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I-Pulse oximetry

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I-Pulse oximetry

I-Tetherless pulse oximetry

Injongo

Ukubeka iliso kwi-oxygen saturation yomntu

I-Pulse oximetryyiengaphazamisiindlela yokubeka iliso yomntui-oxygen saturation.Nangona ukufunda kwayo kwiperipheral oxygen saturation (SpO2) ayisoloko ifana nokufunda okunqweneleka ngakumbi kwe-arterial oxygen saturation (SaO2) ukusukaigesi yegaziUhlalutyo, ezi zimbini zinxulunyaniswa kakuhle ngokwaneleyo ukuba indlela ekhuselekileyo, eluncedo, engabonakaliyo, engabizi kakhulu ye-pulse oximetry ibalulekile ekulinganiseni ukugcwala kweoksijiniklinikhisebenzisa.

Kwimo yesicelo esixhaphakileyo (esidlulisayo), isixhobo soluvo sibekwe kwindawo ebhityileyo yomzimba wesigulane, ngokuqhelekileyo aincam yomnweokanyeindlebe, okanye kwimeko yeusana, ngaphaya konyawo.Isixhobo sidlulisa amaza okukhanya amabini ngenxalenye yomzimba ukuya kwi-photodetector.Ilinganisa ukutshintsha kwe-absorption kwindawo nganyeubude bamaza, ukuvumela ukuba imisele iukufunxangenxa ye-pulsingigazi lomthamboyedwa, ngaphandleigazi le-venous, ulusu, ithambo, izihlunu, amanqatha, kwaye (kwiimeko ezininzi) ipolishi yezikhonkwane.[1]

I-Reflectance pulse oximetry yeyona ndlela ingaqhelekanga kwi-transmissive pulse oximetry.Le ndlela ayifuni icandelo elincinci lomzimba womntu kwaye ngoko ke ifaneleka kakuhle kwisicelo sendalo yonke njengeenyawo, ibunzi, kunye nesifuba, kodwa nayo inemida ethile.I-Vasodilation kunye nokudityaniswa kwegazi le-venous entloko ngenxa yokubuyela kwe-venous esichengeni entliziyweni kunokubangela indibaniselwano ye-arterial kunye ne-pulsations ye-venous kwingingqi yebunzi kwaye ikhokelele kwi-SpO ekhohlisayo.2iziphumo.Iimeko ezinjalo zenzeka ngelixa uphantsi kwe-anesthesia kunyei-endotracheal intubationkunye nokungena komoya ngoomatshini okanye kwizigulana kwiindawo Trendelenburg.[2]

Imixholo

Imbali[hlela]

Ngo-1935, ugqirha waseJamani uKarl Matthes (1905-1962) wavelisa indlebe yokuqala enamaza amabini u-O.2imitha yokucoca enezihluzi ezibomvu neziluhlaza (kamva ezibomvu kunye nezihluzo ze-infrared).Imitha yakhe yaba sisixhobo sokuqala sokulinganisa i-O2ukuhluza.[3]

I-oximeter yokuqala yenziwe nguUGlenn Allan Millikanngeminyaka yee-1940.[4]Ngo-1949, uWood wongeza i-capsule yoxinzelelo ukuze acudise igazi endlebeni ukuze afumane i-O epheleleyo.2Ixabiso lokuhluza xa igazi liphinda laphinda lamkelwa.Ingqikelelo iyafana neyesiqhelo ipulse oximetry yanamhlanje, kodwa bekunzima ukuyiphumeza ngenxa yokungazinzanga.iiseli zeefotokunye nemithombo yokukhanya;namhlanje le ndlela ayisetyenziswa kliniki.Ngowe-1964 uShaw wahlanganisa i-ear oximeter yokuqala yokufunda ngokupheleleyo, esebenzisa ubude obusibhozo bokukhanya.

