Pulse Oximetry and Arterial Blood Gas Oxygen Saturation Discrepancies and Mortality in Extracorporeal Cardiopulmonary Resuscitation Patients: An Extracorporeal Life Support Organization Registry Analysis

医学 四分位间距 体外膜肺氧合 低氧血症 心肺复苏术 体外心肺复苏 体外 麻醉 氧饱和度 复苏 动脉血 内科学 心脏病学 氧气 化学 有机化学
作者
Andrew Kalra,Christopher Wilcox,Winnie Liu,S. Feng,Patricia M. Brown,Bo Soo Kim,Daniel Brodie,Glenn Whitman,Sung‐Min Cho
出处
期刊:Critical Care Medicine [Lippincott Williams & Wilkins]
标识
DOI:10.1097/ccm.0000000000006736
摘要

Objectives: Previous studies have shown that inaccurate peripheral oxygen saturation (SpO2) readings compared with arterial oxygen saturation (SaO2) may occur in extracorporeal membrane oxygenation (ECMO) patients. We hypothesized that a greater Sp o 2 –Sa o 2 discrepancy in extracorporeal cardiopulmonary resuscitation (ECPR) patients is associated with higher mortality due to unrecognized hypoxemia. Design: Retrospective analysis. Setting: Data within the Extracorporeal Life Support Organization Registry from 496 ECMO centers (2018–2024). Patients: Patients 18 years old or older receiving ECPR (first-run only). Interventions: None. Measurements and Main Results: Laboratory measurements including Sp o 2 –Sa o 2 were measured at 24 hours of ECMO support. Acute brain injury (ABI) included hypoxic-ischemic brain injury, ischemic stroke, intracranial hemorrhage, and seizures. Based on an inflection point in cubic spline analysis, a Sp o 2 –Sa o 2 threshold greater than or equal to 4% was used as a binary variable to assess its association with in-hospital mortality. Three thousand nine hundred seventy ECPR patients (median age, 57 yr; 71% male) were included. The median ECMO duration was 4 days (interquartile range, 2–7 d). There were 634 patients (16%) with Sp o 2 –Sa o 2 greater than or equal to 4% and 3336 (84%) with Sp o 2 –Sa o 2 less than 4%. Overall mortality was 60% ( n = 2391). Patients with Sp o 2 –Sa o 2 greater than or equal to 4% had higher mortality compared with patients with Sp o 2 –Sa o 2 less than 4% (67%, n = 425 vs. 59%, n = 1966; p < 0.001). Patients with Sp o 2 –Sa o 2 greater than or equal to 4% had higher serum lactate values than those with Sp o 2 –Sa o 2 less than 4% (3.1 vs. 2.8 mmol/L; p = 0.0017). In multivariable logistic regression adjusted for preselected covariates, Sp o 2 –Sa o 2 greater than or equal to 4% was associated with increased risk of mortality (adjusted odds ratio [aOR], 1.39; 95% CI, 1.13–1.71). Additional risk factors associated with higher mortality included ABI (aOR, 5.81; 95% CI, 4.70–7.20), hyperoxemia greater than or equal to 300 mm Hg (aOR, 1.93; 95% CI, 1.53–2.43), hyperoxemia 200–299 mm Hg (aOR, 1.76; 95% CI, 1.37–2.25), gastrointestinal hemorrhage (aOR, 1.69; 95% CI, 1.42–2.00), renal replacement therapy (aOR, 1.48; 95% CI, 1.03–2.11), hypoxemia less than 60 mm Hg (aOR, 1.45; 95% CI, 1.00–2.10), older age (aOR, 1.19; 95% CI, 1.13–1.26), and higher lactate (aOR, 1.17; 95% CI, 1.13–1.20). Race/ethnicity was not associated with higher mortality. Conclusions: Sp o 2 –Sa o 2 greater than or equal to 4% in the first 24 hours after ECPR is associated with increased risk of mortality, potentially due to unrecognized hypoxemia, irrespective of race/ethnicity.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
RQ完成签到,获得积分20
刚刚
elle完成签到,获得积分10
1秒前
1秒前
陈石头完成签到,获得积分10
1秒前
歪歪完成签到,获得积分10
1秒前
2秒前
2秒前
haha368发布了新的文献求助10
3秒前
典雅的俊驰应助xiayiyi采纳,获得10
3秒前
鲁滨逊发布了新的文献求助20
3秒前
十丶年完成签到,获得积分10
3秒前
3秒前
科小白完成签到,获得积分10
4秒前
小羡完成签到 ,获得积分10
4秒前
酷波er应助tt采纳,获得10
6秒前
Akim应助千秋百事可乐采纳,获得10
6秒前
香蕉觅云应助keke采纳,获得10
6秒前
WooKawai发布了新的文献求助10
7秒前
博弈春秋发布了新的文献求助10
7秒前
7秒前
熊杰发布了新的文献求助10
8秒前
9秒前
9秒前
量子星尘发布了新的文献求助10
10秒前
顾矜应助一点不晓得啦采纳,获得10
10秒前
CR7应助细心蚂蚁采纳,获得20
10秒前
SciGPT应助细心蚂蚁采纳,获得10
10秒前
11秒前
稳重的冬易完成签到,获得积分10
11秒前
顾矜应助飞翔的西红柿采纳,获得30
11秒前
12秒前
12秒前
keke完成签到,获得积分20
13秒前
YOLO发布了新的文献求助10
13秒前
orixero应助苏梓卿采纳,获得10
13秒前
大个应助范德华气体采纳,获得10
13秒前
科研通AI6应助胖胖采纳,获得10
13秒前
Orange应助冰川下的小太阳采纳,获得10
14秒前
14秒前
14秒前
高分求助中
(应助此贴封号)【重要!!请各用户(尤其是新用户)详细阅读】【科研通的精品贴汇总】 10000
网络安全 SEMI 标准 ( SEMI E187, SEMI E188 and SEMI E191.) 1000
小鼠脑外侧隔核的全脑投射研究 500
计划经济时代的工厂管理与工人状况(1949-1966)——以郑州市国营工厂为例 500
INQUIRY-BASED PEDAGOGY TO SUPPORT STEM LEARNING AND 21ST CENTURY SKILLS: PREPARING NEW TEACHERS TO IMPLEMENT PROJECT AND PROBLEM-BASED LEARNING 500
Signals, Systems, and Signal Processing 400
Sociologies et cosmopolitisme méthodologique 400
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 纳米技术 计算机科学 内科学 化学工程 复合材料 物理化学 基因 催化作用 遗传学 冶金 电极 光电子学
热门帖子
关注 科研通微信公众号,转发送积分 4619865
求助须知:如何正确求助?哪些是违规求助? 4021460
关于积分的说明 12449390
捐赠科研通 3705439
什么是DOI,文献DOI怎么找? 2043469
邀请新用户注册赠送积分活动 1075791
科研通“疑难数据库(出版商)”最低求助积分说明 958994