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I-Pulse oximetry

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I-Pulse oximetry

I-Tetherless pulse oximetry

Inhloso

Ukuqapha ukugcwala komoyampilo womuntu

I-Pulse oximetryyin aengahlaseliindlela yokuqapha komuntuukugcwala kwe-oxygen.Nakuba ukufunda kwayo nge-peripheral oxygen saturation (SpO2) akufani ngaso sonke isikhathi nokufunda okufiseleka kakhulu kokugcwala kwe-oxygen emthambo (SaO2) kusukaigesi yegazi le-arterialUkuhlaziya, lokhu okubili kuhlotshaniswa kahle ngokwanele kangangokuthi indlela ephephile, elula, engahlaseli, engabizi kakhulu ye-pulse oximetry ibalulekile ekulinganiseni ukugcwala komoyampiloemtholampilosebenzisa.

Kumodi yayo yohlelo lokusebenza evame kakhulu (i-transmissive), idivayisi yenzwa ibekwa engxenyeni encane yomzimba wesiguli, ngokuvamileumunwenomaindlebe, noma esimweni se-usana, ngaphesheya konyawo.Idivayisi idlulisa amaza okukhanya amabili engxenyeni yomzimba iye kusithwebuli sezithombe.Ikala ukumuncwa okushintshayo endaweni ngayinyeamaza amaza, evumela ukuthi inqumeukumuncwangenxa ye-pulsingigazi le-arterialyedwa, ngaphandleigazi le-venous, isikhumba, ithambo, imisipha, amafutha, futhi (ezimweni eziningi) ukucwebezela kwezinzipho.[1]

I-Reflectance pulse oximetry iyindlela ehlukile engajwayelekile kune-transmissive pulse oximetry.Le ndlela ayidingi ingxenye encane yomzimba womuntu ngakho-ke ifaneleka kahle ekusetshenzisweni kwendawo yonke njengezinyawo, ibunzi, nesifuba, kodwa futhi inokulinganiselwa okuthile.I-Vasodilation kanye nokuhlanganisa igazi le-venous ekhanda ngenxa yokubuyela kwe-venous esengozini enhliziyweni kungabangela inhlanganisela ye-arterial kanye ne-venous pulsations esifundeni sasebunzi futhi kuholele ku-SpO engamanga.2imiphumela.Izimo ezinjalo zenzeka ngenkathi kwenziwa i-anesthesia ngei-endotracheal intubationkanye nokungena komoya ngomshini noma ezigulini ezise-Izindawo zokuhlala e- Trendelenburg.[2]

Okuqukethwe

Umlando[hlela]

Ngo-1935, udokotela waseJalimane uKarl Matthes (1905-1962) wenza indlebe yokuqala enamaza amabili O.2imitha yokugcwalisa enezihlungi ezibomvu neziluhlaza (izihlungi kamuva ezibomvu neze-infrared).Imitha yakhe yaba umshini wokuqala wokulinganisa u-O2saturation.[3]

I-oximeter yasekuqaleni yenziwe nguGlenn Allan Millikanngawo-1940.[4]Ngo-1949, u-Wood wengeza i-capsule yokucindezela ukuze akhiphe igazi endlebeni ukuze athole u-O ophelele.2inani lokugcwala lapho igazi libuyiselwa.Umqondo ufana ne-pulse oximetry yanamuhla, kodwa bekunzima ukuwusebenzisa ngenxa yokungazinzi.ama-photocellkanye nemithombo yokukhanya;namuhla le ndlela ayisetshenziswa emtholampilo.Ngo-1964 uShaw wahlanganisa i-ear oximeter yokuqala yokufunda ngokuphelele, esebenzisa amaza okukhanya ayisishiyagalombili.