I-Pulse oximetry yaphuhliswa ngo-1972, nguTakuo Aoyagikunye noMichio Kishi, iinjineli zebhayoloji, eNihon Kohdenusebenzisa umlinganiselo obomvu ukuya kwi-infrared ukukhanya okufunxayo kumalungu okubetha kwindawo yokulinganisa.USusumu Nakajima, ugqirha wotyando, kunye noogxa bakhe baqala bavavanya isixhobo kwizigulana, besenza ingxelo ngo-1975.[5]Yathengiswa nguI-Bioxngowe-1980.[6][5][7]

Ngo-1987, umgangatho wokunyamekela ukulawulwa kwe-anesthetic jikelele e-US yayiquka i-pulse oximetry.Ukususela kwigumbi lokusebenza, ukusetyenziswa kwe-pulse oximetry ngokukhawuleza kwasasazeka kwisibhedlele sonke, kuqala ukuyaamagumbi okubuyisela, kwaye emva koko ukuyaiiyunithi zokhathalelo olukhulu.I-pulse oximetry yayinexabiso elithile kwiyunithi ye-neonatal apho izigulane zingaphumeleli nge-oxygenation eyaneleyo, kodwa i-oksijini eninzi kunye nokuguquguquka koxinzelelo lwe-oxygen kunokukhokelela ekuboneni ukukhubazeka okanye ukungaboni.i-retinopathy ye-prematurity(ROP).Ngaphaya koko, ukufumana i-arterial blood gas kwi-neonatal isigulane kubuhlungu kwisigulana kunye nonobangela omkhulu we-anemia ye-neonatal.[8]I-artifact eshukumayo inokuba ngumda obalulekileyo wokubeka iliso kwi-pulse oximetry ekhokelela kwii-alamu ezibubuxoki rhoqo kunye nokulahleka kwedatha.Oku kungenxa yokuba ngexesha lokunyakaza kunye ne-peripheral ephantsiukuqhola, ii-pulse oximeters ezininzi azikwazi ukwahlula phakathi kwe-pulsating arterial blood kunye negazi elihambayo le-venous, ekhokelela ekujongeni ngaphantsi kwe-oksijini yokugcwalisa.Uphononongo lwakwangoko lokusebenza kwe-pulse oximetry ngexesha lokushukuma kwesifundo kwenze kwacaca ukuba sesichengeni kobuchwepheshe obuqhelekileyo be-pulse oximetry kwi-artifact eshukumayo.[9][10]

Ngo-1995,UMasimoyazisa iTekhnoloji ye-Signal Extraction (SET) enokulinganisa ngokuchanekileyo ngexesha lokunyakaza kwesigulane kunye ne-perfusion ephantsi ngokuhlula i-arterial signal kwi-venous kunye nezinye iimpawu.Ukusukela ngoko, abavelisi be-pulse oximetry baye baphuhlisa i-algorithms entsha yokunciphisa ezinye ii-alamu zobuxoki ngexesha lokunyakaza[11]njengokwandisa amaxesha aphakathi okanye amaxabiso okukhenkceza kwiscreen, kodwa abafuni ukulinganisa iimeko eziguqukayo ngexesha lentshukumo kunye noxinzelelo oluphantsi.Ke, kusekho umahluko obalulekileyo ekusebenzeni kwe-pulse oximeters ngexesha lemingeni.[12]Kwakhona ngo-1995, uMasimo wazisa i-perfusion index, echaza ubungakanani be-amplitude ye-peripheral.iplethysmographukumila kwamaza.Isalathiso se-Perfusion sibonakaliswe ukunceda oogqirha baqikelele ubuzaza bokugula kunye neziphumo ezibi zokuphefumla kwiintsana,[13][14][15]Ukuqikelela ukuhamba kwe-vena cava ephantsi kakhulu kwiintsana ezinobunzima obuphantsi kakhulu,[16]ukubonelela ngesalathisi sokuqala se-sympathectomy emva kwe-epidural anesthesia,[17]kunye nokuphucula ukubonwa kwesifo senhliziyo esibalulekileyo kwiintsana ezisanda kuzalwa.[18]

