Brief Original
Correlation between oxyhaemoglobin saturation by pulse oximetry and partial pressure of oxygen in patients with acute respiratory failure
Correlación entre la saturación de oxihemoglobina por pulsioximetría y la presión arterial de oxígeno en pacientes con insuficiencia respiratoria aguda
C. Cinesi-Gómeza,
, P. García-Garcíab, I. López-Pelayoc, J.I. Giméneza, L.M. González-Torresa, E. Bernal-Morelld
Corresponding author
a Servicio de Urgencias, Hospital General Universitario Reina Sofía, Murcia, Spain
b Servicio de Urgencias, Hospital General Universitario Los Arcos del Mar Menor, San Javier, Murcia, Spain
c Servicio de Urgencias, Hospital de la Vega Lorenzo Guirao, Cieza, Murcia, Spain
d Sección de Enfermedades Infecciosas, Servicio de Medicina Interna, Hospital General Universitario Reina Sofía, Murcia, Spain
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"apellidos" => "Bernal-Morell" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Servicio de Urgencias, Hospital General Universitario Reina Sofía, Murcia, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Urgencias, Hospital General Universitario Los Arcos del Mar Menor, San Javier, Murcia, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Urgencias, Hospital de la Vega Lorenzo Guirao, Cieza, Murcia, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Sección de Enfermedades Infecciosas, Servicio de Medicina Interna, Hospital General Universitario Reina Sofía, Murcia, Spain" "etiqueta" => "d" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Correlación entre la saturación de oxihemoglobina por pulsioximetría y la presión arterial de oxígeno en pacientes con insuficiencia respiratoria aguda" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1311 "Ancho" => 3068 "Tamanyo" => 187533 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Scatter plot (A) and Bland–Altman (B) plot between PaO<span class="elsevierStyleInf">2</span>/FiO<span class="elsevierStyleInf">2</span> and SpO<span class="elsevierStyleInf">2</span>/FiO<span class="elsevierStyleInf">2</span>.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Background</span><p id="par0005" class="elsevierStylePara elsevierViewall">Acute respiratory failure (ARF) is defined as a partial oxygen pressure in arterial blood (PaO<span class="elsevierStyleInf">2</span>) less than 60<span class="elsevierStyleHsp" style=""></span>mm Hg, breathing ambient air at sea level (fraction of inspired oxygen [FiO<span class="elsevierStyleInf">2</span>] of 0.21).<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">1</span></a> The annual incidence rate of ARF in Great Britain is estimated at 150 patients per 10,000 inhabitants treated in hospital emergency departments (HED).<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Acute respiratory distress syndrome (ARDS) has a closer relationship with oxygenation. Within the new Berlin criteria,<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">3</span></a> the relationship between PaO<span class="elsevierStyleInf">2</span> and FiO<span class="elsevierStyleInf">2</span> is a key parameter that determines the severity of ARDS. Thus, a PaO<span class="elsevierStyleInf">2</span>/FiO<span class="elsevierStyleInf">2</span> value between 200 and 300 corresponds to mild ARDS, a value between 100 and 200 corresponds to moderate ARDS, and a value <100 corresponds to severe ARDS.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">3</span></a> By analogy, PaO<span class="elsevierStyleInf">2</span>/FiO<span class="elsevierStyleInf">2</span> is used to assess the response to oxygen therapy in ARF.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">4</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">PaO<span class="elsevierStyleInf">2</span> is measured through an arterial blood gas (ABG) test, an invasive procedure that sometimes results in technical difficulties and complications.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">5</span></a> Oxyhemoglobin saturation by pulse oximetry (SpO<span class="elsevierStyleInf">2</span>) has excellent correlation with PaO<span class="elsevierStyleInf">2</span><a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">6</span></a> and has therefore been extended as a measure of oxygenation, replacing PaO<span class="elsevierStyleInf">2</span>.<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">7</span></a> Practically all patients with ARF are administered supplemental oxygen before their arrival. Therefore, their FiO<span class="elsevierStyleInf">2</span> on arrival to the HED is >21%.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">8</span></a> The use of PaO<span class="elsevierStyleInf">2</span> as the only measure of oxygenation is insufficient, because it should be weighted with FiO<span class="elsevierStyleInf">2</span>. The use of the PaO<span class="elsevierStyleInf">2</span>/FiO<span class="elsevierStyleInf">2</span> ratio has therefore become widespread as the main oxygenation parameter for patients with ARF. A number of studies have shown a good correlation between PaO<span class="elsevierStyleInf">2</span>/FiO<span class="elsevierStyleInf">2</span> and SpO<span class="elsevierStyleInf">2</span>/FiO<span class="elsevierStyleInf">2</span>.<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">9–12</span></a> However, these studies have been mainly performed on patients with ARDS hospitalized in intensive care units (both pediatric<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">9,10</span></a> and adult<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">11</span></a>) or on patients diagnosed with community-acquired pneumonia in HEDs.