I-Pulse oximetry yasungulwa ngo-1972, nguTakuo Aoyagikanye no-Michio Kishi, i-bioengineers, e-Nihon Kohdenkusetshenziswa isilinganiso sokumuncwa kokukhanya okubomvu ukuya kwe-infrared kwezingxenye ezishayayo endaweni yokulinganisa.USusumu Nakajima, udokotela ohlinzayo, kanye nozakwabo baqale bahlola leli thuluzi ezigulini, babika ngalo ngo-1975.[5]Kwathengiswa ngabakwaI-Bioxngo-1980.[6][5][7]

Ngo-1987, izinga lokunakekelwa kokuphathwa kwe-anesthetic evamile e-US lalihlanganisa i-pulse oximetry.Kusukela egunjini lokuhlinza, ukusetshenziswa kwe-pulse oximetry kwasabalala ngokushesha kuso sonke isibhedlela, kuqala kuyaamagumbi okuthola usizo, bese kuthiizikhungo zabagula kakhulu.I-Pulse oximetry yayibaluleke ngokukhethekile kuyunithi yezingane ezisanda kuzalwa lapho iziguli zingathuthuki kahle ngokuthola umoya-mpilo okwanele, kodwa umoya-mpilo omningi kanye nokushintshashintsha kokuhlushwa komoyampilo kungaholela ekulimaleni kombono noma ekuphuphuthekeni okuvela.i-retinopathy yesifo sikashukela(I-ROP).Ngaphezu kwalokho, ukuthola i-arterial blood gas esigulini esisanda kuzalwa kubuhlungu esigulini futhi kuyimbangela enkulu ye-neonatal anemia.[8]I-artifact enyakazayo ingaba umkhawulo obalulekile ekuqaphelweni kwe-pulse oximetry okuholela kuma-alamu angamanga nokulahlekelwa idatha.Lokhu kungenxa yokuthi ngesikhathi sokunyakaza kanye ne-peripheral ephansiukuqhola, ama- pulse oximeters amaningi awakwazi ukuhlukanisa phakathi kwegazi le-arterial elishayayo kanye negazi le-venous elinyakazayo, okuholela ekubukelweni phansi kokugcwala komoyampilo.Izifundo zakuqala zokusebenza kwe-pulse oximetry ngesikhathi sokunyakaza kwesihloko zenze kwacaca ubungozi bobuchwepheshe obujwayelekile be-pulse oximetry ku-artifact enyakazayo.[9][10]

Ngo-1995,UMasimoyethule I-Signal Extraction Technology (i-SET) engakwazi ukulinganisa ngokunembile phakathi nokunyakaza kwesiguli kanye ne-perfusion ephansi ngokuhlukanisa isignali ye-arterial kusuka ku-venous nezinye izimpawu.Kusukela lapho, abakhiqizi be-pulse oximetry baye bahlakulela ama-algorithms amasha ukuze banciphise ama-alamu angamanga ngesikhathi sokunyakaza[11]njengokwelula izikhathi ezimaphakathi noma amanani okufriza esikrinini, kodwa awasho ukuthi alinganisa izimo ezishintshayo phakathi nokunyakaza nokufaka umoya okuphansi.Ngakho-ke, kusenomehluko obalulekile ekusebenzeni kwama-pulse oximeters phakathi nezimo eziyinselele.[12]Futhi ngo-1995, uMasimo wethula inkomba ye-perfusion, ecacisa ubukhulu be-peripheral.i-plethysmographi-waveform.Inkomba ye-Perfusion ikhonjisiwe ukusiza odokotela ukuba babikezele ukuqina kokugula kanye nemiphumela yokuphefumula emibi ezinganeni ezisanda kuzalwa,[13][14][15]ukubikezela ukugeleza okuphansi kwe-vena cava ezinganeni ezizalwa ezinesisindo esiphansi kakhulu,[16]ukunikeza inkomba yokuqala ye-sympathectomy ngemuva kwe-epidural anesthesia,[17]kanye nokwenza ngcono ukutholakala kwesifo senhliziyo esibucayi ezinsaneni ezisanda kuzalwa.[18]

