Arterial Oxygen Saturation Levels Research Articles

Epidemiological Aspects of Opioid Poisoning in Northern Iran: A Registry-Based Clinical Study.

Opioids are a class of drugs that are commonly used to manage pain due to their analgesic and sedative effects. However, the high consumption of opioids in the community has led to an increase in the incidence of overdoses and poisonings caused by various types of these drugs, whether intentional or unintentional. Therefore, comprehending the epidemiological features of patients experiencing opioid poisoning is crucial. We decided to investigate various epidemiological aspects of patients with opioid poisoning in the Mazandaran province, located in northern Iran, during the period of 2020 to 2021. The present investigation was conducted as a descriptive cross-sectional study, wherein we collected data on patients registered in the Mazandaran Registry Center of Opioid Poisoning (MRCOP) who had a history of using any kind of opioid. We collected information on various parameters, including patient demographics, the type of opioid consumed, the mode of consumption, and clinical outcomes. A total of 240 patients were initially registered at the registry center. However, 17 cases were excluded with personal consent, and eventually, a total of 223 patients were included in the investigation. The majority of the patients 70.9% (n = 158) were male, and the average age was 34.4 ± 16.55 years. The most common cause of poisoning reported in our study was intentional, which was mainly due to a suicide attempt. Furthermore, the most prevalent type of opioid consumed was methadone. The most frequently observed symptoms of poisoning among the patients were drowsiness, a decreased level of consciousness, and reduced arterial oxygen saturation levels. Based on the results of our study, several factors were found to be significant in methadone poisoning, including addiction, age, gender, suicide attempt, and a history of psychiatric disorder. These findings highlight the need for public education and awareness campaigns on the risks associated with opioid use, particularly methadone.

Machine learning model for predicting immediate postoperative desaturation using spirometry signal data

Postoperative desaturation is a common post-surgery pulmonary complication. The real-time prediction of postoperative desaturation can become a preventive measure, and real-time changes in spirometry data can provide valuable information on respiratory mechanics. However, there is a lack of related research, specifically on using spirometry signals as inputs to machine learning (ML) models. We developed an ML model and postoperative desaturation prediction index (DPI) by analyzing intraoperative spirometry signals in patients undergoing laparoscopic surgery. We analyzed spirometry data from patients who underwent laparoscopic, robot-assisted gynecologic, or urologic surgery, identifying postoperative desaturation as a peripheral arterial oxygen saturation level below 95%, despite facial oxygen mask usage. We fitted the ML model on two separate datasets collected during different periods. (Datasets A and B). Dataset A (Normal 133, Desaturation 74) was used for the entire experimental process, including ML model fitting, statistical analysis, and DPI determination. Dataset B (Normal 20, Desaturation 4) was only used for verify the ML model and DPI. Four feature categories—signal property, inter-/intra-position correlation, peak value/interval variability, and demographics—were incorporated into the ML models via filter and wrapper feature selection methods. In experiments, the ML model achieved an adequate predictive capacity for postoperative desaturation, and the performance of the DPI was unbiased.

Relationship between Oxygen Saturation and Blood Cholesterol Levels in the Elderly

According to the World Health Organization (WHO), elderly people are a population group aged 60 years or more (WHO, 2015). In 2010 the number of elderly people was 18.1 million people or 17.6 percent. In 2014 the number increased to 18.8 million people. In Indonesia, elderly people in 2020 are estimated to reach 28.8 million people or 11.34 percent of the total population in the country. Based on 2018 data, Indonesia Health Research Organization (RISKESDA) stated the majority of elderly people in Indonesia have degenerative diseases and/or chronic health problems, such as diabetes and heart disease (Ministry of Health of the Republic of Indonesia, 2018). In the 21st century, a special challenge in the health sector from the continuing increase in the number of elderly people is the emergence of degenerative problems and non-communicable diseases (NCDs) such as hypercholesterolemia, diabetes mellitus, hypertension, and mental health disorders, namely depression, dementia, anxiety disorders, and sleeping disorders. These diseases will cause problems if they are not treated or prevented. Oxygen saturation is the hemoglobin fraction of oxygen saturation relative to the total hemoglobin in the blood or the oxygen level in the blood. Oxygen is bound to Hemoglobin in the Red blood cells or Erythrocytes. The human body needs and regulates a very precise and specific balance of oxygen in the blood, because the human body needs oxygen from the environment outside the body for metabolic processes and body activities. The normal arterial blood oxygen saturation level in humans is 95-100 percent. Based on data from the Global Health Observatory (GHO) from the World Health Organization (WHO), it shows that one third of ischemic heart disease is caused by high cholesterol levels. Overall, elevated cholesterol is estimated to cause 2.6 million deaths (4.5% of total deaths in the world) and 29.7 million disability-adjusted life years (DALYS), or 2% of total DALYS. (Increased ......

