodhiig xidid, maqaarka, lafaha, murqaha, baruurta, iyo (xaaladaha badi) ciddiyaha.[1]

Milicsiga oximetry garaaca wadnaha ayaa ah beddel aan caadi ahayn oo loo beddelo oximetry garaaca wadnaha.Habkani uma baahna qayb dhuuban oo ka mid ah jidhka qofka sidaa darteed si fiican ayuu ugu habboon yahay codsiga caalamiga ah sida cagaha, foodda, iyo laabta, laakiin sidoo kale waxay leedahay xaddidaadyo.Vasodilation iyo isku-darka dhiigga xididdada madaxa ee xididdada dhiigga oo xumaaday oo ku soo laabtay wadnaha waxay keeni kartaa isku-darka garaaca wadnaha iyo xididdada ee gobolka wejiga waxayna u horseedi kartaa SpO.2natiijooyin.Xaaladahan oo kale waxay dhacaan marka lagu suuxinayoxuubka endotrachealiyo hawo-mareenka farsamada ama bukaanada ku jirabooska Trendelenburg.[2]

Nuxurka

Taariikhda[wax ka beddel]

Sannadkii 1935kii, dhakhtar Jarmal ah Karl Matthes (1905-1962) ayaa sameeyay dhegta laba-mawjadaha dheer ee ugu horreysa.2mitirka saturation oo leh filtarrada casaanka iyo cagaarka ah (ka dib shaandhada casaanka iyo infrared).Mitirkiisu wuxuu ahaa qalabkii ugu horreeyay ee lagu cabbiro O2dheregtaan.[3]

Oximeterka asalka ah waxaa sameeyayGlenn Allan Millikan1940-kii.[4]Sannadkii 1949-kii, Wood wuxuu ku daray kaabsulka cadaadiska si uu dhiigga uga tuujiyo dhegta si loo helo O dhamaystiran2qiimaha dheregta marka dhiiga dib loo soo celiyo.Fikradda waxay la mid tahay oximetry garaaca wadnaha caadiga ah ee maanta, laakiin way adkeyd in la hirgeliyo sababtoo ah xasillooni darrounugyada sawir-qaadistaiyo ilaha iftiinka;maanta habkan looma isticmaalo kiliinikada.Sannadkii 1964-kii Shaw waxa uu soo ururiyay oximeterkii dhegta wax-akhriska ugu horreeya, kaas oo isticmaalay siddeed mawjadood oo iftiin ah.

Pulse oximetry waxaa la sameeyay 1972, byTakuo Aoyagiiyo Michio Kishi, bioengineers, atNihon Kohdeniyadoo la isticmaalayo saamiga casaanka iyo nuugista iftiinka infrared ee qaybaha garaaca ee goobta cabbirka.Susumu Nakajima, oo ah dhakhtar qalliin, iyo asxaabtiisa ayaa markii ugu horreysay qalabkan ku tijaabiyay bukaanno, iyaga oo ka warbixiyay 1975-kii.[5]Waxaa ka ganacsan jirayBioxsanadkii 1980kii.[6][5][7]