Amaphepha apapashiweyo athelekise itekhnoloji yokutsalwa komqondiso kwezinye iitekhnoloji ze-pulse oximetry kwaye abonise iziphumo ezincomekayo ezithe gqolo ezincomekayo kwitekhnoloji yokutsalwa komqondiso.[9][12][19]Itekhnoloji yokukhupha itekhnoloji ye-pulse oximetry ibonakaliswe ukuguqulela ekuncedeni oogqirha baphucule iziphumo zesigulane.Kolunye uphononongo, i-retinopathy ye-prematurity (umonakalo wamehlo) yancitshiswa ngama-58% kwiintsana ezinobunzima obuphantsi kakhulu kwiziko zisebenzisa itekhnoloji ye-extraction ye-signal, ngelixa kungekho kuncipha kwi-retinopathy ye-prematurity kwelinye iziko kunye neekliniki ezifanayo zisebenzisa i-protocol efanayo. kodwa ngetekhnoloji yokutsalwa kwe-non-signal.[20]Olunye uphononongo lubonise ukuba itekhnoloji yokukhutshwa komqondiso we-pulse oximetry iphumela kwimilinganiselo embalwa yegesi yegazi, ixesha elikhawulezayo lokulunyulwa kweoksijini, ukusetyenziswa kwenzwa ephantsi, kunye nobude obuphantsi bokuhlala.[21]Umlinganiselo-ngentshukumo kunye nezakhono eziphantsi ze-perfusion ziye zavumela ukuba zisetyenziswe kwiindawo ezingakhange zibekwe esweni ngaphambili ezifana nomgangatho oqhelekileyo, apho ii-alamu zobuxoki ziye zabetha i-pulse oximetry eqhelekileyo.Njengobungqina boku, uphando oluphawulekayo lwapapashwa kwi-2010 ebonisa ukuba oogqirha base-Dartmouth-Hitchcock Medical Centre basebenzisa iteknoloji ye-extraction technology pulse oximetry kumgangatho oqhelekileyo bakwazi ukunciphisa ukusebenza kweqela lokuphendula ngokukhawuleza, ukudluliselwa kwe-ICU, kunye neentsuku ze-ICU.[22]Ngo-2020, uphononongo lokuphinda lulandelelwe kwiziko elifanayo lubonise ukuba ngaphezulu kweminyaka elishumi yokusebenzisa i-pulse oximetry ngetekhnoloji yokutsalwa kweempawu, kunye nenkqubo yokujonga isigulana, bekukho izigulane ezibhubhileyo kwaye akukho zigulana zonzakaliswa yi-opioid-induced breath depression. ngelixa uhlolo oluqhubekayo lwalusetyenziswa.[23]

Ngo-2007, uMasimo wazisa umlinganiselo wokuqala wepleth ukuguquguquka kwesalathisi(PVI), apho izifundo ezininzi zeklinikhi zibonise ukuba zibonelela ngendlela entsha yovavanyo oluzenzekelayo, olungabonakaliyo lwesigulane sokukwazi ukuphendula kulawulo lwamanzi.[24][25][26]Amanqanaba afanelekileyo e-fluid abalulekile ekunciphiseni imingcipheko yasemva kokuhlinzwa kunye nokuphucula iziphumo zesigulane: umthamo we-fluid ophantsi kakhulu (ungaphantsi kwe-hydration) okanye uphezulu kakhulu (i-over-hydration) ibonakaliswe ukunciphisa ukuphulukiswa kwenxeba kunye nokwandisa umngcipheko wokusuleleka okanye iingxaki zentliziyo.[27]Kutshanje, iNkonzo yezeMpilo yeSizwe e-United Kingdom kunye ne-French Anesthesia kunye ne-Critical Care Society idwelise ukubeka iliso kwe-PVI njengenxalenye yezicwangciso zabo ezicetyisiweyo zolawulo lwe-intra-operative fluid.[28][29]