Amaphepha ashicilelwe aqhathanise ubuchwepheshe bokukhipha isignali nobunye ubuchwepheshe be-pulse oximetry futhi abonise imiphumela emihle engaguquki yobuchwepheshe bokukhipha isignali.[9][12][19]Ubuchwepheshe bokukhipha isignali ukusebenza kwe-pulse oximetry nakho kuboniswe ukuhumusha ekusizeni odokotela bathuthukise imiphumela yesiguli.Kolunye ucwaningo, i-retinopathy ye-prematurity (ukulimala kwamehlo) yehliswe ngo-58% ezinganeni ezizalwa ezinesisindo esiphansi kakhulu esikhungweni kusetshenziswa ubuchwepheshe bokukhipha isignali, kuyilapho kungekho kuncipha kwe-retinopathy yokukhula ngaphambi kwesikhathi kwesinye isikhungo esinabodokotela abafanayo besebenzisa isimiso esifanayo. kodwa ngobuchwepheshe bokukhipha okungewona amasignali.[20]Olunye ucwaningo luye lwabonisa ukuthi ubuchwepheshe bokukhipha isignali ye-pulse oximetry buphumela ekulinganisweni kwegesi yegazi le-arterial embalwa, isikhathi esisheshayo sokulunyulwa komoyampilo, ukusetshenziswa kwenzwa okuphansi, kanye nobude obuphansi bokuhlala.[21]Isilinganiso sokunyakaza kanye namandla okufafaza aphansi enawo nawo akuvumela ukuthi kusetshenziswe ezindaweni ebezingagadiwe ngaphambili njengephansi elijwayelekile, lapho ama-alamu angamanga ehlasele i-pulse oximetry evamile.Njengobufakazi balokhu, ucwaningo oluyingqopha-mlando lwanyatheliswa ngo-2010 olubonisa ukuthi odokotela base-Dartmouth-Hitchcock Medical Centre basebenzisa ubuchwepheshe bokukhipha isignali ye-pulse oximetry esitezi esivamile bakwazi ukwehlisa ukusebenza kweqembu lokuphendula ngokushesha, ukudluliselwa kwe-ICU, nezinsuku ze-ICU.[22]Ngo-2020, ucwaningo olulandelanayo lokubuyela emuva esikhungweni esifanayo lubonise ukuthi ngaphezu kweminyaka eyishumi yokusebenzisa i-pulse oximetry ngobuchwepheshe bokukhipha isignali, kuhlanganiswe nesistimu yokuqapha isiguli, kwakungekho ukufa kwesiguli futhi azikho iziguli ezalinyazwa ukucindezeleka kokuphefumula okubangelwa i-opioid. ngenkathi kusetshenziswa ukuqapha okuqhubekayo.[23]

Ngo-2007, uMasimo wethula isilinganiso sokuqala se-pleth variability index(PVI), okuye kwaboniswa izifundo eziningi zemitholampilo inikeza indlela entsha yokuhlola okuzenzakalelayo, okungavamisile kwekhono lesiguli lokuphendula ekuphathweni koketshezi.[24][25][26]Amazinga oketshezi afanelekile abalulekile ekwehliseni izingozi zangemva kokuhlinzwa nokuthuthukisa imiphumela yesiguli: uketshezi oluncane kakhulu (under-hydration) noma oluphezulu kakhulu (over-hydration) luye lwaboniswa ukunciphisa ukuphola kwesilonda futhi lwandisa ingozi yokutheleleka noma izinkinga zenhliziyo.[27]Muva nje, Isevisi Yezempilo Kazwelonke e-United Kingdom kanye ne-French Anesthesia and Critical Care Society bafake ohlwini ukuqapha kwe-PVI njengengxenye yamasu abo aphakanyisiwe okulawula uketshezi lwangaphakathi kokusebenza.[28][29]