Remote photoplethysmography-based human vital sign prediction using cyclical algorithm.

This article aims to predict vital signs like heart rate (HR), respiration rate, and arterial oxygen saturation using ambient light video, eliminating chronic distortions through improved frame quality with BER estimation. The study employs the cascade residual CNN-FPNR technique for preprocessing and SNR enhancement using energy variance maximization. The image cascade network (ICNet) facilitates segmentation, achieving strong segmentation in low-light ambient videos. Remote photoplethysmography (iPPG) enables noncontact vital sign monitoring, predicting HR and respiratory rate (RR). An innovative noninvasive temperature and cyclical algorithm, incorporating principal component analysis and fast Fourier transform, evaluate patient HR and RR. To address challenges related to involuntary movements, a dynamic time-warping-based optimization method is used for precise region selection. The study introduces an intensity variance-based threshold analysis for arterial oxygen saturation level determination. Ultimately, the support vector machine (SVM) classification technique evaluates the ground truth, showcasing the system's promising potential for remote and accurate vital sign assessment.

Combined remifentanil/sevoflurane in paediatric tonsil surgery anesthesia: Effect on recovery time of respiration and consciousness in paediatric patients

Purpose: To evaluate the effectiveness of combined remifentanil/sevoflurane anesthesia on hemodynamic stability and postoperative recovery in paediatric tonsil surgery.
 Methods: In this prospective study, a total of 102 paediatric patients who underwent tonsil surgery in Taihe County People's Hospital between February 2021 and April 2022 were recruited and randomized at a ratio of 1:1 to receive either propofol alone (control group) or remifentanil plus sevoflurane (study group) during paediatric tonsil surgery, with 51 patients in each group. The anaesthetic effect of the two regimens was the primary endpoint and was evaluated by monitoring the mean arterial pressure (MAP), heart rate (HR) and oxygen saturation (SpO2) levels of the patients before anaesthesia (T0), immediately after intubation (T1), at the beginning of surgery (T2) and at extubation (T3).
 Results: Remifentanil plus sevoflurane resulted in more stable MAP and HR of patients at T1, T2 and T3 than propofol alone (p < 0.05). Furthermore, patients in the two groups exhibited similar SpO2 levels at T0, T1, T2 and T3 (p > 0.05).
 Conclusion: The combined use of remifentanil and sevoflurane anaesthetics is effective in paediatric patients undergoing tonsil surgery and thus may offer a viable alternative for such clinical practice. The drug combination maintains intraoperative haemodynamic stability in patients, boosts postoperative recovery, and lowers the risk of postoperative adverse events.

Anesthetic effect of sufentanil in patients undergoing cardiovascular surgery

Purpose: To investigate the effect of sufentanil on anesthesia in patients undergoing cardiovascular surgery. 
 Methods: The subjects comprised a total of 100 patients who were scheduled to undergo cardiovascular surgery in Taikang Tongji (Wuhan) Hospital from January 2021 to December 2021 and met the inclusion criteria. The eligible patients were assigned in a ratio of 1:1 to receive either remifentanil (control group) or sufentanil (study group) during cardiovascular surgery, with 50 patients in each group. The anesthetic effect of remifentanil and sufentanil was compared. 
 Results: Patients treated with sufentanil experienced a faster onset of anesthesia and a shorter time-lapse before extubation, postoperative spontaneous breathing recovery, and postoperative anesthesia recovery when compared with those administered with remifentanil (p < 0.05). Sufentanil provided more potent pain mitigation for patients undergoing cardiovascular surgery than remifentanil, as shown by the lower visual analogue scale (VAS) scores of patients in the study group (p < 0.05). Patients administered with sufentanil showed better levels of mean arterial pressure (MAP) and oxygen saturation (SpO2) than remifentanil, suggesting better hemodynamic benefits provided by sufentanil (p < 0.01). During cardiovascular surgery performed in this study, sufentanil resulted in a higher safety profile by reducing significantly the incidence of adverse reactions (6 %) than remifentanil (30 %) (p < 0.01). 
 Conclusions: Sufentanil exhibits a better anesthetic effect in patients undergoing cardiovascular surgery than remifentanil. It provides potent pain mitigation, effectively ameliorates patients’ hemodynamic status, and reduces the risk of adverse reactions. Future studies with larger sample sizes are required to validate these findings.

