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Esophageal pulse oximetry is more accurate and detects hypoxemia earlier than conventional pulse oximetry

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《医学前沿（英文）》 2012年第6卷第4期页码 406-410 doi: 10.1007/s11684-012-0217-3

摘要：

The esophagus is perfused directly by prominent arteries and may provide a more consistent tissue source for pulse oximetry. The goal of this study was to evaluate the sensitivity and accuracy of an esophageal pulse oximetry probe on patients during controlled hypoxemia in comparison to measurements obtained with conventional pulse oximetry (SpulseO₂). Forty-five ASA I–II adult patients were included in this prospective observational study. Nellcor digital oximetric probes were placed on finger tips for SpulseO₂ before anesthesia. After tracheal intubation, an esophageal probe was placed in the lower segment of the esophagus for esophageal oximetric monitoring (SoesO₂). All patients were disconnected from the breathing circuit to establish a controlled hypoxemia, and were re-connected to the breathing circuit and ventilated with 100% oxygen immediately when SoesO₂ dropped to 90%. Matched SoesO₂ and SpulseO₂ readings were recorded when SoesO₂measurements were at 100%, 95%, 90% and the lowest reading. The time for SoesO₂ and SpulseO₂ to drop from 100% to 95%, 90% and return to 100% was recorded. Oxygen saturation from arterial blood samples (SartO₂) was also measured at each time point respectively. The linear correlation coefficient of the regression analysis between SartO₂ and SoesO₂ was 0.954. The mean±2SD of the difference was 0.3%±4.3% for SoesO₂vs. SartO₂ and 6.8%±5.6% for SpulseO₂vs. SartO₂ (P<0.001). The 95% confidence interval for the absolute difference between SoesO₂ and SartO₂ was 0.3% to 0.7% and 6.2% to 7.4% between SpulseO₂ and SartO₂. The time to reach 90% saturation measured with SoesO₂ was approximately 94 seconds earlier than the SpulseO₂ (P<0.001). In conclusion, SoesO₂ is more accurate and enables earlier detection of hypoxemia when compared to conventional pulse oximetry during hypoxemia for patients undergoing general anesthesia.

关键词： esophageal pulse oximetry conventional pulse oximetry hypoxemia

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Clinical characteristics in lymphangioleiomyomatosis-related pulmonary hypertension: an observation on 50 patients

Xiuxiu Wu, Wenshuai Xu, Jun Wang, Xinlun Tian, Zhuang Tian, Kaifeng Xu

《医学前沿（英文）》 2019年第13卷第2期页码 259-266 doi: 10.1007/s11684-018-0634-z

摘要： Lymphangioleiomyomatosis (LAM) is a rare diffuse cystic lung disease. Knowledge on LAM-related pulmonary hypertension (PH) is limited. This study aimed to analyze the clinical characteristics of LAM with elevated pulmonary artery pressure (PAP) and evaluate the potential efficacy of sirolimus. The study involved 50 LAM patients who underwent echocardiography. According to the tricuspid regurgitation velocity (TRV), these patients were divided into the TRV≤2.8 m/s group and TRV>2.8 m/s group. Both groups comprised 25 females with an average age of 38.6±8.1 and 41.5±8.9 years. In the TRV>2.8 m/s group, the estimated systolic PAP (SPAP) was significantly elevated (52.08±12.45 mmHg vs. 30.24±5.25mmHg, <0.01). Linear analysis showed that SPAP was correlated with forced expiratory volume in 1 s (FEV ), diffusing capacity of the lungs for carbon monoxide, alveolar arterial oxygen gradient (P O ), and 6 min walking distance ( = −0.392, −0.351, 0.450, and −0.591, respectively; <0.05), in which P O was a risk factor for SPAP elevation ( = 0.064, OR= 1.066, <0.05). Moreover, in 10 patients who received sirolimus therapy, SPAP decreased from 57.0±12.6 mmHg to 35.2±11.1 mmHg. The study showed that LAM patients with PH exhibit poor pulmonary function and hypoxemia and may benefit from sirolimus treatment.

关键词： lymphangioleiomyomatosis pulmonary hypertension pulmonary function hypoxemia sirolimus