Sannadkii 1987kii, heerka daryeelka ee maamulka suuxinta guud ee Maraykanka waxaa ku jiray oximetry garaaca wadnaha.Laga soo bilaabo qolka qalliinka, isticmaalka oximetry garaaca wadnaha ayaa si degdeg ah ugu faafay isbitaalka oo dhan, marka hore ilaaqolalka soo kabashada, ka dibna kuqaybaha daryeelka degdega ah.Pulse oximetry waxay qiimo gaar ah ku lahayd unugga dhallaanka halkaaso bukaannadu aysan ku baraarugin ogsijiin ku filan, laakiin oksijiin badan iyo isbedbeddelka xoogga oksijiinta waxay u horseedi kartaa aragga daciifnimo ama indho la'aan.indho-indho-dareenka ee xilli-ciyaareedka(ROP).Intaa waxaa dheer, helitaanka gaaska dhiigga halbowlaha ee bukaanka dhallaanka ah waxay xanuun ku tahay bukaanka waana sababta ugu weyn ee dhiig-yaraanta dhallaanka.[8]Dhaqdhaqaaqa artifact wuxuu noqon karaa xaddidaad weyn oo la socodka oximetry garaaca wadnaha taasoo keentay digniino been abuur ah oo joogto ah iyo luminta xogta.Tani waa sababta oo ah inta lagu jiro dhaqdhaqaaqa iyo meelaha hoosedhiigbax, oximeters badan oo garaaca wadnaha ah ma kala saari karaan inta u dhaxaysa dhiigga halbowlaha ah ee dhaqdhaqaaqaya iyo dhaqdhaqaaqa dhiigga xididdada, taas oo horseedaysa in la dhayalsado dheecaanka oksijiinta.Daraasadihii hore ee waxqabadka oximetry garaaca wadnaha inta lagu jiro dhaqdhaqaaqa mawduuca ayaa cadeeyay dayacanka tignoolajiyada oximetry garaaca wadnaha ee caadiga ah ee dhaqdhaqaaqa dhaqdhaqaaqa.[9][10]

Sannadkii 1995kii.Masimowaxa la keenay Tignoolajiyada Soo saarista Calaamadaha (SET) taas oo si sax ah u cabbiri karta inta lagu jiro dhaqdhaqaaqa bukaanka iyo dhiig-karka hooseeya iyadoo la kala saarayo calaamadda halbowlaha ee xididdada iyo calaamadaha kale.Tan iyo markaas, soosaarayaasha pulse oximetry waxay soo saareen algorithms-yada cusub si ay u yareeyaan qaylo-dhaanta beenta ah qaarkood inta lagu jiro dhaqdhaqaaqa[11]sida kordhinta celceliska waqtiyada ama qiimaha qaboojinta ee shaashadda, laakiin ma sheeganayaan inay cabbiraan xaaladaha isbeddelka ah inta lagu jiro dhaqdhaqaaqa iyo dhiigbax hooseeya.Sidaa darteed, weli waxaa jira kala duwanaansho muhiim ah oo ku saabsan waxqabadka oximeter-ka garaaca wadnaha inta lagu jiro xaaladaha adag.[12]Sidoo kale 1995kii, Masimo waxa ay soo bandhigtay tusmaynta perfusion , iyada oo qiyaasaysa baaxadda durugsanplethysmographqaab mawjadTusmada fayraska ayaa la muujiyay si ay uga caawiso dhakhaatiirta inay saadaaliyaan darnaanta jirrada iyo natiijooyinka hore ee neefsiga ee dhallaanka cusub,[13][14][15]saadaaliso socodka cava cava hoose ee hooseeya ee dhallaanka miisaankoodu hooseeyo,[16]Bixi calaamad hore oo ah sympathectomy ka dib suuxinta epidural'ka,[17]iyo in la wanaajiyo ogaanshaha cudurka wadnaha ee lagu dhasho ee halista ah ee dhallaanka cusub.[18]