A Comparative Study of Nasal Fiberoptic Intubation with Laryngeal Mask Airway Fiberoptic Intubation in Children with a Difficult Airway

Background: Considering that the gold standard for intubation in children with a difficult airway is the use of fiberoptic bronchoscopy, and few studies have evaluated its application in children, the present study aimed at comparing two bronchoscopic techniques of nasal fiberoptic tracheal intubation (FOI-Nasal) and fiberoptic intubation via laryngeal mask airway (FOI-LMA) in children with a difficult airway.
 Methods: A single-blind randomized clinical trial was performed on 40 six-month-old to six-year-old children that were divided into two groups each consisting of 20 patients.  The participants were all candidates for elective surgery with clinical criteria for the anticipated difficult intubation. FOI-Nasal and FOI-LMA were performed in the first and second groups, respectively. Mean arterial pressure (MAP), heart rate (HR), and blood oxygen saturation levels (SpO2) were assessed and recorded before anesthesia (T1), immediately before bronchoscopy (T2), and immediately after intubation with endotracheal tube (T3). Moreover, ETCO2, the first successful insertion attempt, and the intubation time were recorded, as well.
 Results: The results of the present study revealed that parameters including MAP, HR, and SpO2 at times T1, T2, and T3 were not significantly different between the two groups after adjusting for potential confounding factors (P> 0.05). However, ETCO2 in FOI-Nasal group with a mean of 38.40 ± 3.57 was significantly higher than that of the FOI-LMA group with a mean of 34.35 ± 3.15 (P = 0.001). In addition, the intubation time in the FOI-LMA group with a mean of 32.40 ± 7.45 was significantly shorter than that of the FOI-Nasal group with a mean of 51.75 ± 9.97 (P <0.001). The success rate in the first attempt in the FOI-Nasal group with the value of 70% was lower than that of the FOI-LMA group with the value of 90%; however, this difference was not statistically significant (P> 0.05).
 Conclusion: According to the results of the present study, the intubation time in the FOI-LMA group was significantly shorter than that of the FOI-Nasal group. Moreover, the success rate of the first attempt in the FOI-LMA group was higher than that of the FOI-Nasal group. Therefore, it can be stated that FOI-LMA as compared to FOI-Nasal can be regarded as an easier technique, with a shorter intubation time, a higher success rate, and a greater stability of children’s hemodynamic parameters.

Development of a Flexible Smart Wearable Oximeter Insole for Monitoring SpO2 Levels of Diabetics’ Foot Ulcer

This work presents the development of a fully functional prototype of a wearable smart shoe insole that can monitor arterial oxygen saturation (SpO <sub xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">2</sub> ) levels at the foot of a diabetic patient using photoplethysmography (PPG) signals. Continuous monitoring of SpO <sub xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">2</sub> levels at foot in patients with diabetic foot ulcer (DFU) can provide critical information on the severity of the ulcer, the wound healing process, and alerting clinicians for critical limb ischemia. The developed oximetry system seamlessly integrates the Internet of things (IoT) via a custom-developed Android mobile application, thus enabling “at-home” monitoring. Twenty healthy subjects were tested, and the insole oximeter was able to successfully estimate SpO <sub xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">2</sub> levels at the toe. An average error of ≈ 2.6% was calculated for the measured/estimated SpO <sub xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">2</sub> levels at the subjects’ toe when compared to a reference oximeter attached to the finger. Perfusion Index (PI) - which represents the blood flow/supply in tissues - was used as a method for validating the oximeter readings. It was observed that fingers (index fingers) generally have larger PI values when compared to the toe, while PI results of both monitoring sites were in the acceptable range. In addition, a dataset was formed for the twenty test subjects, and machine learning (ML) techniques were applied to predict the SpO <sub xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">2</sub> level and the site of measurement (Finger or Toe), using multiple linear regression and classification methods. The ML results show that AC components of the PPG signals have a more significant contribution to the SpO <sub xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">2</sub> estimations when compared to the DC components. In addition, KNN (K=1) classifier, was able to successfully predict the monitoring sites, with a test accuracy of 96.86%.