<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">12</span></a> There have been no studies on the correlation between PaO<span class="elsevierStyleInf">2</span>/FiO<span class="elsevierStyleInf">2</span> and SpO<span class="elsevierStyleInf">2</span>/FiO<span class="elsevierStyleInf">2</span> in patients treated in HEDs with ARF triggered by any cause, which is the reason for the current research study.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Material and methods</span><p id="par0020" class="elsevierStylePara elsevierViewall">We conducted a prospective, observational multicenter study in which 3 Spanish HEDs participated. The study began on January 1, 2015 and ended on December 31, 2016. One day a week (chosen randomly), we consecutively included patients with suspected ARF who attended these HEDs. An ABG test was performed at the discretion of the physician who treated the patient.</p><p id="par0025" class="elsevierStylePara elsevierViewall">For the oxygen therapy with nasal tube at 1 and 2<span class="elsevierStyleHsp" style=""></span>L/min, the FiO<span class="elsevierStyleInf">2</span> was calculated at 28% and 32%, respectively. For the facemask reservoir, the value was calculated at 80%. We excluded from the study those patients with a PaO<span class="elsevierStyleInf">2</span>/FiO<span class="elsevierStyleInf">2</span> >300.</p><p id="par0030" class="elsevierStylePara elsevierViewall">The demographic, clinical and laboratory data were collected on a form. The SpO<span class="elsevierStyleInf">2</span> was measured with a pulse oximeter (Nellcor<span class="elsevierStyleSup">®</span> OxiMax<span class="elsevierStyleSup">®</span> NPB-40) when extracting the ABG.</p><p id="par0035" class="elsevierStylePara elsevierViewall">The study was conducted according to current legislation and was approved by the clinical research ethics committee of University General Hospital Reina Sofia of Murcia, and the patients signed the informed consent document.</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Statistical analysis</span><p id="par0040" class="elsevierStylePara elsevierViewall">We calculated a sample size of 163 patients, taking into account a statistical power of 95%, an alpha error of 0.05, a correlation of at least 0.70 and estimated losses of 15%. The qualitative variables are described by their categories and percentages, and the continuous variables are described by their means and standard deviation (normal distribution) or medians and interquartile ranges (nonparametric distribution, according to the Kolmogorov–Smirnov test). The correlation between PaO<span class="elsevierStyleInf">2</span>/FiO<span class="elsevierStyleInf">2</span> and SpO<span class="elsevierStyleInf">2</span>/FiO<span class="elsevierStyleInf">2</span> was assessed with a Bland–Altman plot. To calculate the correlation, we employed Spearman's rank correlation coefficient. To assess the prediction of PaO<span class="elsevierStyleInf">2</span>/FiO<span class="elsevierStyleInf">2</span> based on SpO<span class="elsevierStyleInf">2</span>/FiO<span class="elsevierStyleInf">2</span>, we employed a simple linear regression. The accepted significance level was <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.05. We employed the IBM<span class="elsevierStyleSup">®</span> SPSS<span class="elsevierStyleSup">®</span> Statistics v.22 program for the statistical calculations.</p></span></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Results</span><p id="par0045" class="elsevierStylePara elsevierViewall">We initially assessed 197 cases, 31 of which (15.7%) were excluded: 24 (12.1%) for presenting a PaO<span class="elsevierStyleInf">2</span>/FiO<span class="elsevierStyleInf">2</span> >300 and 7 (3.5%) for a lack of temporal coincidence between the SpO<span class="elsevierStyleInf">2</span> measurement and the ABG extraction. Ultimately, we analyzed 166 (84.3%) patients, whose mean age was 76.23<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>13.25 years; 94 (56.6%) were men. For 98 (59%) patients who attended the HED, oxygen therapy was started before their arrival. The mean PaO<span class="elsevierStyleInf">2</span>, SpO<span class="elsevierStyleInf">2</span> and FiO<span class="elsevierStyleInf">2</span> levels were 61.64<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>17.3<span class="elsevierStyleHsp" style=""></span>mm Hg, 87.61%<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>8.8% and 0.28%<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.15%, respectively. The median PaO<span class="elsevierStyleInf">2</span>/FiO<span class="elsevierStyleInf">2</span> and SpO<span class="elsevierStyleInf">2</span>/FiO<span class="elsevierStyleInf">2</span> ratios were 256.6 and 359.2, respectively. The clinical characteristics and laboratory test results of the study population are listed in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a><a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0050" class="elsevierStylePara elsevierViewall">The correlation between PaO<span class="elsevierStyleInf">2</span>/FiO<span class="elsevierStyleInf">2</span> and the SpO<span class="elsevierStyleInf">2</span>/FiO<span class="elsevierStyleInf">2</span> was 0.745 (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.001). The correlation of both variables is shown using the scatter and Bland–Altman plots in <a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>. For the hypercapnic and nonhypercapnic patients, the correlation was 0.633 (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.001) and 0.680 (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.001), respectively. For the patients with PaO<span class="elsevierStyleInf">2</span>/FiO<span class="elsevierStyleInf">2</span> levels <200 and >200, we obtained a correlation of 0.824 (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.001) and 0.538 (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.001), respectively.