Waraaqaha la daabacay waxay barbardhigeen tignoolajiyada soo saarista calaamadaha iyo tignoolajiyada kale ee oximetry garaaca waxayna muujiyeen natiijooyin joogto ah oo wanaagsan oo loogu talagalay tignoolajiyada soo saarista calaamadaha.[9][12][19]Tignoolajiyada soo saarista ishaarada waxqabadka oximetry garaaca wadnaha ayaa sidoo kale la muujiyay inay u tarjumeyso caawinta dhakhaatiirta inay hagaajiyaan natiijooyinka bukaanka.Mid ka mid ah daraasadda, retinopathy of prematurity (dhaawaca isha) ayaa hoos u dhacay 58% dhallaanka miisaankoodu hooseeyo ee xarunta iyadoo la adeegsanayo tignoolajiyada soo saarista calaamadaha, halka aysan jirin hoos u dhac ku yimid cudurka retinopathy ee dhicisnimada ee xarun kale oo leh isla dhakhaatiirta isticmaala isla nidaamka. laakiin leh tignoolajiyada soo saarista aan calaamadaha lahayn.[20]Daraasado kale ayaa muujiyay in tignoolajiyada soo saarista calaamadaha garaaca oximetry ay keento cabbirada gaaska dhiigga halbowlaha ah oo yaraada, wakhtiga naaska oksijiinta oo degdeg ah, isticmaalka dareenka hoose, iyo dhererka joogitaanka hoose.[21]Dhaqdhaqaaqa cabbiraadda iyo kartida qandhada hoose waxay sidoo kale u ogolaatay in lagu isticmaalo aagagga hore ee aan la kormeerin sida dabaqa guud, halkaas oo alaarmiga beenta ah ay dhibeen oximetry garaaca wadnaha caadiga ah.Sida caddaynta tan, daraasad taariikhi ah ayaa la daabacay 2010 taasoo muujineysa in dhakhaatiirta Xarunta Caafimaadka ee Dartmouth-Hitchcock iyagoo isticmaalaya tignoolajiyada soo saarista tignoolajiyada garaaca wadnaha ee dabaqa guud ay awoodeen inay hoos u dhigaan dhaqdhaqaaqa kooxda jawaabta degdega ah, wareejinta ICU, iyo maalmaha ICU.[22]Sannadka 2020, daraasad dib-u-eegis ah oo daba-gal ah oo isla machad la mid ah ayaa muujisay in in ka badan toban sano oo la isticmaalayo oximetry pulse oximetry oo leh tignoolajiyada soo saarista calaamadaha, oo ay weheliso nidaamka ilaalinta bukaanka, waxaa jiray eber dhimasho bukaan ah mana jirto bukaanno ay waxyeelo ka soo gaartay niyad-jabka neefsashada ee opioid iyadoo kormeer joogto ah la isticmaalayey.[23]

Sannadkii 2007, Masimo waxay soo bandhigtay cabbirkii ugu horreeyay eetusmada kala duwanaanshiyaha pleth(PVI), oo cilmi-baarisyo badan oo caafimaad ay muujiyeen waxay siisay hab cusub oo si toos ah, qiimeynta aan fiicneyn ee bukaanka awoodda uu uga jawaabo maamulka dareeraha.[24][25][26]Heerarka dareeraha ku habboon ayaa muhiim u ah yareynta khatarta qalliinka ka dib iyo hagaajinta natiijooyinka bukaanka: qiyaasta dareeraha oo aad u hooseeya ( fuuq-yaraan ) ama aad u sarreeya ( fuuq-bax yar ) ayaa la muujiyay inay yareeyaan bogsashada dhaawaca waxayna kordhiyaan khatarta caabuqa ama dhibaatooyinka wadnaha.[27]Dhawaan, Adeegga Caafimaadka Qaranka ee Boqortooyada Midowday (UK) iyo Suuxinta Faransiiska iyo Bulshada Daryeelka Halisku waxay liis gareeyeen kormeerka PVI oo qayb ka ah xeeladahooda la soo jeediyay ee maaraynta dareeraha qalliinka.[28][29]

Sannadkii 2011, koox-shaqaale khabiiro ah ayaa ku taliyay in dhallaanka cusub lagu baaro pulse oximetry si loo kordhiyo ogaanshahacudurada wadnaha lagu dhasho ee halista ah(CCHD).[30]Kooxda shaqada ee CCHD waxay soo xigtay natiijooyinka laba daraasadood oo waaweyn, oo la filayo oo ah 59,876 maadooyin kuwaas oo si gaar ah u isticmaalay tignoolajiyada soo saarista calaamadaha si loo kordhiyo aqoonsiga CCHD oo leh natiijooyin been abuur ah oo yar.[31][32]Kooxda shaqada ee CCHD waxay ku talisay in baadhista ilmaha dhasha lagu sameeyo oximetry garaaca wadnaha ee dulqaadka leh kaas oo sidoo kale lagu ansaxiyay xaalado xiiran hooseeya.Sannadkii 2011, Xoghayaha Caafimaadka iyo Adeegyada Aadanaha ee Maraykanka ayaa ku daray pulse oximetry guddiga baaritaanka lebbiska ee lagu taliyey.[33]Kahor cadaymaha baadhista iyadoo la isticmaalayo tignoolajiyada soo saarista calaamadaha, in ka yar 1% dhallaanka cusub ee Maraykanka ayaa la baadhay.Maanta,Mu'asasada Dhaladka Cusubwaxay diiwaangelisay in u dhow baadhista caalamiga ah ee Maraykanka iyo baadhista caalamiga ahi si xawli ah ayay u fidaysaa.[34]Sannadkii 2014, daraasad saddexaad oo ballaaran oo lagu sameeyay 122,738 dhallaan ah oo sidoo kale si gaar ah u isticmaalay tignoolajiyada soo saarista calaamadaha ayaa muujisay natiijooyin isku mid ah, natiijooyin togan sida labadii daraasadood ee ugu horreeyay.[35]

