The Use of Pulse Oximetry to Determine Hypoxemia in Acute Exacerbations of COPD

COPD
Susana Garcia-GutierrezIRYSS-COPD group

Abstract

There is little evidence that the guideline-recommended oxygen saturation of 92% is the best cut-off point for detecting hypoxemia in COPD exacerbations. To detect and validate pulse oximetry oxygen saturation cut-off values likely to detect hypoxemia in patients with aeCOPD, to explore the correlation between oxygen saturation measured by pulse oximetry and hypoxemia or hypercapnic respiratory failure. Cross-sectional study nested in the IRYSS-COPD study with 2,181 episodes of aeCOPD recruited between 2008 and 2010 in 16 hospitals belonging to the Spanish Public Health System. Data collected include determination of oxygen saturation by pulse oximetry upon arrival in the emergency department (ED), first arterial blood gasometry values, sociodemographic information, background medical history and clinical variables upon ED arrival. Logistic regression models were performed using as the dependent variables hypoxemia (PaO2 < 60 mmHg) and hypercapnic respiratory failure (PaO2 < 60 mmHg and PaCO2 > 45). Optimal cut-off points were calculated. The correlation coefficient between oxygen saturation and pO2 measured by arterial blood gasometry was 0.89. The area under the curve (AUC) for the hypoxemia model was 0.97 (0.96-0.98) and the...Continue Reading

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