Ngo-2011, ithimba lochwepheshe lancoma ukuthi izingane ezisanda kuzalwa zihlolwe nge-pulse oximetry ukuze kwandiswe ukutholakala kwe-pulse oximetry.isifo senhliziyo esibucayi(I-CCHD).[30]Iqembu lomsebenzi le-CCHD licaphune imiphumela yezifundo ezimbili ezinkulu, ezilindelekile zezifundo ezingu-59,876 ezisebenzise ngokukhethekile ubuchwepheshe bokukhipha isignali ukuze kwandiswe ukuhlonzwa kwe-CCHD ngemibono engamanga encane.[31][32]Iqembu lomsebenzi le-CCHD lincome ukuthi ukuhlolwa okusanda kuzalwa kwenziwe nge-motion tolerant pulse oximetry ebuye yaqinisekiswa ezimeni eziphansi zokugcwala.Ngo-2011, uNobhala Wezempilo Nezinsizakalo Zabantu wase-US wengeze i-pulse oximetry kuphaneli yokuhlola iyunifomu enconyiwe.[33]Ngaphambi kobufakazi bokuhlolwa kusetshenziswa ubuchwepheshe bokukhipha isignali, ngaphansi kwe-1% yezingane ezisanda kuzalwa e-United States zahlolwa.Namuhla,I-Newborn Foundationibhalwe phansi eduze nokuhlolwa kwendawo yonke e-United States futhi ukuhlolwa kwamazwe ngamazwe kuyanda ngokushesha.[34]Ngo-2014, ucwaningo olukhulu lwesithathu lwezingane ezisanda kuzalwa eziyi-122,738 eziphinde zasebenzisa kuphela ubuchwepheshe bokukhipha isignali lubonise imiphumela efanayo, emihle njengezifundo ezimbili zokuqala ezinkulu.[35]

I-High-resolution pulse oximetry (HRPO) yenzelwe ukuhlolwa nokuhlolwa kwe-apnea yasendlini ezigulini okungenakwenzeka ukuzenza.i-polysomnography.[36][37]Igcina futhi irekhode kokubiliizinga lokushaya kwenhliziyokanye ne-SpO2 ngezikhawu zesekhondi elingu-1 futhi kuboniswe ocwaningweni olulodwa ukusiza ukuthola ukuphefumula okungasebenzi kahle ezigulini ezihlinzwayo.[38]

Umsebenzi[hlela]

I-spectra yokumuncwa kwe-oxygen hemoglobin (HbO2) kanye ne-deoxygenated hemoglobin (Hb) yamaza amaza abomvu ne-infrared

Uhlangothi lwangaphakathi lwe-pulse oximeter

Imonitha ye-blood-oxygen ibonisa iphesenti legazi elilayishwe umoya-mpilo.Ngokuqondile, ikala ukuthi yiliphi iphesentii-hemoglobin, amaprotheni asegazini athwala umoya-mpilo, ayagcwala.Izigaba ezijwayelekile ezamukelekayo zeziguli ezingenazo izifo zamaphaphu zisuka kumaphesenti angama-95 kuye kwangama-99.Ngegumbi lokuphefumula lesiguli umoya oseduze noma eduzeizinga lolwandle, isilinganiso se-arterial pO2ingenziwa ngemonitha ye-blood-oxygen"Ukugcwala kwe-oxygen ye-peripheral"(SpO2) ukufunda.