Risk factors for persistent tomographic abnormalities at 6 months of follow-up in a cohort of hospitalized patients with moderate and severe COVID-19 living at high altitude.

After COVID-19, functional and tomographic lung alterations may occur, but there are no studies at high altitude where, due to lower barometric pressure, there are lower levels of arterial oxygen pressure and saturation in both normal subjects and patients with respiratory disease. In this study, we evaluated the computed tomographic (CT), clinical, and functional involvement at 3 and 6 months post-hospitalization in survivors with moderate-severe COVID-19, as well the risk factors associated with abnormal lung computed tomography (ALCT) at 6 months of follow-up. Prospective cohort, after hospitalization for COVID-19, of patients older than 18 years residing at high altitude. Follow-up at 3 and 6 months with lung CT, spirometry, diffusing capacity of the lung for carbon monoxide (DLCO), six-minute walk test (6MWT), and oxygen saturation (SpO2). Comparisons between ALCT and normal lung computed tomography (NLCT) groups with X2 and Mann-Whitney U test, and paired test for changes between 3 and 6 months. A multivariate analysis was performed to evaluate the variables associated with ALCT at 6-month follow-up. We included 158 patients, 22.2% hospitalized in intensive care unit (ICU), 92.4% with typical COVID CT scan (peripheral, bilateral, or multifocal ground glass, with or without consolidation or findings of organizing pneumonia), and median hospitalization of 7 days. At 6 months, 53 patients (33.5%) had ALCT. There were no differences between ALCT and NLCT groups in symptoms or comorbidities on admission. ALCT patients were older and more frequently men, smokers and hospitalized in ICU. At 3 months, ALCT patients had more frequently a reduced forced vital capacity (< 80%), and lower meters walked (6MWT) and SpO2. At 6 months, all patients improved lung function with no differences between groups, but there were more dyspnea and lower exercise SpO2 in ALCT group. The variables associated with ALCT at 6 months were age, sex, ICU stay, and typical CT scan. At 6-month follow-up, 33.5% of patients with moderate and severe COVID had ALCT. These patients had more dyspnea and lower SpO2 in exercise. Regardless of the persistence of tomographic abnormalities, lung function and 6MWT improved. We identified the variables associated with ALCT.

Correlation between Oxygen Saturation and Fasting Blood Sugar Levels in the Elderly

According to the World Health Organization (WHO), the elderly are a group of people aged 60 years or more [1]. In 2010 the number of elderly people was recorded at 18.1 million people or 17.6 percent. In 2014 the number increased to 18.8 million people [2]. In Indonesia, the elderly in 2020 are estimated to reach 28.8 million people or 11.34 percent of the total population in the country. The 2018 Riskesdas data noted that the majority of elderly people in Indonesia have degenerative diseases and or chronic health problems, such as diabetes and heart disease. These diseases will cause problems if they are not treated or prevented [3]. Oxygen saturation is the fraction of hemoglobin in oxygen saturation relative to the total hemoglobin in the blood or the oxygen level in the blood. Oxygen is bound by Hemoglobin in red blood cells or Erythrocytes. The human body needs and regulates a very precise and specific oxygen balance in the blood, because the human body needs oxygen from the environment outside the body for metabolic processes and body activities [4]. Normal arterial blood oxygen saturation level in humans is 95-100 percent. Diabetes Mellitus (DM) is a major health problem. Data from a global study shows that the number of people with Diabetes Mellitus in 2011 has reached 366 million people in the world [5]. Objective: The objective is to determine the relationship between oxygen saturation and fasting blood sugar levels in the elderly. Method: This research is an analytic observational study with a cross-sectional design. The research subjects were elderly aged ≥ 60 years who live in the Malalayang Dua Village, Manado City, Indonesia. In this study, the normal reference value for oxygen saturation was 95-100% and the normal fasting blood sugar/glucose (FBG) reference value according to WHO was &lt;100 mg/dL. Based on the analysis of the relationship using the Pearson correlation test, there was a significant relationship between oxygen saturation and fasting ....

