The Experts below are selected from a list of 321 Experts worldwide ranked by ideXlab platform
Takuo Aoyagi - One of the best experts on this subject based on the ideXlab platform.
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Multiwavelength Pulse Oximetry: Theory for the Future
Anesthesia & Analgesia, 2007Co-Authors: Takuo Aoyagi, Masayoshi Fuse, Naoki Kobayashi, Kazuko Machida, Katsuyuki MiyasakaAbstract:BACKGROUND:As the use of Pulse oximeters increases, the needs for higher performance and wider applicability of Pulse Oximetry have increased. To realize the full potential of Pulse Oximetry, it is indispensable to increase the number of optical wavelengths. To develop a multiwavelength Oximetry sys
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Multiwavelength Pulse Oximetry: theory for the future.
Anesthesia and analgesia, 2007Co-Authors: Takuo Aoyagi, Masayoshi Fuse, Naoki Kobayashi, Kazuko Machida, Katsuyuki MiyasakaAbstract:As the use of Pulse oximeters increases, the needs for higher performance and wider applicability of Pulse Oximetry have increased. To realize the full potential of Pulse Oximetry, it is indispensable to increase the number of optical wavelengths. To develop a multiwavelength Oximetry system, a physical theory of Pulse Oximetry must be constructed. In addition, a theory for quantitative measurement of optical absorption in an optical scatterer, such as in living tissue, remains a difficult theoretical and practical aspect of this problem. We adopted Schuster's theory of radiation through a foggy atmosphere for a basis of theory of Pulse Oximetry. We considered three factors affecting Pulse Oximetry: the optics, the tissue, and the venous blood. We derived a physical theoretical formula of Pulse Oximetry. The theory was confirmed with a full SO2 range experiment. Based on the theory, the three-wavelength method eliminated the effect of tissue and improved the accuracy of Spo2. The five-wavelength method eliminated the effect of venous blood and improved motion artifact elimination. Our theory of multiwavelength Pulse Oximetry can be expected to be useful for solving almost all problems in Pulse Oximetry such as accuracy, motion artifact, low-Pulse amplitude, response delay, and errors using reflection Oximetry which will expand the application of Pulse Oximetry. Our theory is probably a rare case of success in solving the difficult problem of quantifying optical density of a substance embedded in an optically scattering medium.
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Pulse Oximetry: Its origin and development
Proceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society, 1992Co-Authors: Takuo AoyagiAbstract:Pulse Oximetry is a method to monitor oxygen saturation of the arterial blood noninvasively and continuously. This method has become indispensable in almost all aspects of modern medical practice, especially for life support in anesthesia. This is an unexpected great pleasure for me as the inventor of Pulse Oximetry. But I believe that Pulse Oximetry is no more than the first fruits of a new concept of noninvasive monitoring of the blood which might be called "Pulse spectro-photometry". I would like to explain the origin of this idea and its development as the Pulse oximeter, together with a new application to the dye dilution method.
Katsuyuki Miyasaka - One of the best experts on this subject based on the ideXlab platform.
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Multiwavelength Pulse Oximetry: Theory for the Future
Anesthesia & Analgesia, 2007Co-Authors: Takuo Aoyagi, Masayoshi Fuse, Naoki Kobayashi, Kazuko Machida, Katsuyuki MiyasakaAbstract:BACKGROUND:As the use of Pulse oximeters increases, the needs for higher performance and wider applicability of Pulse Oximetry have increased. To realize the full potential of Pulse Oximetry, it is indispensable to increase the number of optical wavelengths. To develop a multiwavelength Oximetry sys
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Multiwavelength Pulse Oximetry: theory for the future.