Oximetry garaaca garaaca sare (HRPO) ayaa loo sameeyay baadhista hurdada hurdada ee guriga iyo tijaabinta bukaanada ay tahay wax aan macquul ahayn in la sameeyopolysomnography.[36][37]Waxay kaydisaa oo duubtaa labadabaheerka garaaca wadnahaiyo SpO2 ee 1 ilbiriqsi gudahood waxaana lagu muujiyay hal daraasad si loo ogaado neefsashada hurdo la'aanta ee bukaannada qalliinka.[38]

Shaqada[wax ka beddel]

Nuugista haemoglobin oksijiin ah (HbO2) iyo haemoglobin deoxygenated (Hb) ee hirarka casaanka iyo infrared

Dhinaca gudaha ee oximeter garaaca wadnaha

Kormeeraha dhiigga-oxygen-ku wuxuu muujiyaa boqolleyda dhiigga ee ku raran ogsijiinta.Si gaar ah, waxa ay cabbirtaa inta boqolkiibahemoglobin, borotiinka dhiiga ku jira ee qaada ogsijiinta, waa la raran yahay.Heerarka caadiga ah ee la aqbali karo ee bukaanada aan lahayn cudurka sambabada ayaa ah 95 ilaa 99 boqolkiiba.Bukaanka hawo qolka neefsashada ah ama meel u dhowheerka badda, qiyaasta halbowlaha PO2waxaa laga samayn karaa kormeeraha dhiigga-oxygen"Qeylka Ogsajiinta ku wareegsan"(SpO2) akhriska.

Oximeter-ka caadiga ah ee garaaca wadnaha wuxuu isticmaalaa processor-ka elegtarooniga ah iyo lammaane yar yardareere iftiin leh(LEDs) oo wajahaya aphotodiodeiyada oo loo marayo qayb translucent ah oo ka mid ah jidhka bukaanka, badiyaa caarada faraha ama dhegta.Hal LED waa casaan, oo lehdhererka hirarkaoo ah 660 nm, kan kalena waainfrarediyadoo dhererkeedu yahay 940 nm.Nuugista iftiinka ee mawjadahan dhererkoodu aad ayuu u kala duwan yahay inta u dhaxaysa dhiigga ku raran ogsijiinta iyo dhiig la'aanta ogsijiinta.Hemoglobin oksijiin leh ayaa nuugaya iftiin badan oo infrared ah waxayna u ogolaataa iftiin badan oo casaan ah inuu dhex maro.Hemoglobin deoxygenated wuxuu u oggolaanayaa iftiin badan oo infrared ah inuu dhex maro oo nuugo iftiin cas oo badan.Isku xigxiga LED-yada iyada oo loo marayo wareeggooda mid ka mid ah, ka dibna kan kale, ka dibna labaduba waxay ka baxayaan qiyaastii soddon jeer ilbiriqsi kasta taas oo u oggolaanaysa photodiode in ay si gooni ah uga jawaabto iftiinka casaanka iyo infrared-ka oo ay sidoo kale hagaajiyaan saldhigga iftiinka ambient.[39]

