背景:监测血液氧合在固定犀牛中至关重要,易受阿片类药物引起的低氧血症。这项研究评估了可靠性,NoninPalmSAT2500A脉搏血氧计和MasimoRadical-7双波长脉搏血氧计技术的临床性能和趋势能力,他们的探头放置在两个测量位置,第三眼睑的内表面和固定的白犀牛的伤痕耳廓。用基于依托吗啡的药物组合固定了八头白犀牛,并在12分钟后给予布托啡诺,40分钟后的氧气,的归宿。Nonin和Masimo设备,用双波长探针连接到第三眼睑和耳朵记录动脉外周血氧-血红蛋白饱和度(SpO2)在预先确定的时间点,同时测量动脉血氧血红蛋白饱和度(SaO2),从抽取的血液样本中,通过台式AVOXometer4000联合血氧计(参考方法)。使用Bland-Altman和面积均方根(ARMS)方法评估了Nonin和Masimo设备的可靠性。使用受试者工作特征(ROC)曲线和灵敏度测量来评估设备的临床性能以准确检测临床低氧血症。特异性,以及阳性和阴性预测值。通过从四象限图计算一致率来评估设备的趋势能力。
结果:只有将透反射探头连接到第三眼睑的Nonin装置可在70%至100%的饱和度范围内提供可靠的SpO2测量值(偏差-1%,精度4%,ARMS4%)。具有连接到第三眼睑的透反射探针的Nonin和Masimo装置在检测临床低氧血症方面均具有很高的临床性能[ROC曲线下面积(AUC):分别为0.93和0.90]。然而,将传输探头连接到耳朵的Nonin和Masimo设备不可靠,仅提供中等的临床表现。Nonin和Masimo设备,在两个测量地点,一致性率低于推荐阈值≥90%,表明趋势能力差。
结论:可靠性的总体评估,临床性能和趋势能力表明,在第三眼睑连接有透反射探针的Nonin装置最适合监测固定犀牛的血氧。固定过程可能影响心血管功能,从而限制了装置的性能。
BACKGROUND: Monitoring blood oxygenation is essential in immobilised rhinoceros, which are susceptible to opioid-induced hypoxaemia. This study assessed the reliability, clinical performance and trending ability of the Nonin PalmSAT 2500 A pulse oximeter\'s and the Masimo Radical-7 pulse co-oximeter\'s dual-wavelength technology, with their probes placed at two measurement sites, the inner surface of the third-eyelid and the scarified ear pinna of immobilised white rhinoceroses. Eight white rhinoceros were immobilised with etorphine-based drug combinations and given butorphanol after 12 min, and oxygen after 40 min, of recumbency. The Nonin and Masimo devices, with dual-wavelength probes attached to the third-eyelid and ear recorded arterial peripheral oxygen-haemoglobin saturation (SpO2) at pre-determined time points, concurrently with measurements of arterial oxygen-haemoglobin saturation (SaO2), from drawn blood samples, by a benchtop AVOXimeter 4000 co-oximeter (reference method). Reliability of the Nonin and Masimo devices was evaluated using the Bland-Altman and the area root mean squares (ARMS) methods. Clinical performance of the devices was evaluated for their ability to accurately detect clinical hypoxemia using receiver operating characteristic (ROC) curves and measures of sensitivity, specificity, and positive and negative predictive values. Trending ability of the devices was assessed by calculating concordance rates from four-quadrant plots.
RESULTS: Only the Nonin device with transflectance probe attached to the third-eyelid provided reliable SpO2 measurements across the 70 to 100% saturation range (bias - 1%, precision 4%, ARMS 4%). Nonin and Masimo devices with transflectance probes attached to the third-eyelid both had high clinical performance at detecting clinical hypoxaemia [area under the ROC curves (AUC): 0.93 and 0.90, respectively]. However, the Nonin and Masimo devices with transmission probes attached to the ear were unreliable and provided only moderate clinical performance. Both Nonin and Masimo devices, at both measurement sites, had concordance rates lower than the recommended threshold of ≥ 90%, indicating poor trending ability.
CONCLUSIONS: The overall assessment of reliability, clinical performance and trending ability indicate that the Nonin device with transflectance probe attached to the third-eyelid is best suited for monitoring of blood oxygenation in immobilised rhinoceros. The immobilisation procedure may have affected cardiovascular function to an extent that it limited the devices\' performance.