Anesthesia and analgesia, 2007Co-Authors: Takuo Aoyagi, Masayoshi Fuse, Naoki Kobayashi, Kazuko Machida, Katsuyuki MiyasakaAbstract:As the use of Pulse oximeters increases, the needs for higher performance and wider applicability of Pulse Oximetry have increased. To realize the full potential of Pulse Oximetry, it is indispensable to increase the number of optical wavelengths. To develop a multiwavelength Oximetry system, a physical theory of Pulse Oximetry must be constructed. In addition, a theory for quantitative measurement of optical absorption in an optical scatterer, such as in living tissue, remains a difficult theoretical and practical aspect of this problem. We adopted Schuster's theory of radiation through a foggy atmosphere for a basis of theory of Pulse Oximetry. We considered three factors affecting Pulse Oximetry: the optics, the tissue, and the venous blood. We derived a physical theoretical formula of Pulse Oximetry. The theory was confirmed with a full SO2 range experiment. Based on the theory, the three-wavelength method eliminated the effect of tissue and improved the accuracy of Spo2. The five-wavelength method eliminated the effect of venous blood and improved motion artifact elimination. Our theory of multiwavelength Pulse Oximetry can be expected to be useful for solving almost all problems in Pulse Oximetry such as accuracy, motion artifact, low-Pulse amplitude, response delay, and errors using reflection Oximetry which will expand the application of Pulse Oximetry. Our theory is probably a rare case of success in solving the difficult problem of quantifying optical density of a substance embedded in an optically scattering medium.
Tom Pedersen - One of the best experts on this subject based on the ideXlab platform.
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The Cochrane Library - Pulse Oximetry for perioperative monitoring.
The Cochrane database of systematic reviews, 2014Co-Authors: Tom Pedersen, A M Moller, Karen Hovhannisyan, Amanda Nicholson, Andrew F Smith, Sharon R LewisAbstract:Background This is an update of a review last published in Issue 9, 2009, of The Cochrane Library. Pulse Oximetry is used extensively in the perioperative period and might improve patient outcomes by enabling early diagnosis and, consequently, correction of perioperative events that might cause postoperative complications or even death. Only a few randomized clinical trials of Pulse Oximetry during anaesthesia and in the recovery room have been performed that describe perioperative hypoxaemic events, postoperative cardiopulmonary complications and cognitive dysfunction. Objectives To study the use of perioperative monitoring with Pulse Oximetry to clearly identify adverse outcomes that might be prevented or improved by its use.The following hypotheses were tested.1. Use of Pulse Oximetry is associated with improvement in the detection and treatment of hypoxaemia.2. Early detection and treatment of hypoxaemia reduce morbidity and mortality in the perioperative period.3. Use of Pulse Oximetry per se reduces morbidity and mortality in the perioperative period.4. Use of Pulse Oximetry reduces unplanned respiratory admissions to the intensive care unit (ICU), decreases the length of ICU readmission or both. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (2013, Issue 5), MEDLINE (1966 to June 2013), EMBASE (1980 to June 2013), CINAHL (1982 to June 2013), ISI Web of Science (1956 to June 2013), LILACS (1982 to June 2013) and databases of ongoing trials; we also checked the reference lists of trials and review articles. The original search was performed in January 2005, and a previous update was performed in May 2009. Selection criteria We included all controlled trials that randomly assigned participants to Pulse Oximetry or no Pulse Oximetry during the perioperative period. Data collection and analysis Two review authors independently assessed data in relation to events detectable by Pulse Oximetry, any serious complications that occurred during anaesthesia or in the postoperative period and intraoperative or postoperative mortality. Main results The last update of the review identified five eligible studies. The updated search found one study that is awaiting assessment but no additional eligible studies. We considered studies with data from a total of 22,992 participants that were eligible for analysis. These studies gave insufficient detail on the methods used for randomization and allocation concealment. It was impossible for study personnel to be blinded to participant allocation in the study, as they needed to be able to respond to Oximetry readings. Appropriate steps were taken to minimize detection bias for hypoxaemia and complication outcomes. Results indicated that hypoxaemia was reduced in the Pulse Oximetry group, both in the operating theatre and in the recovery room. During observation in the recovery room, the incidence of hypoxaemia in the Pulse Oximetry group was 1.5 to three times less. Postoperative cognitive function was independent of perioperative monitoring with Pulse Oximetry. A single study in general surgery showed that postoperative complications occurred in 10% of participants in the Oximetry group and in 9.4% of those in the control group. No statistically significant differences in cardiovascular, respiratory, neurological or infectious complications were detected in the two groups. The duration of hospital stay was a median of five days in both groups, and equal numbers of in-hospital deaths were reported in the two groups. Continuous Pulse Oximetry has the potential to increase vigilance and decrease pulmonary complications after cardiothoracic surgery; however, routine continuous monitoring did not reduce transfer to an ICU and did not decrease overall mortality. Authors' conclusions These studies confirmed that Pulse Oximetry can detect hypoxaemia and related events. However, we found no evidence that Pulse Oximetry affects the outcome of anaesthesia for patients. The conflicting subjective and objective study results, despite an intense methodical collection of data from a relatively large general surgery population, indicate that the value of perioperative monitoring with Pulse Oximetry is questionable in relation to improved reliable outcomes, effectiveness and efficiency. Routine continuous Pulse Oximetry monitoring did not reduce transfer to the ICU and did not decrease mortality, and it is unclear whether any real benefit was derived from the application of this technology for patients recovering from cardiothoracic surgery in a general care area.