I-pulse oximeter evamile isebenzisa iphrosesa ye-elekthronikhi kanye nepheya elincaneama-diode akhipha ukukhanya(Ama-LED) abheke ai-photodiodengengxenye yomzimba wesiguli eguquguqukayo, ngokuvamile isihloko somunwe noma indlebe.I-LED eyodwa ibomvu, eneubude begagasika-660 nm, kanti enye ii-infrarednge-wavelength engu-940 nm.Ukumuncwa kokukhanya kulawa maza wamaza kwehluka kakhulu phakathi kwegazi eligcwele umoya-mpilo kanye negazi elintula umoya-mpilo.I-hemoglobin ene-oxygen imunca ukukhanya okwengeziwe kwe-infrared futhi ivumele ukukhanya okubomvu okwengeziwe kudlule.I-Deoxygenated hemoglobin ivumela ukukhanya okwengeziwe kwe-infrared ukuthi kudlule futhi ibambe ukukhanya okubomvu okwengeziwe.Ama-LED alandelana ngomjikelezo wawo wokuvula okukodwa, bese omunye, bese ecisha womabili izikhathi ezingamashumi amathathu ngomzuzwana ovumela i-photodiode ukuthi iphendule ekukhanyeni okubomvu ne-infrared ngokuhlukana futhi ilungisele isisekelo sokukhanya okuzungezile.[39]

Inani lokukhanya elidluliswayo (ngamanye amazwi, elingamuncwe) liyalinganiswa, futhi amasignali ahlukene ajwayelekile akhiqizwa ngobude begagasi ngalinye.Lezi zimpawu ziyashintshashintsha ngokuhamba kwesikhathi ngoba inani legazi le-arterial elikhona liyakhuphuka (ngokoqobo ishayela) ngokushaya kwenhliziyo ngakunye.Ngokukhipha ukukhanya okuncane okudlulisiwe ekukhanyeni okudlulisiwe kubude beza obunye, imiphumela yezinye izicubu iyalungiswa, ikhiqize isignali eqhubekayo yegazi elithambile elithambile.[40]Isilinganiso sesilinganiso sokukhanya okubomvu nesilinganiso sokukhanya kwe-infrared sibe sesibalwa ngephrosesa (emele isilinganiso se-hemoglobin ene-oksijini ne-deoxygenated hemoglobin), bese lesi silinganiso siguqulelwa ku-SpO.2ngeprosesa nge-aitafula lokubheka[40]ngokusekelwe kuUmthetho kabhiya-Lambert.[39]Ukuhlukaniswa kwesignali futhi kufeza ezinye izinjongo: i-plethysmograph waveform (“pleth wave”) emele isignali ye-pulsatile ngokuvamile iboniswa ukuze kuboniswe inkomba yokushaya kanye nekhwalithi yesignali,[41]kanye nesilinganiso sezinombolo phakathi kwe-pulsatile kanye ne-baseline absorbance (“inkomba ye-perfusion“) ingasetshenziselwa ukuhlola ukuxutshwa kwamanzi.[25]

Inkomba[hlela]

I-pulse oximeter probe isetshenziswa emunweni womuntu

I-pulse oximeter yi-aidivayisi yezokwelaphaeqapha ngokungaqondile ukugcwala komoyampilo kwesiguliigazi(ngokungafani nokulinganisa ukugcwala komoyampilo komoyampilo ngqo ngesampula yegazi) kanye nezinguquko kumthamo wegazi esikhumbeni, okukhiqizai-photoplethysmogramokungase kuqhutshekwe kucutshungulwe kukhoezinye izilinganiso.[41]I-pulse oximeter ingase ifakwe kumonitha wesiguli esinamapharamitha amaningi.Iziqapha eziningi nazo zibonisa izinga lokushaya kwenhliziyo.Ama-pulse oximeter aphathwayo, asebenza ngebhethri ayatholakala futhi ukuze athuthwe noma ahlolwe ekhaya komoyampilo wegazi.