Ngo-2011, iqela leengcali licebise ukuba usana olusanda kuzalwa luhlolwe nge-pulse oximetry ukwandisa ukubonwa kwe-pulse oximetry.isifo sentliziyo esibalulekileyo(CCHD).[30]Iqela lomsebenzi we-CCHD licaphule iziphumo zezifundo ezimbini ezinkulu, ezilindelekileyo zezifundo ze-59,876 ezisebenzise kuphela iteknoloji yokukhupha i-signal extraction ukunyusa ukuchongwa kwe-CCHD kunye neengcamango zobuxoki ezincinci.[31][32]Iqela lomsebenzi le-CCHD licebise ukuba uvavanyo olusandul 'ukuzalwa lwenziwe nge-motion tolerant pulse oximetry ekwaqinisekisiweyo kwiimeko eziphantsi zokuxilisa.Kwi-2011, uNobhala wezeMpilo wase-US kunye neeNkonzo zoLuntu wongeze i-pulse oximetry kwiphaneli yokuhlola iyunifomu ephakanyisiweyo.[33]Phambi kobungqina bokuhlolwa kusetyenziswa itekhnoloji yokutsalwa kwemiqondiso, ngaphantsi kwe-1% yeentsana ezisanda kuzalwa e-United States zahlolwa.Namhlanje,ISiseko Esisandul' Ukuzalwaiye yabhala kufutshane novavanyo lwehlabathi lonke eUnited States kwaye ukuhlolwa kwamazwe ngamazwe kwanda ngokukhawuleza.[34]Kwi-2014, isifundo esikhulu sesithathu se-122,738 yeentsana ezisanda kuzalwa eziye zasebenzisa kuphela iteknoloji yokukhupha izibonakaliso zibonise iziphumo ezifanayo, ezintle njengezifundo ezibini zokuqala.[35]

I-high-resolution pulse oximetry (HRPO) yenzelwe ukuhlolwa kwe-apnea yokulala ekhaya kunye novavanyo kwizigulana ekungenakwenzeka ukuba ziyenzele.ipholysomnografi.[36][37]Igcina kwaye irekhode zombiniizinga lokubetha kwentliziyokunye ne-SpO2 kwizithuba ze-1 yesibini kwaye ibonakaliswe kwisifundo esinye ukunceda ukufumanisa ukuphefumla okungahambi kakuhle kwizigulane zotyando.[38]

Umsebenzi[hlela]

I-spectra yokufunxa i-oksijini ye-hemoglobin (HbO2) kunye ne-deoxygenated hemoglobin (Hb) ye-wavelengths ebomvu kunye ne-infrared

Icala langaphakathi le-pulse oximeter

I-blood-oxygen monitor ibonisa ipesenti yegazi elifakwe i-oxygen.Ngokuthe ngqo, ilinganisa ukuba yiyiphi ipesentiihemoglobin, iproteni esegazini ethwala ioksijini, iyalayishwa.Uluhlu oluqhelekileyo olwamkelekileyo kwizigulane ezingenazo i-pulmonary pathology zivela kwi-95 ukuya kwi-99 ekhulwini.Kwigumbi lokuphefumla isigulana elingaphakathi okanye elikufutshaneumgangatho wolwandle, uqikelelo lwe-pO yemithambo2inokwenziwa kwimonitha yegazi-oksijini"Ukuhluthwa kwe-oxygen ejikelezayo"(SpO2) ukufunda.