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Pulse Oximetry for perioperative monitoring
Cochrane Database of Systematic Reviews, 2014Co-Authors: Tom Pedersen, A M Moller, Karen Hovhannisyan, Amanda Nicholson, Andrew F Smith, Sharon R LewisAbstract:Background This is an update of a review last published in Issue 9, 2009, of The Cochrane Library. Pulse Oximetry is used extensively in the perioperative period and might improve patient outcomes by enabling early diagnosis and, consequently, correction of perioperative events that might cause postoperative complications or even death. Only a few randomized clinical trials of Pulse Oximetry during anaesthesia and in the recovery room have been performed that describe perioperative hypoxaemic events, postoperative cardiopulmonary complications and cognitive dysfunction. Objectives To study the use of perioperative monitoring with Pulse Oximetry to clearly identify adverse outcomes that might be prevented or improved by its use.The following hypotheses were tested.1. Use of Pulse Oximetry is associated with improvement in the detection and treatment of hypoxaemia.2. Early detection and treatment of hypoxaemia reduce morbidity and mortality in the perioperative period.3. Use of Pulse Oximetry per se reduces morbidity and mortality in the perioperative period.4. Use of Pulse Oximetry reduces unplanned respiratory admissions to the intensive care unit (ICU), decreases the length of ICU readmission or both. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (2013, Issue 5), MEDLINE (1966 to June 2013), EMBASE (1980 to June 2013), CINAHL (1982 to June 2013), ISI Web of Science (1956 to June 2013), LILACS (1982 to June 2013) and databases of ongoing trials; we also checked the reference lists of trials and review articles. The original search was performed in January 2005, and a previous update was performed in May 2009. Selection criteria We included all controlled trials that randomly assigned participants to Pulse Oximetry or no Pulse Oximetry during the perioperative period. Data collection and analysis Two review authors independently assessed data in relation to events detectable by Pulse Oximetry, any serious complications that occurred during anaesthesia or in the postoperative period and intraoperative or postoperative mortality. Main results The last update of the review identified five eligible studies. The updated search found one study that is awaiting assessment but no additional eligible studies. We considered studies with data from a total of 22,992 participants that were eligible for analysis. These studies gave insufficient detail on the methods used for randomization and allocation concealment. It was impossible for study personnel to be blinded to participant allocation in the study, as they needed to be able to respond to Oximetry readings. Appropriate steps were taken to minimize detection bias for hypoxaemia and complication outcomes. Results indicated that hypoxaemia was reduced in the Pulse Oximetry group, both in the operating theatre and in the recovery room. During observation in the recovery room, the incidence of hypoxaemia in the Pulse Oximetry group was 1.5 to three times less. Postoperative cognitive function was independent of perioperative monitoring with Pulse Oximetry. A single study in general surgery showed that postoperative complications occurred in 10% of participants in the Oximetry group and in 9.4% of those in the control group. No statistically significant differences in cardiovascular, respiratory, neurological or infectious complications were detected in the two groups. The duration of hospital stay was a median of five days in both groups, and equal numbers of in-hospital deaths were reported in the two groups. Continuous Pulse Oximetry has the potential to increase vigilance and decrease pulmonary complications after cardiothoracic surgery; however, routine continuous monitoring did not reduce transfer to an ICU and did not decrease overall mortality. Authors' conclusions These studies confirmed that Pulse Oximetry can detect hypoxaemia and related events. However, we found no evidence that Pulse Oximetry affects the outcome of anaesthesia for patients. The conflicting subjective and objective study results, despite an intense methodical collection of data from a relatively large general surgery population, indicate that the value of perioperative monitoring with Pulse Oximetry is questionable in relation to improved reliable outcomes, effectiveness and efficiency. Routine continuous Pulse Oximetry monitoring did not reduce transfer to the ICU and did not decrease mortality, and it is unclear whether any real benefit was derived from the application of this technology for patients recovering from cardiothoracic surgery in a general care area.