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0055" class="elsevierStylePara elsevierViewall">The simple linear regression analysis showed the following relationship between the oxygenation parameters: PaO<span class="elsevierStyleInf">2</span>/FiO<span class="elsevierStyleInf">2</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>41.9<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>0.50<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>(SpO<span class="elsevierStyleInf">2</span>/FiO<span class="elsevierStyleInf">2</span>). The <span class="elsevierStyleItalic">R</span><span class="elsevierStyleSup">2</span> value was 0.654 (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.01).</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Discussion</span><p id="par0060" class="elsevierStylePara elsevierViewall">This study shows that SpO<span class="elsevierStyleInf">2</span>/FiO<span class="elsevierStyleInf">2</span> is a noninvasive indicator that can substitute PaO<span class="elsevierStyleInf">2</span>/FiO<span class="elsevierStyleInf">2</span> for assessing the degree of oxygenation in patients with ARF who are admitted to HEDs. It is important to note that the correlation between the 2 parameters was higher in those patients with greater severity, with PaO<span class="elsevierStyleInf">2</span>/FiO<span class="elsevierStyleInf">2</span> values less than 200.</p><p id="par0065" class="elsevierStylePara elsevierViewall">The start of oxygen therapy in the outpatient setting is increasingly frequent, as observed by Susanto and Thomas in a study on patients with chronic obstructive pulmonary disease.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">8</span></a> Therefore, the use of SpO<span class="elsevierStyleInf">2</span>/FiO<span class="elsevierStyleInf">2</span> in the emergency department has clinical relevance because it helps us determine the patient's oxygenation while we proceed to extract the ABG. The importance of pulse oximetry is even greater in outpatient emergency services, given the lack of gasometers in ambulances.</p><p id="par0070" class="elsevierStylePara elsevierViewall">The classic study by Rice et al.<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">11</span></a> included only patients with ARDS or acute pulmonary lesion hospitalized in an intensive care unit. The correlation between SpO<span class="elsevierStyleInf">2</span>/FiO<span class="elsevierStyleInf">2</span> and PaO<span class="elsevierStyleInf">2</span>/FiO<span class="elsevierStyleInf">2</span> was 0.89, a reading that was slightly higher than that observed in our study (0.745). This difference was probably because the Rice et al. study selected more cases and performed more than one joint measurement of pulse oximetry with blood gas test on the same patient.<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">11</span></a> Another study on pediatric patients analyzed 1298 gasometric measurements in 383 patients.<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">10</span></a> The correlation was 0.61 and therefore lower than that observed in our study.</p><p id="par0075" class="elsevierStylePara elsevierViewall">Moreover, the present study supports the results of the study by Sanz et al.,<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">12</span></a> which included patients diagnosed with pneumonia and treated in an HED. In both studies, the usefulness of the SpO<span class="elsevierStyleInf">2</span>/FiO<span class="elsevierStyleInf">2</span> ratio was greater in patients with more severe disease (PaO<span class="elsevierStyleInf">2</span>/FiO<span class="elsevierStyleInf">2</span> less than 200).</p><p id="par0080" class="elsevierStylePara elsevierViewall">The main limitation of this study was the small sample size, which could lead to an error in the accuracy of the regression formula, although this result was statistically significant. Another limitation is that the study analyzed the overall correlation between SpO<span class="elsevierStyleInf">2</span>/FiO<span class="elsevierStyleInf">2</span> and PaO<span class="elsevierStyleInf">2</span>/FiO<span class="elsevierStyleInf">2</span>, without establishing severity cutoff points.</p><p id="par0085" class="elsevierStylePara elsevierViewall">In conclusion, SpO<span class="elsevierStyleInf">2</span>/FiO<span class="elsevierStyleInf">2</span> can substitute PaO<span class="elsevierStyleInf">2</span>/FiO<span class="elsevierStyleInf">2</span> as a measure of oxygenation for patients with ARF. Further studies with larger patient samples are needed to establish cutoff points for SpO<span class="elsevierStyleInf">2</span>/FiO<span class="elsevierStyleInf">2</span> depending on the severity of the ARF.