I-pulse oximeter eqhelekileyo isebenzisa iprosesa ye-electronic kunye neebini ezincinciiidiode ezikhupha ukukhanya(ii-LED) ezijongene ne-aifotodiodengokusebenzisa indawo eguquguqukayo yomzimba wesigulane, ngokuqhelekileyo incam yomnwe okanye indlebe.I-LED enye ibomvu, ngeubude bamazaye-660 nm, kwaye enye ii-infraredngobude obungamaza angama-940 nm.Ukufunxwa kokukhanya kula maza amaza kwahluka kakhulu phakathi kwegazi eligcwele ioksijini kunye negazi eliswele ioksijini.Ihemoglobin eneoksijini ifunxa ngakumbi ukukhanya kwe-infrared kwaye ivumela ukukhanya okubomvu ngakumbi ukuba kudlule.I-hemoglobin ene-deoxygenated ivumela ukukhanya okungaphezulu kwe-infrared ukuba kudlule kwaye ifunxe ukukhanya okubomvu ngakumbi.Ii-LEDs zilandelelana kumjikelo wazo wesinye, emva koko ke zombini zicime malunga namashumi amathathu amatyeli ngesekhondi evumela ifotodiode ukuba iphendule kukukhanya okubomvu kunye ne-infrared ngokwahlukeneyo kwaye ilungelelanise isiseko sokukhanya kwe-ambient.[39]

Isixa sokukhanya esisasazwayo (ngamanye amazwi, esingafunxwanga) siyalinganiswa, kwaye imiqondiso eyahlukileyo eqhelekileyo iyaveliswa kumgama wamaza ngamnye.Ezi zibonakaliso ziyaguquguquka ekuhambeni kwexesha ngenxa yokuba ubungakanani begazi le-arterial elikhoyo liyenyuka (ngokoqobo i-pulses) ngokubetha kwentliziyo nganye.Ngokususa ukukhanya okugqithisiweyo okuncinci ukusuka ekukhanyeni okugqithisiweyo kwi-wavelength nganye, iimpembelelo zezinye izicubu zilungiswa, zivelisa umqondiso oqhubekayo wegazi le-pulsatile arterial.[40]Umlinganiselo womlinganiselo wokukhanya obomvu kumlinganiselo wokukhanya kwe-infrared ngoko ubalwa yiprosesa (emele umlinganiselo wehemoglobin ene-oksijini ukuya kwi-hemoglobin ene-deoxygenated), kwaye lo mlinganiselo uguqulelwa kwi-SpO2ngeprosesa nge-aitafile yokujonga[40]ngokusekelwe kwiUmthetho weBeer-Lambert.[39]Ukwahlula umqondiso kunceda ezinye iinjongo: i-plethysmograph waveform ("i-pleth wave") emele isignali ye-pulsatile idla ngokuboniswa ukubonisa okubonakalayo kwee-pulses kunye nomgangatho womqondiso,[41]kunye nomlinganiselo wamanani phakathi kwe-pulsatile kunye ne-baseline absorbance (“isalathisi sokudumba") ingasetyenziselwa ukuvavanya ukuxuba.[25]

Isalathiso[hlela]

I-pulse oximeter probe ifakwe emnweni womntu

I-pulse oximeter yi-aisixhobo sonyangoejonga ngokungangqalanga ukugcwala kweoksijini yesigulanaigazi(ngokuchaseneyo nokulinganisa ukugcwala kweoksijini ngokuthe ngqo kwisampulu yegazi) kunye notshintsho kumthamo wegazi eluswini, ukuvelisaifotoplethysmogramenokuthi iqhubekele phambilieminye imilinganiselo.[41]I-pulse oximeter inokufakwa kwi-monitor yesigulane ye-multiparameter.Uninzi lweemonitha zikwabonisa izinga lokubetha kwentliziyo.Ii-oximeters eziphathwayo, ezisebenza ngebhetri zikwakhona ukuze zithuthwe okanye kujongwe ioksijini yegazi ekhaya.

