Hyperoxemia, Hypoxemia, Respiratory Failure
Conditions
Brief summary
The oximeter is used to monitor intensive care patients undergoing oxygen therapy. It indicates pulsed oxygen saturation (SpO2), a reflection of arterial oxygen saturation (SaO2) which enables detection of hypoxemia and hyperoxia, both deleterious state. Current SpO2 recommendations aim to reduce both risk of hypoxemia and hyperoxia. SpO2 is considered the 5th vital sign. Current recommendations for SpO2 targets do not consider the variability of oximeters used in clinical practice. This variability and lack of specification represent an obstacle to an optimal practice of oxygen therapy. Thus, this study aims to compare the SpO2 values of different oximeters (General Electric-GE, Medtronic, Masimo and Nonin) used in clinical practice with the SaO2 reference value obtained by an arterial gas in order to specify the precision and the systematic biases of the oximeters studied. This data will also make it possible to refine the recommendations concerning optimal oxygenation
Interventions
DEVICESpO2 and SaO2 comparison
Several pulse oximeter will be place on patient find few minutes before arterial blood gases. During an arterial blood sample, all SpO2 will be recorded
Sponsors
Laval University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
0 Years to 100 Years
Healthy volunteers
No
Inclusion criteria
Adult population Inclusion Criteria: * ≥ 18 years old (adult population) - * Patients admitted to the Intensive Care Unit * Artery catheter already installed Pediatric population * Below 18 years old * Patients admitted to the Intensive Care Unit * Artery catheter already installed
Exclusion criteria
* No or poor signal with the usual pulse oximeter/based on clinician judgment * High dose of vasopressors or inotropes (epinephrine or norepinephrine ˃ 1mcg/kg/min), shock state (lactates above 3 mmoles/L) * Pigmented nails or nail polish * Methemoglobinemia history * Hemoglobin below 80 g/L * Patient in isolation (multi-resistant bacteria, C-Difficile, SARS-COV-2…) * Prone position, Extra Corporel Membrane Oxygenator
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Difference between Nonin oximeter SpO2 value and the SaO2 value on arterial blood gases | During procedure (arterial blood gas sample collection) | Difference between Nonin oximeter SpO2 and the SaO2 value |
| Difference between GE oximeter SpO2 value and the SaO2 value on arterial blood gases | During procedure (arterial blood gas sample collection) | Difference between GE oximeter SpO2 and the SaO2 value |
| Difference between Nellcor oximeter SpO2 value and the SaO2 value on arterial blood gases | During procedure (arterial blood gassample collection) | Difference between Nellcor oximeter SpO2 and the SaO2 value |
| Difference between Masimo oximeter SpO2 value and the SaO2 value on arterial blood gases | During procedure (arterial blood gas sample collection) | Difference between Masimo oximeter SpO2 and the SaO2 value |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Overestimation and underestimation of SaO2 | During procedure (arterial blood gas sample collection) | Percent of pairs with overestimation and underestimation of SaO2 for each oximeter. |
| Hypoxemia detection | During procedure (arterial blood gas sample collection) | Ability to detect hypoxemia (SpO2 below 90% and PaO2 \< 60 mmHg) |
Other
| Measure | Time frame | Description |
|---|---|---|
| Hyperoxemia detection | During procedure (arterial blood gas sample collection) | Ability to detect hyperoxemia (SpO2 above 95% and PaO2 \> 100 mmHg) |
| Gaps between the different oximeters | During procedure (arterial blood gas sample collection) | Average of the SpO2 value gaps between the different oximeters tested |
Countries
Canada
Outcome results
None listed