Qadarka iftiinka la kala qaado (si kale haddii loo dhigo, ee aan la nuugin) waa la cabbiraa, waxaana la soo saaraa calaamado caadi ah oo kala duwan oo u dhexeeya hirarka dhererka.Calaamadahani waxay isbedbedelaan wakhtiga sababtoo ah qadarka dhiiga halbowlaha ah ee jooga ayaa kordha (macnaha garaaca wadnaha) garaac kasta.Iyadoo laga jarayo iftiinka ugu yar ee la kala qaado ee iftiinka la kala qaado ee mawjadaha dhererka kasta, saameynta unugyada kale waa la saxaa, taasoo dhalinaysa calaamad joogto ah oo loogu talagalay dhiigga halbowlaha wadnaha.[40]Saamiga cabbiraadda iftiinka cas iyo cabbirka iftiinka infrared-ka ayaa markaa xisaabiya processor-ku (taas oo ka dhigan saamiga haemoglobin-ka oksijiinta leh iyo haemoglobin deoxygenated), saamigan ayaa markaa loo beddelaa SpO2Processor-ka iyada oo loo marayo amiiska raadinta[40]ku salaysanBeer–Lambert law.[39]Kala soocida calaamaduhu waxay sidoo kale u adeegtaa ujeedooyin kale: qaab mawjadaha 'plethysmograph waveform' ("wave pleth") oo ka dhigan calaamadda garaaca wadnaha ayaa badanaa lagu soo bandhigaa tilmaam muuqaal ah ee garaaca wadnaha iyo sidoo kale tayada calaamadaha,[41]iyo saamiga nambarada u dhexeeya nuugista garaaca wadnaha iyo gunta hoose ("index perfusion") waxaa loo isticmaali karaa in lagu qiimeeyo dhiig-karka.[25]

Tilmaam[wax ka beddel]

Baadhitaanka oximeter-ka garaaca wadnaha ayaa lagu mariyey farta qofka

Oximeter garaaca wadnaha waa aqalab caafimaadtaasoo si aan toos ahayn ula socota qoyaanka ogsijiinta ee bukaankadhiig(oo ka soo horjeeda in si toos ah loo cabbiro qoyaanka oksijiinta iyada oo loo marayo muunadda dhiigga) iyo isbeddelka mugga dhiigga ee maqaarka, soo saarista aphotoplethysmogramtaas oo laga yaabo in laga sii baaraandegocabbiro kale.[41]Oximeter-ka garaaca wadnaha ayaa laga yaabaa in lagu daro kormeeraha bukaan-socodka badan ee cabbirrada.Kormeerayaasha intooda badani waxay sidoo kale muujiyaan heerka garaaca wadnaha.La qaadi karo, oximeterada garaaca wadnaha ku shaqeeya ee batari ku shaqeeya ayaa sidoo kale diyaar u ah gaadiidka ama la socodka dhiiga-ogsajiinta guriga.

Faa'iidooyinka[wax ka beddel]

Pulse oximetry ayaa si gaar ah ugu habboonaan duullaan lahayncabbirka joogtada ah ee dheecaanka ogsijiinta dhiigga.Taas beddelkeeda, heerka gaasta dhiigga waa in si kale lagu go'aamiyaa shaybaarka ku jira muunadda dhiigga ee la soo saaray.Oximetry garaaca wadnaha ayaa faa'iido u leh goob kasta oo uu bukaanku joogoogsijiintawaa mid aan degganayn, oo ay ku jiraandaryeelka degdega ah, qalliinka, soo kabashada, xaaladaha degdega ah iyo goobaha qaybta isbitaalka,duuliyayaashadiyaaradaha aan la cadaadin, si loo qiimeeyo ogsijiinta bukaan kasta, iyo go'aaminta waxtarka ama baahida loo qabo kaabogsijiin.Inkasta oo oximeter-ka garaaca wadnaha loo isticmaalo si loola socdo ogsijiinta, ma go'aamin karo dheef-shiid kiimikaadka oksijiinta, ama qadarka oksijiinta uu isticmaalo bukaanku.Ujeedadaas awgeed, waa lagama maarmaan in sidoo kale la cabbirocarbon dioxide(CO2) heerarka.Waxaa suurtogal ah in sidoo kale loo isticmaali karo in lagu ogaado cilladaha aan caadiga ahayn ee hawada.Si kastaba ha ahaatee, isticmaalka oximeter garaaca wadnaha si loo ogaadohawo-qaadidwaxay ku liidataa isticmaalka oksijiinta dheeriga ah, sababtoo ah waa marka bukaanku neefsado hawada qolka in cilladaha shaqada neefsashada lagu ogaan karo si kalsooni leh isticmaalkeeda.Sidaa darteed, maamulka joogtada ah ee ogsijiinta dheeriga ah ayaa laga yaabaa inay noqoto mid aan loo baahnayn haddii bukaanku awoodo inuu ku ilaaliyo oksijiin ku filan hawada qolka, maadaama ay keeni karto hypoventilation oo aan la ogaan.[42]