Iingenelo[hlela]

I-Pulse oximetry ilungele ngakumbiengaphazamisiumlinganiselo oqhubekayo we-blood saturation.Ngokwahlukileyo, amanqanaba erhasi yegazi ngenye indlela kufuneka amiselwe kwilabhoratri kwisampulu yegazi elitsaliweyo.I-Pulse oximetry iluncedo kuyo nayiphi na indawo apho isigulaneioksijiniayizinzile, kuqukaukhathalelo olunzulu, ukusebenza, ukuchacha, unxunguphalo kunye nezicwangciso zewadi yesibhedlele,abaqhubi beenqwelomoyakwinqwelomoya engaxinzelelwanga, kuvavanyo lwaso nasiphi na i-oxygenation yesigulana, kunye nokugqiba ukusebenza okanye imfuno yokongeza.ioksijini.Nangona i-pulse oximeter isetyenziselwa ukubeka iliso kwi-oxygenation, ayikwazi ukumisela i-metabolism ye-oksijini, okanye inani le-oksijini esetyenziswa sisigulane.Ngenxa yale njongo, kuyimfuneko kwakhona ukulinganisaumoya omdaka(CO2) amanqanaba.Kusenokwenzeka ukuba isenokusetyenziswa ukufumanisa izinto ezingaqhelekanga ekuphuhliseni umoya.Nangona kunjalo, ukusetyenziswa kwe-pulse oximeter ukubonahypoventilationiphazamiseka ngokusetyenziswa kwe-oksijeni eyongezelelweyo, njengoko kuphela xa izigulane ziphefumula umoya wegumbi ukuba ukungaqhelekanga kumsebenzi wokuphefumula kunokubonwa ngokuthembekileyo ngokusetyenziswa kwayo.Ngoko ke, ukulawulwa kwesiqhelo kwe-oksijeni eyongezelelweyo kunokungafuneki ukuba isigulane siyakwazi ukugcina i-oxygen eyaneleyo emoyeni wegumbi, kuba kunokubangela ukuba i-hypoventilation ingabonakali.[42]

Ngenxa yokulula kwabo ukusebenzisa kunye nokukwazi ukubonelela ngokuqhubekayo kunye nokukhawuleza kwamaxabiso okugcwala kwe-oksijini, i-pulse oximeters ibaluleke kakhuluiyeza likaxakekakwaye ziluncedo kakhulu kwizigulana ezineengxaki zokuphefumla okanye zentliziyo, ngakumbiCOPD, okanye ukuxilongwa kwezinyeukuphazamiseka kokulalanjengeukuphelelwa umoyakwayehypopnea.[43]Ipulse oximeters ephathwayo esebenza ngebhetri iluncedo kubaqhubi abasebenza kwinqwelomoya engacinezelekanga ngaphezu kwe-10,000 yeenyawo (3,000 m) okanye 12,500 leenyawo (3,800 m) eUS.[44]apho kufuneka ioksijini eyongezelelweyo.Ii-oximeter eziphathwayo zepulse zikwaluncedo kubakhweli beentaba kunye neembaleki ezinamaqondo eoksijini anokwehla phezuluukuphakamaokanye ngokwenza umthambo.Ezinye ii-pulse oximeters eziphathwayo zisebenzisa isoftwe ebonisa i-oksijini yegazi lesigulana kunye ne-pulse, esebenza njengesikhumbuzo sokujonga amanqanaba e-oxygen egazini.

Uphuculo lwakutsha nje loqhakamshelwano lwenze ukuba izigulana zikwazi ukufumana i-oksijini yegazi ngokuqhubekayo ngaphandle koqhagamshelo olunentambo kwi-monitor yasesibhedlele, ngaphandle kokuncama ukuhamba kwedatha yesigulana ebuyela kwiimonitha ezisecaleni kwebhedi kunye neenkqubo zokucupha isigulana.IMasimo Radius PPG, eyaziswa ngo-2019, ibonelela nge-tetherless pulse oximetry isebenzisa itekhnoloji ye-Masimo yokutsalwa kophawu, ivumela izigulana ukuba zihambe ngokukhululekileyo nangokukhululeka ngelixa zisajongwa ngokuqhubekayo nangokuthembekileyo.[45]I-Radius PPG inokusebenzisa iBluetooth ekhuselekileyo ukwabelana ngedatha yesigulana ngokuthe ngqo nge-smartphone okanye esinye isixhobo esikrelekrele.[46]

