Pulse oximetry for the diagnosis and management of acute respiratory distress syndrome.
review · Level V
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- Record sourced from PubMed, PMID 36049490.
- Also identified by DOI 10.1016/S2213-2600(22)00058-3 and PMC identifier 9423770.
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Abstract
The diagnosis of acute respiratory distress syndrome (ARDS) traditionally requires calculation of the ratio of partial pressure of arterial oxygen to fraction of inspired oxygen (PaO<sub>2</sub>/FiO<sub>2</sub>) using arterial blood, which can be costly and is not possible in many resource-limited settings. By contrast, pulse oximetry is continuously available, accurate, inexpensive, and non-invasive. Pulse oximetry-based indices, such as the ratio of pulse-oximetric oxygen saturation to FiO<sub>2</sub> (SpO<sub>2</sub>/FiO<sub>2</sub>), have been validated in clinical studies for the diagnosis and risk stratification of patients with ARDS. Limitations of the SpO<sub>2</sub>/FiO<sub>2</sub> ratio include reduced accuracy in poor perfusion states or above oxygen saturations of 97%, and the potential for reduced accuracy in patients with darker skin pigmentation. Application of pulse oximetry to the diagnosis and management of ARDS, including formal adoption of the SpO<sub>2</sub>/FiO<sub>2</sub> ratio as an alternative to PaO<sub>2</sub>/FiO<sub>2</sub> to meet the diagnostic criterion for hypoxaemia in ARDS, could facilitate increased and earlier recognition of ARDS worldwide to advance both clinical practice and research.
Medical subject headings
- Oximetry
- Respiratory Distress Syndrome