电容描记术
医学
脉搏血氧仪
不利影响
麻醉
荟萃分析
呼吸监测
重症监护医学
科克伦图书馆
通气不足
呼吸系统
内科学
作者
Ashish K. Khanna,Akshat Banga,Joseph Rigdon,Brian N. White,Christian Cuvillier,Jose G. Ferraz,Fredrik Olsen,Loren Hackett,Vikas Bansal,Roop Kaw
标识
DOI:10.1016/j.jclinane.2024.111374
摘要
The current standards of postoperative respiratory monitoring on medical-surgical floors involve spot-pulse oximetry checks every 4–8 h, which can miss the opportunity to detect prolonged hypoxia and acute hypercapnia. Continuous respiratory monitoring can recognize acute respiratory depression episodes; however, the existing evidence is limited. We sought to review the current evidence on the effectiveness of continuous pulse oximetry (CPOX) with and without capnography versus routine monitoring and their effectiveness for detecting postoperative respiratory failure, opioid-induced respiratory depression, and preventing downstream adverse events. We performed a systematic literature search on Ovid Medline, Embase, and Cochrane Library databases for articles published between 1990 and April 2023. The study protocol was registered in Prospero (ID: 439467), and PRISMA guidelines were followed. The NIH quality assessment tool was used to assess the quality of the studies. Pooled analysis was conducted using the software R version 4.1.1 and the package meta. The stability of the results was assessed using sensitivity analysis. Systematic Review and Meta-Analysis. Postoperative recovery area. 56,538 patients, ASA class II to IV, non-invasive respiratory monitoring, and post-operative respiratory depression. Continuous pulse oximetry with or without capnography versus routine monitoring. Respiratory rate, oxygen saturation, adverse events, and rescue events. 23 studies (17 examined CPOX without capnography and 5 examined CPOX with capnography) were included in this systematic review. CPOX was better at recognizing desaturation (SpO2 < 90%) OR: 11.94 (95% CI: 6.85, 20.82; p < 0.01) compared to standard monitoring. No significant differences were reported for ICU transfer, reintubation, and non-invasive ventilation between the two groups. Oxygen desaturation was the only outcome better detected with CPOX in postoperative patients in hospital wards. These comparisons were limited by the small number of studies that could be pooled for each outcome and the heterogeneity between the studies.
科研通智能强力驱动
Strongly Powered by AbleSci AI