Izinzuzo[hlela]

I-Pulse oximetry ilungele kakhuluengahlaseliukulinganisa okuqhubekayo kokugcwala kwe-oxygen egazini.Ngokuphambene, amaleveli egesi yegazi uma kungenjalo anqunywe elabhorethri ngesampula yegazi elikhishiwe.I-Pulse oximetry iwusizo kunoma yisiphi isilungiselelo lapho isiguliumoya-mpiloayizinzile, kuhlanganisaukunakekelwa okukhulu, ukusebenza, ukutakula, izimo eziphuthumayo kanye nezilungiselelo zewodi yasesibhedlela,abashayeli bezindizaendizeni engacindezelwanga, ukuze kuhlolwe umoya wanoma yisiphi isiguli, kanye nokunquma ukusebenza kahle noma isidingo sokungezelelaumoya-mpilo.Nakuba i-pulse oximeter isetshenziselwa ukuqapha ukuhamba kwe-oxygen, ayikwazi ukunquma ukuguqulwa kwe-oksijeni, noma inani le-oxygen elisetshenziswa isiguli.Ngale njongo, kuyadingeka futhi ukukalai-carbon dioxide(CO2) amazinga.Kungenzeka ukuthi ingasetshenziswa futhi ukuthola ukungahambi kahle ekungeneni komoya.Kodwa-ke, ukusetshenziswa kwe-pulse oximeter ukutholai-hypoventilationiphazamiseka ngokusetshenziswa kwe-oksijini eyengeziwe, njengoba kuphela lapho iziguli ziphefumula umoya wegumbi lapho okungajwayelekile ekusebenzeni kokuphefumula kungatholwa ngokuthembekile ngokusetshenziswa kwawo.Ngakho-ke, ukuphathwa okujwayelekile kwe-oksijeni eyengeziwe kungase kungadingeki uma isiguli sikwazi ukugcina umoya-mpilo owanele emoyeni wekamelo, ngoba kungabangela i-hypoventilation ingabonakali.[42]

Ngenxa yobulula bawo bokusebenzisa kanye nekhono lokuhlinzeka ngamavelu e-oksijini aqhubekayo futhi asheshayo, ama-pulse oximeters abaluleke kakhuluumuthi ophuthumayofuthi ziwusizo kakhulu ezigulini ezinezinkinga zokuphefumula noma zenhliziyo, ikakhulukaziI-COPD, noma ukuxilongwa kwezinyeukuphazamiseka kokulalanjengei-apneafuthii-hyopnea.[43]Ama-pulse oximeter aphathwayo asebenza ngebhethri awusizo kubashayeli bezindiza abasebenza endizeni engacindezelwe ngaphezu kwamafithi angu-10,000 (3,000 m) noma amafithi angu-12,500 (3,800) e-US.[44]lapho kudingeka khona umoya-mpilo owengeziwe.Ama-portable pulse oximeters nawo awusizo kwabaqwali bezintaba nakubasubathi amaleveli awo komoyampilo angase ehle phezuluukuphakamanoma ngokuzivocavoca.Amanye ama-pulse oximeters aphathwayo asebenzisa isofthiwe eshadi umoya wegazi lesiguli kanye neshayela, esebenza njengesikhumbuzo sokuhlola amazinga komoyampilo wegazi.

Intuthuko yakamuva yokuxhumana nayo manje yenze kwaba nokwenzeka ngeziguli ukuthi zihlale ziqashwe ngokuqhubekayo ukugcwala komoyampilo egazini ngaphandle kokuxhumeka ngekhebula kumonitha wasesibhedlela, ngaphandle kokudela ukugeleza kwedatha yesiguli ebuyela kubaqaphi abaseceleni kombhede kanye nezinhlelo zokugada isiguli ezimaphakathi.IMasimo Radius PPG, eyethulwe ngo-2019, ihlinzeka nge-tetherless pulse oximetry isebenzisa ubuchwepheshe bokukhipha isignali ye-Masimo, evumela iziguli ukuthi zihambe ngokukhululeka nangokunethezeka kuyilapho zisabhekwa ngokuqhubekayo nangokuthembekile.[45]I-Radius PPG ingase futhi isebenzise i-Bluetooth evikelekile ukwabelana ngedatha yesiguli ngokuqondile ne-smartphone noma enye idivayisi ehlakaniphile.[46]

Ukulinganiselwa[hlela]