Ukulinganiselwa[hlela]

I-Pulse oximetry ilinganisa kuphela ukugcwala kwe-hemoglobin, hayiukungena komoyakwaye ayingomlinganiselo opheleleyo wokwanela kokuphefumla.Ayithathi ndawoiigesi zegaziihlolwe kwilabhoratri, kuba ayibonisi ntsilelo yesiseko, amanqanaba ecarbon dioxide, igazipH, okanyeibhicarbonate(HCO3−) ukugxila.Imetabolism yeoksijini inokulinganiswa ngokulula ngokujonga i-CO ephelelwe lixesha2, kodwa amanani e-saturation awanikezi ngcaciso malunga nomxholo we-oksijini yegazi.Uninzi lweoksijini esegazini luthwalwa yihemoglobin;kwi-anemia enzima, igazi liqulethe i-hemoglobin encinci, ethi nangona ihluthekile ayikwazi ukuthwala ioksijini eninzi.

Ufundo oluphantsi ngempazamo lunokubangelwahypoperfusionyesiphelo sisetyenziselwa ukubeka iliso (kaninzi ngenxa yokubanda kwelungu, okanye ukusukaivasoconstrictionyesibini kusetyenziso lweivasopressorii-arhente);usetyenziso olungalunganga loluvo;kakhuluurhawuzeloulusu;okanye ukunyakaza (njengokuqhaqhazela), ngakumbi ngexesha le-hypoperfusion.Ukuqinisekisa ukuchaneka, inzwa kufuneka ibuyisele i-pulse eqhubekayo kunye / okanye i-pulse waveform.Ubuchwephesha be-pulse oximetry buhluke kwizakhono zabo zokubonelela ngedatha echanekileyo ngexesha leemeko zokunyakaza kunye ne-perfusion ephantsi.[12][9]

I-Pulse oximetry nayo ayingomlinganiselo opheleleyo wokwanela kweoksijini ejikelezayo.Ukuba akukho nto yaneleyoukuphuma kwegaziokanye i-hemoglobin eyaneleyo egazini (ianemia), izicubu zinokuhluphekahypoxianangona i-arterial saturation ephezulu.

Ekubeni i-pulse oximetry ilinganisa kuphela ipesenteji ye-hemoglobin eboshiweyo, ukufundwa okuphakamileyo okanye okungahambi kakuhle kuya kwenzeka xa i-hemoglobin ibophelela kwenye into ngaphandle kwe-oxygen:

  • I-Hemoglobin inobudlelwane obuphezulu kwi-carbon monoxide kunokuba iyenzayo kwi-oksijini, kwaye ufundo oluphezulu lunokwenzeka nangona isigulana sine-hypoxemic.Kwiimeko zeityhefu yecarbon monoxide, oku kungachanekanga kunokulibazisa ukuqatshelwa kwehypoxia(inqanaba le-oksijini yeselula ephantsi).
  • Ityhefu yecyanideinika ukufundwa okuphezulu kuba inciphisa ukutsalwa kweoksijini kwigazi le-arterial.Kule meko, ukufunda akuyonyani, njengoko ioksijini yegazi ye-arterial iphezulu ngokwenene kwityhefu yokuqala ye-cyanide.[ingcaciso efunekayo]
  • I-Methemoglobinemiangokwempawu ibangela ukufundwa kwe-pulse oximetry phakathi kwe-80s.
  • I-COPD [ingakumbi i-bronchitis engapheliyo] inokubangela ufundo olungeyonyani.[47]

Indlela engabonakaliyo evumela umlinganiselo oqhubekayo we-dyshemoglobins yi-pulseI-CO-oximeter, eyakhiwa ngo-2005 nguMasimo.[48]Ngokusebenzisa ubude bamaza ongezelelweyo,[49]Inika oogqirha indlela yokulinganisa i-dyshemoglobins, i-carboxyhemoglobin, kunye ne-methemoglobin kunye ne-hemoglobin epheleleyo.[50]