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:9 [ 0 => array:3 [ "identificador" => "xres947401" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objectives" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Material and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec919882" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres947400" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivos" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Material y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec919883" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Background" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Material and methods" "secciones" => array:1 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Statistical analysis" ] ] ] 6 => array:2 [ "identificador" => "sec0020" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0025" "titulo" => "Discussion" ] 8 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2017-05-08" "fechaAceptado" => "2017-08-12" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec919882" "palabras" => array:3 [ 0 => "Acute respiratory failure" 1 => "PaO<span class="elsevierStyleInf">2</span>/FiO<span class="elsevierStyleInf">2</span>" 2 => "Pulse oximetry" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec919883" "palabras" => array:3 [ 0 => "Insuficiencia respiratoria aguda" 1 => "PaO<span class="elsevierStyleInf">2</span>/FiO<span class="elsevierStyleInf">2</span>" 2 => "Pulsioximetría" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objectives</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To ascertain the correlation between the partial pressure of oxygen (PaO<span class="elsevierStyleInf">2</span>) and oxyhaemoglobin saturation by pulse oximetry (SpO<span class="elsevierStyleInf">2</span>) in patients who were admitted to the emergency department with suspected acute respiratory failure.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Material and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A prospective, observational multicentre study was conducted in the emergency departments of 3 Spanish hospitals.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">The study included 166 patients who presented mean<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>standard deviation PaO<span class="elsevierStyleInf">2</span>, SpO<span class="elsevierStyleInf">2</span> and fraction of inspired oxygen (FiO<span class="elsevierStyleInf">2</span>) values of 61.64<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>17.3<span class="elsevierStyleHsp" style=""></span>mm Hg, 87.61<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>8.8% and 0.28<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.15%, respectively. The median PaO<span class="elsevierStyleInf">2</span>/FiO<span class="elsevierStyleInf">2</span> and SpO<span class="elsevierStyleInf">2</span>/FiO<span class="elsevierStyleInf">2</span> ratios were 256.6 and 359.2, respectively. The correlation between PaO<span class="elsevierStyleInf">2</span>/FiO<span class="elsevierStyleInf">2</span> and the SpO<span class="elsevierStyleInf">2</span>/FiO<span class="elsevierStyleInf">2</span> was 0.745 (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.001).</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The SpO<span class="elsevierStyleInf">2</span>/FiO<span class="elsevierStyleInf">2</span> ratio can be used to calculate PaO<span class="elsevierStyleInf">2</span>/FiO<span class="elsevierStyleInf">2</span> and determine the oxygenation state of patients with acute respiratory failure.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objectives" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Material and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivos</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Averiguar la correlación entre la presión arterial de oxígeno (PaO<span class="elsevierStyleInf">2</span>) y la saturación de la oxihemoglobina por pulsioximetría (SpO<span class="elsevierStyleInf">2</span>) en pacientes que acuden a Urgencias con sospecha de insuficiencia respiratoria aguda.</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Material y métodos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Estudio prospectivo, observacional y multicéntrico realizado en los servicios de Urgencias de 3 hospitales españoles.</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Se incluyeron 166 pacientes, que presentaron unos valores medios<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>desviación estándar de PaO<span class="elsevierStyleInf">2</span>, SpO<span class="elsevierStyleInf">2</span> y fracción inspiratoria de O<span class="elsevierStyleInf">2</span> (FiO<span class="elsevierStyleInf">2</span>) de 61,64<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>17,3<span class="elsevierStyleHsp" style=""></span>mmHg, 87,61<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>8,8% y 0,28<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0,15%, respectivamente. La mediana de los cocientes PaO<span class="elsevierStyleInf">2</span>/FiO<span class="elsevierStyleInf">2</span> y SpO<span class="elsevierStyleInf">2</span>/FiO<span class="elsevierStyleInf">2</span> fue de 256,6 y 359,2, respectivamente. La correlación entre la PaO<span class="elsevierStyleInf">2</span>/FiO<span class="elsevierStyleInf">2</span> y la SpO<span class="elsevierStyleInf">2</span>/FiO<span class="elsevierStyleInf">2</span> fue de 0,745 (p<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0,001).</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">La SpO<span class="elsevierStyleInf">2</span>/FiO<span class="elsevierStyleInf">2</span> se puede utilizar como estimación de la PaO<span class="elsevierStyleInf">2</span>/FiO<span class="elsevierStyleInf">2</span> y conocer el estado de oxigenación del paciente con insuficiencia respiratoria aguda.