Comparison of the Effects of Midazolam, Propofol, and Dexmede-tomidine on Hemodynamics Variation in Patients Undergoing Cataract Surgery under Local Anesthesia at 5th Azar Hospital in Gorgan in 2021-2022

Introduction: Cataract surgery is a common surgery, especially among the elderly, and the choice of anesthesia medications is critical in such patients. In this study, the effects of midazolam, propofol, and dexmedetomidine were investigated for sedation in patients undergoing cataract surgery under local anesthesia. Method: Ninety patients were included in this study and underwent cataract surgery using class II and III anesthesia (according to the ASA criteria). They were also randomly assigned to three groups. The first group received midazolam, the second group received propofol, and the third group received dexmedetomidine. During the surgery and recovery phase, blood pressure, arterial blood oxygen saturation, heart rate, and the occurrence of complications were recorded. Data were analyzed using the SPSS software (version 23) at a significance level of 0.05. Results: Alterations in arterial blood oxygen saturation (SpO2) levels were not significantly different among the three groups (P&gt;0.05); however, there were fewer changes in SpO2 levels at recovery in the propofol group (P&lt;0.05). Moreover, alterations in blood pressure did not differ significantly across the three groups during the surgery (P&gt;0.05), whereas during the recovery, they were lower in the group receiving dexmedetomidine (P&gt;0.05). Finally, Heart rates were not significantly different among the three groups during surgery and recovery (P&gt;0.05). Conclusion: The results demonstrated that in patients with hypertension and tachycardia, dexmedetomidine may be a better choice for sedation.

Impaired brain networks functional connectivity after acute mild hypoxia.

This study aimed to analyze the changes in brain networks functional connectivity of pilots exposed to simulated hypoxia using resting-state functional magnetic resonance imaging (fMRI). A total of 35 healthy male pilots exposed to 14.5% oxygen concentration (corresponding to an altitude of 3000 m) underwent resting-state fMRI scans. The independent component analysis (ICA) approach was used to analyze changes in the resting-state brain networks functional connectivity of pilots after hypoxic exposure, and 9 common components in brain functional networks were identified. In the functional connections that showed significant group differences, linear regression was used to examine the association between functional connectivity and clinical characteristics. The brain networks functional connectivity after hypoxia exposure decreased significantly, including the left frontoparietal network and visual network 1-area, left frontoparietal network and visual network 2-area, right frontoparietal network and visual network 2-area, dorsal attention network and ventral attention network, dorsal attention network and auditory network, and ventral attention network and visual network 1-area. We found no correlation between the altered functional connectivity and arterial oxygen saturation level. Our findings provide insights into the mechanisms underlying hypoxia-induced cognitive impairment in pilots.

A case report of Budd-Chiari syndrome with cardiac complications and low SpO2 successfully managed by an Integrated-approach

Budd-Chiari syndrome [BCS] is a rare, potentially life-threatening condition characterized by the triad of abdominal pain, ascites, and hepatomegaly (with or without jaundice). There will be an underlying disorder in most cases. The diagnosis, as well as management of the case, requires a multidisciplinary approach. The treatment should aim at reducing the presenting symptoms as well as removing the underlying pathology. Here we explain a case report of a 21-year-old male patient in the subacute stage of BCS with its complications and considered as a candidate for liver transplantation. His liver enzymes, PT/INR, D- dimer, and homocysteine values were above normal levels. The arterial oxygen saturation level was subnormal, and he was on supportive oxygen supplement. Inferior venacava [IVC] Doppler revealed a non-obstructive intrahepatic thrombus. The patient was treated with Homoeopathic medicine Arsenicum album and Arnica montana, given as an adjuvant to conventional treatment.

The use of protective masks and the level of arterial oxygen saturation at rest and after exercise.

