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Revista chilena de pediatría

versión impresa ISSN 0370-4106

Resumen

ALVAREZ G., Cecilia; BERTRAND N., Pablo; CAMPOS M, Eugenia  y  SANCHEZ D., Ignacio. Continuous nocturnal monitoring of arterial oxygen saturation in paedriatric patients with suspected hypoxia. Rev. chil. pediatr. [online]. 2001, vol.72, n.2, pp. 110-120. ISSN 0370-4106.  http://dx.doi.org/10.4067/S0370-41062001000200005.

The monitoring of arterial oxygen saturation (Sa02) is used in detecting hypoxia in patients with chronic pulmonary disease. A single daily measurement (SDM) may underestimate the presence of hypoxia during sleep or feeding. We present the results of a study using continuous nocturnal measurements (CNM) of Sa02 carried out between august 1993 and november 1998 to evaluate the sensitivity and specificity of SDM and CNM in the detection of hypoxia. 290 CNM were performed in 167 patients using a pulse oximeter Ohmeda Biox 3700 with an 8 hour automatic storage of Sa02 and cardiac frequency. Indications for inclusion in the study were suspicion of hypoxia (SH) in 243 studies (83.8%) in 130 patients; 103 with bronchopulmonar dysplasia (BPD), 66 with chronic pulmonary disease (CPD) and 24 with congenital cardiopathy (CC). Or for suspicion of sleep apnoea (SA) in 47 ( 16.2%) cases. 42.5% of the studies were in patients less than 6 months. Patients with SA were significantly older than those with SH ( 42 vs 7 months respectively, p < 0.01 Mann-Whitney). Of the 167 patients 53.3% were male, between groups this was only significant in the group SH with BPD (61%) vs SH with CPD. In 45.5% of patients more than one study was carried out, corresponding to 93% of patients with SH. 44.5% of patients were recieving oxygen therapy, of these 42.1% had BPD and 29.7% CPD. In 28 studies SDM was compared with CNM, 18 SH with BPD and 10 SH with CPD. Results for SDM were 92.2 + 2.3% and 94.1 + 1.9% respectively and for CNM < 90% in 23.5% and 27.7% of the study time of 8 hours. SDM as indication for oxygen therapy had a sensitivity of 15.5% and a specificity of 100%. For CNM we considered a positive indication for oxygen therapy to be >10% of the study time with a Sa02 of < 90%. We conclude that SDM of Sa02 underestimates hypoxic episodes and we recommend the use of CNM of Sa02 for the evaluation of hypoxia and management of oxygen therapy in patients with suspected hypoxia

Palabras llave : oxygen therapy; oxygen saturation; hipoxia; apnoea.

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