Sababtoo ah fududaantooda isticmaalka iyo awoodda ay u leeyihiin inay bixiyaan qiyamka buuxinta ogsijiinta oo joogto ah oo degdeg ah, oximeter-yada garaaca wadnaha ayaa ah muhiimad muhiim ahdawada degdega ahwaxayna sidoo kale aad faa'iido ugu leeyihiin bukaanada qaba dhibaatooyinka neefsashada ama wadnaha, gaar ahaanCOPD, ama ogaanshaha qaarhurdo la'aansidaapneaiyohypopnea.[43]Oximeterada garaaca wadnaha ee ku shaqeeya baytari la qaadi karo ayaa faa'iido u leh duuliyayaasha ku shaqeeya diyaarad aan cadaadis saarnayn oo ka sarreysa 10,000 fuudh (3,000 m) ama 12,500 cagood (3,800 m) gudaha Maraykanka[44]halkaas oo ogsijiin dheeri ah looga baahan yahay.Oximeterada garaaca wadnaha ee la qaadi karo ayaa sidoo kale faa'iido u leh kuwa fuula buuraha iyo cayaartoyda heerkooda ogsajiinta laga yaabo inay hoos u dhacdo si sarejoogyadaama jimicsi.Qaar ka mid ah oximeter-yada garaaca wadnaha ee la qaadan karo waxay adeegsadaan software-ka jaantuska ogsijiinta dhiigga bukaanka iyo garaaca garaaca wadnaha, taasoo u adeegta xasuusin si loo eego heerarka ogsijiinta dhiigga.

Horumarka isku xirnaanta ee dhawaa ayaa sidoo kale hadda u suurtageliyay bukaanada in si joogto ah loola socdo qulqulka oksijiinta dhiigooda iyada oo aan la xirin xiriirinta fiilada ee kormeeraha isbitaalka, iyada oo aan loo hurin qulqulka xogta bukaanka ee dib loogu celiyo kormeerayaasha sariiraha iyo nidaamyada ilaalinta bukaanka dhexe.Masimo Radius PPG, oo la soo bandhigay 2019, waxay bixisa oximetry garaaca wadnaha ee aan tetherless iyadoo la isticmaalayo tignoolajiyada soo saarista calaamada Masimo, taasoo u oggolaanaysa bukaanada inay si xor ah oo raaxo leh u dhaqaaqaan iyadoo wali si joogto ah oo la isku halleyn karo loola socdo.[45]Radius PPG waxa kale oo uu isticmaali karaa Bluetooth aamin ah si uu ula wadaago xogta bukaanka si toos ah talefanka casriga ah ama aaladaha kale ee smart.[46]

Xaddid[wax ka beddel]