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Pulse Oximetry for perioperative monitoring.
The Cochrane database of systematic reviews, 2009Co-Authors: Tom Pedersen, A M Moller, Karen HovhannisyanAbstract:Pulse Oximetry is extensively used in the perioperative period and might improve patient outcomes by enabling an early diagnosis and, consequently, correction of perioperative events that might cause postoperative complications or even death. Only a few randomized clinical trials of Pulse Oximetry during anaesthesia and in the recovery room have been performed that describe perioperative hypoxaemic events, postoperative cardiopulmonary complications, and cognitive dysfunction. The objective of this review was to assess the effects of perioperative monitoring with Pulse Oximetry and to clearly identify the adverse outcomes that might be prevented or improved by the use of Pulse Oximetry. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2009, Issue 2), MEDLINE (1966 to May 2009), EMBASE (1980 to May 2009), CINAHL (1982 to May 2009), ISI Web of Science (1956 to May 2009), LILACS (1982 to May 2009), and databases of ongoing trials; and checked the reference lists of trials and review articles. We included all controlled trials that randomized patients to either Pulse Oximetry or no Pulse Oximetry during the perioperative period. Two authors independently assessed data in relation to events detectable by Pulse Oximetry, any serious complications that occurred during anaesthesia or in the postoperative period, and intra- or postoperative mortality. Searching identified five reports. We considered the studies with data from a total of 22,992 patients that were eligible for analysis. Results indicated that hypoxaemia was reduced in the Pulse Oximetry group, both in the operating theatre and in the recovery room. During observation in the recovery room, the incidence of hypoxaemia in the Pulse Oximetry group was 1.5 to three times less. Postoperative cognitive function was independent of perioperative monitoring with Pulse Oximetry. The one study in general surgery showed that postoperative complications occurred in 10% of the patients in the Oximetry group and in 9.4% in the control group. No statistically significant differences were detected in cardiovascular, respiratory, neurologic, or infectious complications in the two groups. The duration of hospital stay was a median of five days in both groups, and an equal number of in-hospital deaths was registered in the two groups. Continuous Pulse Oximetry has the potential to increase vigilance and decrease pulmonary complications after cardiothoracic surgery, however routine continuous monitoring did not reduce transfer to an intensive care unit (ICU) or overall mortality. The studies confirmed that Pulse Oximetry can detect hypoxaemia and related events. However, we have found no evidence that Pulse Oximetry affects the outcome of anaesthesia for patients. The conflicting subjective and objective results of the studies, despite an intense methodical collection of data from a relatively large general surgery population, indicate that the value of perioperative monitoring with Pulse Oximetry is questionable in relation to improved reliable outcomes, effectiveness, and efficiency. Routine continuous Pulse Oximetry monitoring did not reduce either transfer to ICU or mortality, and it is unclear if there is any real benefit from the application of this technology in patients who are recovering from cardiothoracic surgery in a general care area.
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Pulse Oximetry in perioperative monitoring
Ugeskrift for laeger, 2003Co-Authors: Anne Sofie Konstantin Poulsen, Tom PedersenAbstract:BACKGROUND Monitoring with Pulse Oximetry might improve patient outcome by enabling an early diagnosis and consequently, correction of perioperative events that might cause postoperative complications or even death. Only a few randomised clinical trials of Pulse Oximetry have been performed during anaesthesia and in the recovery room which describe perioperative hypoxaemic events, postoperative cardiopulmonary complications and cognitive dysfunction. OBJECTIVES To study the effect of perioperative monitoring with Pulse Oximetry to clearly identify the adverse outcomes that might be prevented or improved by the use of Pulse Oximetry. SEARCH STRATEGY Trials were identified by computerised searches of the Cochrane Library, MEDLINE, EMBASE, and by checking the reference lists of trials and review articles. SELECTION CRITERIA All controlled trials that randomised patients to either Pulse Oximetry or no Pulse Oximetry during the perioperative period, including the operating and recovery room. DATA COLLECTION AND ANALYSIS We collected data in relation to events detectable by Pulse Oximetry, any serious complications that occurred during anaesthesia or in the postoperative period, intra- or postoperative mortality, and duration of recovery or intensive care stay. Formal statistical synthesis of individual trials was not performed in view of the variety of outcomes studied. MAIN RESULTS Searching identified six reports; four studies with data from a total of 21,773 patients were considered eligible for analysis. Only two studies specifically addressed the outcomes in question; both found no effect on the rate of postoperative complications using perioperative Pulse Oximetry. Two studies used hypoxaemia detectable by Pulse Oximetry to assess the value of perioperative monitoring, although outcomes were not given. It was found that hypoxaemia was reduced in the Pulse Oximetry group both in the operating theratre and in the recovery room. During observation in the recovery room, the incidence of hypoxaemia in the Pulse Oximetry group was 1.5-3 times less. The postoperative cognitive function using the Wechsler memory scale and continuous reaction time was independent of perioperative monitoring with Pulse Oximetry. The other study showed that postoperative complications occurred in 10% of the patients in the Oximetry group and in 9.4% in the control group. The two groups did not differ in cardiovascular, respiratory, neurologic, or infectious complications. The duration of hospital stay was a median of 5 days in both groups, and an equal number of in-hospital deaths was registered in the two groups. REVIEWERS' CONCLUSIONS The studies confirmed that Pulse Oximetry can detect hypoxaemia and related events. However, we have found no evidence that Pulse Oximetry affects the outcome of anaesthesia. The conflicting subjective and objective results of the studies, despite an intense, methodical collection of data from a relatively large population, indicate that the value of perioperative monitoring with Pulse Oximetry is questionable in relation to improved reliable outcomes, effectiveness and efficiency.