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivos" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Material y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Cinesi-Gómez C, García-García P, López-Pelayo I, Giménez JI, González-Torres LM, Bernal-Morell E. Correlación entre la saturación de oxihemoglobina por pulsioximetría y la presión arterial de oxígeno en pacientes con insuficiencia respiratoria aguda. Rev Clin Esp. 2017;217:522–525.</p>" ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1311 "Ancho" => 3068 "Tamanyo" => 187533 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Scatter plot (A) and Bland–Altman (B) plot between PaO<span class="elsevierStyleInf">2</span>/FiO<span class="elsevierStyleInf">2</span> and SpO<span class="elsevierStyleInf">2</span>/FiO<span class="elsevierStyleInf">2</span>.</p>" ] ] 1 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Abbreviations</span>: DBP, diastolic blood pressure; FiO<span class="elsevierStyleInf">2</span>, fraction of inspired oxygen; HCO<span class="elsevierStyleInf">3</span><span class="elsevierStyleSup">−</span>, bicarbonate; NIV, noninvasive ventilation; PaO<span class="elsevierStyleInf">2</span>, partial pressure of oxygen in arterial blood; pCO<span class="elsevierStyleInf">2</span>, partial pressure of carbon dioxide; pO<span class="elsevierStyleInf">2</span>, partial pressure of oxygen; SBP, systolic blood pressure; SpO<span class="elsevierStyleInf">2</span>, oxyhemoglobin saturation.</p><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">The values are expressed as mean<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>standard deviation, median (interquartile range) or number (percentage), as necessary.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variables \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Age, years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">76<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>13 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Sex, male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">94 (56.6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Patients with long-term home oxygen therapy \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">35 (21.1) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Patients with household NIV \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">34 (20.4) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">FiO<span class="elsevierStyleInf">2</span>, % \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">21.0 (21.0–37.5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">SpO<span class="elsevierStyleInf">2</span>, % \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">90.0 (86.5–93.5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">SBP, mm Hg \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">136.5<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>25.2 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">DBP, mm Hg \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">74.5<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>16.7 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Heart rate, bpm \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">87.0 (74.0–106.0) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Respiratory rate, bpm \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">22.0 (17.0–26.75) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Temperature, °C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">36.6 (35.0–36.6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">pH \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">7.37 (7.30–7.42) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">pO<span class="elsevierStyleInf">2</span>, mm Hg \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">59.25 (50.5–72.0) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">pCO<span class="elsevierStyleInf">2</span>, mm Hg \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">50.36 (42.7–59.6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">HCO<span class="elsevierStyleInf">3</span><span class="elsevierStyleSup">−</span>, mmol/L \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">25.8 (23.8–29.2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hypoxemic respiratory failure \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">114 (68.7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hemoglobin, g/dL \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">14.0 (12.5–14.5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Creatinine, mg/dL \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.10 (0.78–1.10) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">PaO<span class="elsevierStyleInf">2</span>/FiO<span class="elsevierStyleInf">2</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">256.6 (178.4–296.8) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">SpO<span class="elsevierStyleInf">2</span>/FiO<span class="elsevierStyleInf">2</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">359.2 (251.6–438.0) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1604532.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Clinical characteristics and laboratory tests of the study population on admission to the hospital emergency department.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:12 [ 0 => array:3 [ "identificador" => "bib0065" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Critical care in the emergency department: acute respiratory failure" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "P.A. 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