Oximetry-ga garaaca ayaa kaliya cabbira saturation haemoglobin, ma ahahawo qaadidmana aha cabbir dhammaystiran oo ku filan neefsashada.Ma aha bedelgaasaska dhiiggalagu hubiyay shaybaarka, sababtoo ah ma bixiso wax calaamad ah oo ku saabsan dhimista aasaasiga ah, heerarka carbon dioxide, dhiiggapH, amabicarbonate(HCO3-) xooga saarid.Dheef-shiid kiimikaadka ogsijiinta waxaa si sahal ah loo qiyaasi karaa iyadoo la kormeerayo CO2, laakiin tirooyinka saturation ma bixiyaan macluumaad ku saabsan waxa ku jira ogsijiinta dhiigga.Inta badan ogsijiinta dhiigga ku jirta waxaa qaada hemoglobin;Dhiig-yarida daran, dhiiggu waxa ku jira hemoglobin yar, kaas oo inkasta oo la dheregsan yahay aanu qaadi karin ogsijiin badan.

Akhrinta khaldan ee hooseeya waxaa sababi karahypoperfusionee cirifka loo isticmaalo la socodka (badanaa sababtuna tahay addimada oo qabow, ama ka timidvasoconstrictionlabaad ee isticmaalkavasopressorwakiilada);Codsiga dareenka khaldan;heer sare ahcaajisnimomaqaarka;ama dhaqdhaqaaqa (sida gariir), gaar ahaan marka lagu jiro hypoperfusion.Si loo hubiyo saxnaanta, dareemaha waa inuu soo celiyaa garaaca garaaca iyo/ama waveform garaaca wadnaha oo joogto ah.Tignoolajiyada oximetry-ga garaaca waxay ku kala duwan yihiin awoodooda si ay u bixiyaan xog sax ah inta lagu jiro xaaladaha dhaqdhaqaaqa iyo qulqulka hoose.[12][9]

Pulse oximetry sidoo kale maaha cabbir dhammaystiran oo ku filan oksijiinta wareegga dhiigga.Haddii ay jirto wax ku filandhiigbaxaama hemoglobin ku filan dhiigadhiig yaraan), nudaha ayaa dhibi karahypoxiain kasta oo ay sare u kacdo dheecaanka oksijiinta halbowlaha ah.

Maaddaama oximetry garaaca wadnaha uu cabbiro oo keliya boqolkiiba hemoglobin-xidhan, akhrin been abuur ah ama sare u hooseeya ayaa dhici doona marka haemoglobin ku xidho shay aan ahayn ogsijiinta:

  • Hemoglobin waxa uu xidhiidh sare la leeyahay kaarboon moono-oksaydh marka loo eego sida uu u leeyahay ogsijiinta, akhris sare ayaa laga yaabaa inuu dhaco inkasta oo bukaanku runtii yahay hypoxemic.Xaaladahasunta kaarboon monoksaydh, khaladkan ayaa laga yaabaa inuu dib u dhigo aqoonsigahypoxia(heerka ogsijiinta gacanta oo hooseeya).
  • Sunta sunta ahwaxay ku siinaysaa akhris sare sababtoo ah waxay yaraynaysaa soo saarista ogsajiinta ee dhiiga halbowlaha ah.Xaaladdan oo kale, akhrintu maaha mid been ah, maadaama ogsijiinta dhiigga halbowlaha ah ay runtii aad u sarreeyso sumoowga hore ee cyanide.[caddayn loo baahan yahay]
  • Methemoglobinemiasi gaar ah waxay sababtaa akhrinta oximetry garaaca wadnaha bartamihii 80-meeyadii.
  • COPD [gaar ahaan boronkiitada raaga] waxay keeni kartaa akhrin been ah.[47]

Habka aan fiicneyn ee u oggolaanaya cabbirka joogtada ah ee dyshemoglobins waa garaaca wadnahaCO-oximeter, kaas oo la dhisay 2005 by Masimo.[48]Adigoo isticmaalaya mowjadaha dhaadheer ee dheeraadka ah,[49]Waxay siisaa daaweeyayaasha hab lagu cabbiro dyshemoglobins, karboxyhemoglobin, iyo methemoglobin oo ay weheliso wadarta haemoglobin.[50]

Isticmaalka oo sii kordhaya[wax ka beddel]