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Pulse Oximetry for perioperative monitoring.
The Cochrane database of systematic reviews, 2001Co-Authors: Tom Pedersen, P Pedersen, A M MollerAbstract:Monitoring with Pulse Oximetry might improve patient outcome by enabling an early diagnosis and consequently, correction of perioperative events that might cause postoperative complications or even death. Only a few randomised clinical trials of Pulse Oximetry have been performed during anaesthesia and in the recovery room which describe perioperative hypoxaemic events, postoperative cardiopulmonary complications and cognitive dysfunction. To study the effect of perioperative monitoring with Pulse Oximetry to clearly identify the adverse outcomes that might be prevented or improved by the use of Pulse Oximetry. Trials were identified by computerised searches of the Cochrane Library, MEDLINE, EMBASE, and by checking the reference lists of trials and review articles. All controlled trials that randomised patients to either Pulse Oximetry or no Pulse Oximetry during the perioperative period, including the operating and recovery room. We collected data in relation to events detectable by Pulse Oximetry, any serious complications that occurred during anaesthesia or in the postoperative period, intra- or postoperative mortality, and duration of recovery or intensive care stay. Formal statistical synthesis of individual trials was not performed in view of the variety of outcomes studied. Searching identified six reports; four studies with data from a total of 21,773 patients were considered eligible for analysis. Only two studies specifically addressed the outcomes in question; both found no effect on the rate of postoperative complications using perioperative Pulse Oximetry. Two studies used hypoxaemia detectable by Pulse Oximetry to assess the value of perioperative monitoring, although outcomes were not given. It was found that hypoxaemia was reduced in the Pulse Oximetry group both in the operating theatre and in the recovery room. During observation in the recovery room, the incidence of hypoxaemia in the Pulse Oximetry group was 1.5-3 times less. The postoperative cognitive function using the Wechsler memory scale and continuous reaction time was independent of perioperative monitoring with Pulse Oximetry. The other study showed that postoperative complications occurred in 10% of the patients in the Oximetry group and in 9.4% in the control group. The two groups did not differ in cardiovascular, respiratory, neurologic, or infectious complications. The duration of hospital stay was a median of 5 days in both groups, and an equal number of in-hospital deaths was registered in the two groups. The studies confirmed that Pulse Oximetry can detect hypoxaemia and related events. However, we have found no evidence that Pulse Oximetry affects the outcome of anaesthesia. The conflicting subjective and objective results of the studies, despite an intense, methodical collection of data from a relatively large population, indicates that the value of perioperative monitoring with Pulse Oximetry is questionable in relation to improved reliable outcomes, effectiveness and efficiency.
Allan L. Coates - One of the best experts on this subject based on the ideXlab platform.
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Pulse Oximetry in sickle cell disease.