I-Pulse oximetry ikala kuphela ukugcwala kwe-hemoglobin, hhayiukungena komoyafuthi akusona isilinganiso esiphelele sokwanela kokuphefumula.Ayithatheli indawoamagesi egaziihlolwe elabhorethri, ngoba ayinikezi inkomba yokushoda kwesisekelo, amazinga e-carbon dioxide, igazipH, nomai-bicarbonate(HCO3−) ukugxilisa ingqondo.I-metabolism yomoya-mpilo ingalinganiswa kalula ngokuqapha i-CO ephelelwe yisikhathi2, kodwa izibalo zokugcwala kwamanzi azinikezi ulwazi mayelana nokuqukethwe komoyampilo egazini.Iningi lomoya-mpilo osegazini lithwalwa yi-hemoglobin;ku-anemia enzima, igazi line-hemoglobin encane, okuthi naphezu kokugcwala kwayo ingakwazi ukuthwala umoya-mpilo omningi.

Ukufundwa okuphansi ngephutha kungase kubangelwehypoperfusionkomkhawulo osetshenziselwa ukuqapha (imvamisa ngenxa yokuthi isitho siyabanda, noma sisukai-vasoconstrictionokwesibili ekusetshenzisweni kwei-vasopressorama-ejenti);uhlelo lokusebenza lwenzwa olungalungile;kakhulunesibindiisikhumba;noma ukunyakaza (njengokuqhaqhazela), ikakhulukazi ngesikhathi se-hypoperfusion.Ukuqinisekisa ukunemba, inzwa kufanele ibuyisele ukushaya kwenhliziyo okuqinile kanye/noma i-pulse waveform.Ubuchwepheshe be-Pulse oximetry buyahluka ngamakhono abo okuhlinzeka ngedatha enembile phakathi nezimo zokunyakaza kanye nokugcwaliswa okuphansi.[12][9]

I-Pulse oximetry nayo ayisona isilinganiso esiphelele sokwanela komoya-mpilo wokujikeleza.Uma kungenaneleukugeleza kwegazinoma i-hemoglobin enganele egazini (i-anemia), izicubu zingahluphekai-hypoxianaphezu kokugcwala kwe-oxygen ephezulu ye-arterial.

Njengoba i-pulse oximetry ikala kuphela iphesenti le-hemoglobin eboshiwe, ukufundwa okuphakeme okungamanga noma okuphansi okungamanga kuzokwenzeka lapho i-hemoglobin ibophezela kokuthile okungewona umoya-mpilo:

  • I-Hemoglobin ihlobene kakhulu ne-carbon monoxide kune-oksijini, futhi ukufunda okuphezulu kungase kwenzeke naphezu kokuba isiguli empeleni sine-hypoxemic.Ezimweni zeubuthi be-carbon monoxide, lokhu kungalungile kungase kubambezele ukubonwa kwei-hypoxia(izinga eliphansi le-oxygen yamaselula).
  • Ubuthi be-cyanideinikeza ukufundwa okuphezulu ngoba kunciphisa ukukhishwa komoya-mpilo egazini le-arterial.Kulokhu, ukufundwa akulona amanga, njengoba i-arterial blood oxygen iphezulu ngempela ebusheni bokuqala be-cyanide.[ukucaciswa okudingekayo]
  • I-Methemoglobinemiakubangela ukufundwa kwe-pulse oximetry maphakathi nawo-80s.
  • I-COPD [ikakhulukazi i-bronchitis engapheli] ingase ibangele ukufundwa okungamanga.[47]

Indlela engavamile evumela ukulinganiswa okuqhubekayo kwe-dyshemoglobins ishayelaI-CO-oximeter, eyakhiwa ngo-2005 nguMasimo.[48]Ngokusebenzisa amaza amaza engeziwe,[49]inikeza odokotela indlela yokukala i-dyshemoglobins, i-carboxyhemoglobin, ne-methemoglobin kanye ne-hemoglobin ephelele.[50]