Sida lagu sheegay warbixin ay soo saartay iData Research suuqa la socodka oximetry garaaca wadnaha ee Maraykanka ee qalabka iyo dareemayaasha ayaa ka badnaa 700 milyan USD sanadkii 2011.[51]

Sannadkii 2008dii, in ka badan kala badh soosaarayaasha qalabka caafimaadka ee caalamiga ah ee dhoofiya ayaa soo galayShiinahawaxay ahaayeen kuwa soo saara oximeters garaaca wadnaha.[52]

Ogaanshaha hore ee COVID-19[wax ka beddel]

Pulse oximeters ayaa loo isticmaalaa in lagu caawiyo ogaanshaha horeCOVID-19Infekshannada, kuwaas oo keeni kara marka hore aan la ogaan karin heerka hoose ee dheecaanka oksijiinta halbowlaha iyo hypoxia.New York Timesayaa sheegay in "Saraakiisha caafimaadku ay ku kala qaybsan yihiin in la socodka guriga ee qalabka garaaca wadnaha waa in lagula taliyaa si baahsan inta lagu jiro Covid-19.Daraasadaha lagu kalsoonaan karo ayaa muujinaya natiijooyin isku dhafan, waxaana jira hagitaan yar oo ku saabsan sida loo doorto mid.Laakiin dhakhaatiir badan ayaa kula talinayaa bukaannada inay mid helaan, taasoo ka dhigaysa aaladda masiibada. ”[53]

Cabbiraad la helaywax ka beddel]

Sidoo kale eeg:Photoplethysmogram

Isbeddellada ku yimaadda mugga dhiigga ee maqaarka awgeed, aplethysographickala duwanaanshiyaha waxaa lagu arki karaa calaamada iftiinka ee la helay (gudbinta) dareemaha on oximeter.Kala duwanaanshaha waxaa lagu tilmaami karaa sida ashaqo xilliyeed, kaas oo isna loo qaybin karo qayb DC ah (qiimaha ugu sarreeya)[a]iyo qayb AC ah (dooxada ugu sarreysa ee laga jaray).[54]Saamiga qaybta AC iyo qaybta DC, ee lagu muujiyay boqolkiiba, waxa loo yaqaan(ku durugsan)dhiigbaxindex(Pi) ee garaaca wadnaha, iyo sida caadiga ah waxay leedahay kala duwanaansho u dhaxaysa 0.02% ilaa 20%.[55]Cabbir hore oo loo yaqaanpulse oximetry plethysmographic(POP) kaliya waxa ay cabbirtaa qaybta “AC”, waxaana gacanta laga soo qaatay pixels-ka kormeeraha.[56][25]

Tusmada kala duwanaanshaha Pleth(PVI) waa cabbirka kala duwanaanshaha tusaha fayraska, kaas oo dhaca inta lagu jiro wareegyada neefsashada.Xisaab ahaan waxa loo xisaabiyaa sida (Pimax- Pimin)/Pimax× 100%, halkaasoo ugu badnaan iyo ugu yaraan qiyamka Pi ay ka yihiin hal ama wareegyo badan oo neefsasho ah.[54]Waxaa la muujiyay inay tahay tilmaame faa'iido leh, oo aan fiicneyn oo ka jawaab celinta dareeraha joogtada ah ee bukaanada ku jira maareynta dareeraha.[25] Baaxadda waveform-ka garaaca wadnaha oximetry(ΔPOP) waa farsamo hore oo la mid ah oo loogu talagalay isticmaalka POP-ga gacanta laga helay, oo loo xisaabiyo (POP)max- POPmin)/(POPmax+ POPmin)*2.[56]

sidoo kale eeg[wax ka beddel]

Xusuusin[wax ka beddel]

  1. ^Qeexitaankan ay isticmaasho Masimo way ka duwan tahay celceliska qiimaha loo isticmaalo habaynta calaamadaha;waxaa loola jeedaa in lagu cabbiro nuugista dhiigga halbowlayaasha pulsatile ee ka sarreeya nuugista asalka ah.

Tixraac[wax ka beddel]

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Waqtiga boostada: Juun-04-2020