Studies of influenza, and human coronaviruses provide evidence that the use of a medical mask can prevent the spread of infectious droplets from an infected person to someone else. After global public health emergency of coronavirus SARS-CoV-2 causing illness of COVID-19 was changing frequency of wearing a mask. Therefore, study was undertaken to assess whether the use of protective masks affects the level of oxygen saturation during rest and during exercise. The test consisted of a non-invasive measurement of oxygen saturation by percutaneous determination of arterial oxygen saturation with the use of the pulse oximeter. Oxygen saturation was measured during rest and after physical exertion performed without a protective mask (2 types of masks were used: surgical and FFP2), as well as during rest and after physical exertion performed with the use of a protective mask. The analysis of the oxygen saturation, heart rate, blood pressure and respiratory rate included data on 48 subjects. Comparing the post-exercise and pre-exercise values showed a significant difference between all of them. There were no differences found in any variables according to the mask/no-mask status. A short-term physical exercise performed in a group of healthy young people using protective masks did not affect oxygen saturation, heart rate, blood pressure and respiratory rate. Med Pr. 2022;73(5):363-68.

First in-human modified atrial septostomy combining radiofrequency ablation and balloon dilation

ObjectivePreclinical research suggests that the combined use of radiofrequency ablation and balloon dilation (CURB) could create stable interatrial communications without device implantation. This study examined the first in-human use of...

Magnesium sulfate administration in difficult laryngoscopy: An effective and safe method

PurposeDifficult laryngeal exposure during laryngeal microsurgery and laser surgery is a major concern for otolaryngologists. This study evaluated the efficacy and safety of magnesium sulfate administration in difficult laryngeal exposure patients. Study designQuasi-experimental design. Materials and methodsForty adult patients scheduled for laryngeal microsurgery with difficult laryngeal exposure according to Cormack-Lehane (CL) classification were included. Magnesium sulfate 50% (20–30 mg/kg) was administered as a bolus injection. Laryngeal exposure and hemodynamic stability were evaluated before and after the intervention. ResultsCL grading was shown a statistically significant improvement after magnesium sulfate administration. There are no clinically significant changes in the mean arterial pressure, heart rate, and oxygen saturation levels in the patients who received magnesium sulfate for better laryngeal exposure. ConclusionMagnesium sulfate is an effective and safe drug for better viewing in difficult laryngeal exposure patients.

Early outcomes of fenestrated intra-extracardiac Fontan procedure: Insights, experiences, and expectations.

Intraextracardiac Fontan procedure (FP) aimed to combine the advantages of lateral tunnel and extracardiac conduit modifications of the original technique. Herein, we present our early outcomes in patients with intraextracardiac fenestrated FP. A retrospective analysis was performed to evaluate intraextracardiac fenestrated Fontan patients between 2014 and 2021. Seventeen patients were operated on with a mean age and body weight of 9.1 ± 5.5 years and 28.6 ± 14.6 kg. Sixteen patients (94%) were palliated as univentricular physiology with hypoplasia of one of the ventricles. One patient (6%) with well-developed two ventricles with double outlet right ventricle and complete atrioventricular septal defect had straddling of the chordae prohibiting a biventricular repair. All of the patients had cavopulmonary anastomosis before Fontan completion, except one case. Fenestration was performed in all cases. Postoperative mean pulmonary artery pressures and arterial oxygen saturation levels at follow-up were 10 ± 2.4 mmHg and 91.3 ± 2.7%, respectively. Mean duration of pleural drainage was 5.4 ± 2.3 days. All of the fenestrations are patent at a mean follow-up period of 4.8 ± 7.7 years, except one case. Any morbidity and mortality were not encountered. Early outcomes of intraextracardiac fenestrated FP are encouraging. This procedure may improve the results in a patient population who should be palliated as univentricular physiology, especially in cases with complex cardiac anatomy.

The Use of Wearable Pulse Oximeters in the Prompt Detection of Hypoxemia and During Movement: Diagnostic Accuracy Study.