Ukwandisa ukusetyenziswa[hlela]

Ngokwengxelo ye-iData Research i-US pulse oximetry monitoring market yezixhobo kunye ne-sensor yayingaphezulu kwe-700 yezigidi ze-USD kwi-2011.[51]

Ngo-2008, ngaphezulu kwesiqingatha sabathengisi bezixhobo zonyango abathumela ngaphandle kumazwe ngamazweeTshayinayaba ngabavelisi be-pulse oximeters.[52]

Ukufunyaniswa kwangoko kwe-COVID-19[hlela]

I-Pulse oximeters isetyenziselwa ukunceda ekubhaqweni kwangaphambiliI-COVID-19usulelo, olunokuthi lubangele ekuqaleni ukugcwala kweoksijini ephantsi kunye ne-hypoxia.INew York Timesingxelo yokuba "amagosa ezempilo ahlulwe malunga nokuba ukujonga ekhaya nge-pulse oximeter kufuneka kunconyelwe ngokubanzi ngexesha le-Covid-19.Izifundo zokuthembeka zibonisa iziphumo ezixubeneyo, kwaye kukho isikhokelo esincinci malunga nendlela yokukhetha esinye.Kodwa oogqirha abaninzi bacebisa abaguli ukuba bayifumane, beyenza ibe yeyona nto iphambili kulo bhubhani. ”[53]

Imilinganiselo ethathwe[hlela]

Bona kwakho:Ifotoplethysmogram

Ngenxa yotshintsho kumthamo wegazi eluswini, aiplethysmographicukwahluka kunokubonwa kwisignali yokukhanya efunyenweyo (ukudluliselwa) yinzwa kwi-oximeter.Ukwahluka kunokuchazwa njengeumsebenzi ngamaxesha, leyo yona inokwahlulwa ibe licandelo le DC (ixabiso lencopho)[a]kunye necandelo le-AC (incopho yokuthabatha intlambo).[54]Umyinge wecandelo le-AC kunye necandelo le-DC, elichazwe njengepesenti, laziwa njenge(i-peripheral)ukuqholaisalathisi(Pi) ye-pulse, kwaye ngokuqhelekileyo inoluhlu lwe-0.02% ukuya kwi-20%.[55]Umlinganiselo wangaphambili obizwa ngokuba yiipulse oximetry plethysmographic(POP) ilinganisa kuphela icandelo le-"AC", kwaye lithathwe ngesandla kwiipikseli zokuhlola.[56][25]

Isalathiso sokuguquguquka kwePleth(PVI) ngumlinganiselo wokuguquguquka kwesalathisi se-perfusion, esenzeka ngexesha lokuphefumla.Ngokwezibalo ibalwa njenge (Pimax-Piimiz)/Pimax× 100%, apho awona maxabiso aphezulu kunye nobuncinci bePi asuka kumjikelo wokuphefumla omnye okanye emininzi.[54]Kuye kwaboniswa ukuba luncedo, isalathisi esingabonakaliyo sokuphendula ngokuqhubekayo kwamanzi kwizigulane eziphantsi kolawulo lwamanzi.[25] I-Pulse oximetry plethysmographic waveform amplitude(ΔPOP) bubuchule bangaphambili obufanayo bokusetyenziswa kwiPOP eyenziwe ngesandla, ibalwe njenge(POP)max-POPimiz)/(POPmax+ POPimiz)*2.[56]

Bona kwakho[hlela]

Amanqaku[hlela]

  1. ^Le nkcazo isetyenziswe nguMasimo iyahluka kwixabiso eliqhelekileyo elisetyenziswe ekuqhubeni umqondiso;kuthetha ukulinganisa i-pulsatile arterial absorbance over the baseline absorbance.

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Ixesha lokuposa: Jun-04-2020