探討脈動式氧合測量器於小兒加護病房臨床應用的限制

脈動式氧合測量器(pulse oximetry)是一種廣泛應用於手術室、加護病房及其他臨床單位的監視儀器，但在某些臨床情下，脈動式氧合測量器於使用上有其限制。因此，本研究目的：探討脈動式氧合測量器於小兒加護病房臨床應用的限制。本研究結果發現：本研究樣本的SpO2值與SaO2值有差異性存在(t=5.984, p<.01)，但兩者相關性高(r=0.920, p<.01)；SpO2值之正確性與病童的血球容積、膽紅素值、動脈血中氧濃度、動脈血中二氧化碳濃度、動脈血中的酸鹼度、是否靜脈注射冠狀動脈擴張劑(NTG)及是否靜脈滴注PGE1等變項間有關，而病童的體溫、動脈式氧合測量器置放的位置、血中鈣離子濃度、血紅素濃度及是否靜脈輸注血管收縮劑等變項與SpO2值之正確性之間無關。由本研究可了解醫護人員在使用動脈式氧合測量器時，需對其使用限制有所了解，才能更有效地預測病人的病，進而促進護理品質。
Pulse oximetry is a widely used monitoring technique in operation room, intensive care units, and other areas. In light of some clinical limitations that have been noted in pulse oximetry in PICU. Our aim of this descriptive study was to detect the limitation of pulse oximetry. Data analyzed with a paired t-test showed a statistically significant difference between the SpO2 and SaO2 values (t=5.984, p<.01). The Pearson correlation coefficient between pulse oximetry (SpO2) and direct blood oxygen saturation (SaO2) measurement was 0.920 (p<.01). For the difference between SpO2 and SaO2, significant correlations were noted with hematocrit (Hct), bilirubin level, hemoglobin level, arterial oxygen partial pressure (PaO2), arterial carbon dioxide partial pressure (PaCO2), arterial blood of acid-base level (PH), NTG use, and PGE1 use. No significant correlations were noted with patient temperature, calcium level, position of pulse oximetry, and vasoconstrictor use. The data showed that the ability of pulse oximetry is limited. We must understand the limitation of pulse oximetry, then we can predict patient conditions, and improve the quality of nursing care.