Ukwandisa ukusetshenziswa[hlela]

Ngokombiko we-iData Research imakethe yokuqapha i-pulse oximetry yase-US yemishini nezinzwa yayingaphezu kwezigidi ezingu-700 USD ngo-2011.[51]

Ngo-2008, ngaphezu kwengxenye yabakhiqizi bemishini yezokwelapha abakhulu abathumela kwamanye amazweChinababengabakhiqizi be-pulse oximeters.[52]

Ukutholwa kusenesikhathi kwe-COVID-19[hlela]

Ama-pulse oximeter asetshenziselwa ukusiza ukutholwa kusenesikhathiI-COVID-19ukutheleleka, okungase kubangele ekuqaleni ukugcwala okuphansi kwe-arterial oxygen saturation kanye ne-hypoxia.I-New York Timesibike ukuthi "izikhulu zezempilo zihlukene phakathi ngokuthi ngabe ukuqapha kwasekhaya nge-pulse oximeter kufanele kunconywe yini ngesikhathi se-Covid-19.Izifundo zokuthembeka zibonisa imiphumela exubile, futhi kunesiqondiso esincane sokuthi ungasikhetha kanjani esisodwa.Kepha odokotela abaningi beluleka iziguli ukuthi zithole eyodwa, okwenza kube yigajethi yobhubhane lwalesi sifo. ”[53]

Izilinganiso ezitholiwe[hlela]

Bona futhi:I-Photoplethysmogram

Ngenxa yoshintsho kumthamo wegazi esikhumbeni, ai-plethysmographicukushintshashintsha kungabonakala kusignali yokukhanya eyamukelwe (ukudlulisa) yinzwa ku-oximeter.Ukwehluka kungachazwa ngokuthi aumsebenzi ngezikhathi ezithile, yona engahlukaniswa ibe ingxenye ye-DC (inani eliphakeme)[a]kanye nengxenye ye-AC (isiqongo sokususa isigodi).[54]Isilinganiso sengxenye ye-AC nengxenye ye-DC, evezwa njengephesenti, saziwa ngokuthi(i-peripheral)ukuqholainkomba(Pi) yokushaya kwenhliziyo, futhi ngokuvamile inobubanzi obungu-0.02% ukuya ku-20%.[55]Isilinganiso sangaphambili esibizwa ngokuthi ii-pulse oximetry plethysmographic(POP) ikala kuphela ingxenye ye-“AC”, futhi isuselwa mathupha kumaphikseli okuqapha.[56][25]

Inkomba yokuhlukahluka kwe-pleth(i-PVI) isilinganiso sokuhlukahluka kwenkomba ye-perfusion, okwenzeka phakathi nemijikelezo yokuphefumula.Ngokwezibalo kubalwa ngokuthi (Piubuningi-Piimiz)/Piubuningi× 100%, lapho amanani aphezulu kanye nobuncane be-Pi asuka kumjikelezo wokuphefumula owodwa noma eminingi.[54]Kuboniswe ukuthi kuyinkomba ewusizo, engabonakali yokusabela koketshezi okuqhubekayo ezigulini ezilawulwa uketshezi.[25] I-Pulse oximetry plethysmographic waveform amplitudeI-(ΔPOP) iyindlela yangaphambili efana neyokusetshenziswa ku-POP ethathwe ngesandla, ebalwa njengokuthi(POPubuningi- I-POPimiz)/(POPubuningi+ I-POPimiz)*2.[56]

Bona futhi[hlela]

Amanothi[hlela]

  1. ^Le ncazelo esetshenziswa uMasimo iyahlukahluka enanini elivamile elisetshenziswa ekucubunguleni isignali;kuhloswe ukukala ukumuncwa kwegazi kwe-pulsatile arterial phezu kokumunca okuyisisekelo.

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Isikhathi sokuthumela: Jun-04-2020