BackgroundCommercially available wearable (ambulatory) pulse oximeters have been recommended as a method for managing patients at risk of physiological deterioration, such as active patients with COVID-19 disease receiving care in hospital isolation rooms; however, their reliability in usual hospital settings is not known.ObjectiveWe report the performance of wearable pulse oximeters in a simulated clinical setting when challenged by motion and low levels of arterial blood oxygen saturation (SaO2).MethodsThe performance of 1 wrist-worn (Wavelet) and 3 finger-worn (CheckMe O2+, AP-20, and WristOx2 3150) wearable, wireless transmission–mode pulse oximeters was evaluated. For this, 7 motion tasks were performed: at rest, sit-to-stand, tapping, rubbing, drinking, turning pages, and using a tablet. Hypoxia exposure followed, in which inspired gases were adjusted to achieve decreasing SaO2 levels at 100%, 95%, 90%, 87%, 85%, 83%, and 80%. Peripheral oxygen saturation (SpO2) estimates were compared with simultaneous SaO2 samples to calculate the root-mean-square error (RMSE). The area under the receiver operating characteristic curve was used to analyze the detection of hypoxemia (ie, SaO2<90%).ResultsSpO2 estimates matching 215 SaO2 samples in both study phases, from 33 participants, were analyzed. Tapping, rubbing, turning pages, and using a tablet degraded SpO2 estimation (RMSE>4% for at least 1 device). All finger-worn pulse oximeters detected hypoxemia, with an overall sensitivity of ≥0.87 and specificity of ≥0.80, comparable to that of the Philips MX450 pulse oximeter.ConclusionsThe SpO2 accuracy of wearable finger-worn pulse oximeters was within that required by the International Organization for Standardization guidelines. Performance was degraded by motion, but all pulse oximeters could detect hypoxemia. Our findings support the use of wearable, wireless transmission–mode pulse oximeters to detect the onset of clinical deterioration in hospital settings.Trial RegistrationISRCTN Registry 61535692; http://www.isrctn.com/ISRCTN61535692International Registered Report Identifier (IRRID)RR2-10.1136/bmjopen-2019-034404

The Association of Oxygen Saturation and Haemoglobin Level on Elderly

According to the World Health Organization (WHO), the elderly is a population group aged 60 years or more. In 2010 the number of elderly people was recorded at 18.1 million people or 17.6%. In 2014 the number increased to 18.8 million people. The number in Indonesia is estimated to reach 28.8 million people or 11.34 percent of the total population in 2020. Data from Indonesia Basic Health Research 2018 showed that most of the elderly in Indonesia have degenerative diseases such as diabetes and heart disease [1]. In the 21st century, a special challenge in the health sector is the increasing number of elderly with degenerative problems and non-communicable diseases (NCDs) such as diabetes, hypertension, and mental health disorders (depression, dementia, anxiety disorders, and sleeping disorder). These diseases will cause serious problems if they are not addressed or if prevention is not carried out. This condition causes the elderly to be vulnerable to serious complications. Hemoglobin (Hb) is an iron-rich protein in red blood cells whose function is to carry oxygen throughout the body. This protein also functions to give blood its red color. In order to function properly, the hemoglobin level in the blood must be within the normal range. Oxygen saturation is the fraction of hemoglobin oxygen saturation relative to the total hemoglobin in the blood. The human body requires and regulates a very precise and specific balance of oxygen in the blood. The normal arterial blood oxygen saturation level in humans is 95-100%. Objective: The objective is to determine the relationship between oxygen saturation and Hemoglobin levels in the Elderly. Method: This study is an analytic observational study with a cross-sectional design. The research subjects are elderly people aged ≥ 60 years who live in Malalayang Dua Village, Manado City. In this study, the reference value of normal oxygen saturation is 95-100% and the Reference Value of Hb based on WHO, men &lt; 13 g/dL, .............

Hipoxemia silenciosa y uso de oxímetro de pulso en el hogar para detección precoz de complicaciones por Covid-19: reporte de un caso y revisión de la literatura

Silent hypoxemia is one of the clinical presentations caused by SARS-CoV-2. It is still considered a medical mystery, as there are inconsistencies between arterial oxygen saturation levels and respiratory symptoms; a clinical scenario that had not been seen before. Their main risk is that it delays medical assistance because they do not have breathing difficulties and, when they consult, the lung damage is quite advanced. The early detection of hypoxia can favor the premature diagnosis of COVID-19 pneumonia and start treatment without delay. The pulse oximeter is presented as a useful, inexpensive, and easy-to-use tool for monitoring oxygen saturation at home in mild illness and detecting silent hypoxemia. This work presents the case of a patient with COVID-19 who, thanks to the use of a pulse oximeter at home, was able to detect silent hypoxemia and favored the early diagnosis of SARS-CoV-2 pneumonia.