Archives of disease in childhood, 1993Co-Authors: Paolo T. Pianosi, T. D. Charge, Dixie W. Esseltine, Allan L. CoatesAbstract:Patients with sickle cell disease usually have mild hypoxaemia and their oxyhaemoglobin dissociation curve is shifted to the right. It follows that oxygen saturation in sickle cell disease should be lower than normal. Most subjects in this clinic had normal oxygen saturation by Pulse Oximetry, however. To improve the understanding of this paradox, arterialised capillary oxygen tension (PO2) and oxygen saturation were compared with simultaneously measured Pulse oximeter saturation in 20 children with sickle cell disease. In addition, the PO2 at 50% haemoglobin saturation (P50) was compared with saturation measured by Pulse Oximetry in all 20 patients. It was found that saturation measured by Pulse Oximetry was, on the whole, similar to that calculated from the sampled blood. Individual deviations were not random, however, and were partly explained by differences in P50 values. It is concluded that Pulse Oximetry gives variable results in patients with sickle cell disease and should be used with caution to predict arterial saturation in this patient group.
A M Moller - One of the best experts on this subject based on the ideXlab platform.
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The Cochrane Library - Pulse Oximetry for perioperative monitoring.
The Cochrane database of systematic reviews, 2014Co-Authors: Tom Pedersen, A M Moller, Karen Hovhannisyan, Amanda Nicholson, Andrew F Smith, Sharon R LewisAbstract:Background This is an update of a review last published in Issue 9, 2009, of The Cochrane Library. Pulse Oximetry is used extensively in the perioperative period and might improve patient outcomes by enabling early diagnosis and, consequently, correction of perioperative events that might cause postoperative complications or even death. Only a few randomized clinical trials of Pulse Oximetry during anaesthesia and in the recovery room have been performed that describe perioperative hypoxaemic events, postoperative cardiopulmonary complications and cognitive dysfunction. Objectives To study the use of perioperative monitoring with Pulse Oximetry to clearly identify adverse outcomes that might be prevented or improved by its use.The following hypotheses were tested.1. Use of Pulse Oximetry is associated with improvement in the detection and treatment of hypoxaemia.2. Early detection and treatment of hypoxaemia reduce morbidity and mortality in the perioperative period.3. Use of Pulse Oximetry per se reduces morbidity and mortality in the perioperative period.4. Use of Pulse Oximetry reduces unplanned respiratory admissions to the intensive care unit (ICU), decreases the length of ICU readmission or both. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (2013, Issue 5), MEDLINE (1966 to June 2013), EMBASE (1980 to June 2013), CINAHL (1982 to June 2013), ISI Web of Science (1956 to June 2013), LILACS (1982 to June 2013) and databases of ongoing trials; we also checked the reference lists of trials and review articles. The original search was performed in January 2005, and a previous update was performed in May 2009. Selection criteria We included all controlled trials that randomly assigned participants to Pulse Oximetry or no Pulse Oximetry during the perioperative period. Data collection and analysis Two review authors independently assessed data in relation to events detectable by Pulse Oximetry, any serious complications that occurred during anaesthesia or in the postoperative period and intraoperative or postoperative mortality. Main results The last update of the review identified five eligible studies. The updated search found one study that is awaiting assessment but no additional eligible studies. We considered studies with data from a total of 22,992 participants that were eligible for analysis. These studies gave insufficient detail on the methods used for randomization and allocation concealment. It was impossible for study personnel to be blinded to participant allocation in the study, as they needed to be able to respond to Oximetry readings. Appropriate steps were taken to minimize detection bias for hypoxaemia and complication outcomes. Results indicated that hypoxaemia was reduced in the Pulse Oximetry group, both in the operating theatre and in the recovery room. During observation in the recovery room, the incidence of hypoxaemia in the Pulse Oximetry group was 1.5 to three times less. Postoperative cognitive function was independent of perioperative monitoring with Pulse Oximetry. A single study in general surgery showed that postoperative complications occurred in 10% of participants in the Oximetry group and in 9.4% of those in the control group. No statistically significant differences in cardiovascular, respiratory, neurological or infectious complications were detected in the two groups. The duration of hospital stay was a median of five days in both groups, and equal numbers of in-hospital deaths were reported in the two groups. Continuous Pulse Oximetry has the potential to increase vigilance and decrease pulmonary complications after cardiothoracic surgery; however, routine continuous monitoring did not reduce transfer to an ICU and did not decrease overall mortality. Authors' conclusions These studies confirmed that Pulse Oximetry can detect hypoxaemia and related events. However, we found no evidence that Pulse Oximetry affects the outcome of anaesthesia for patients. The conflicting subjective and objective study results, despite an intense methodical collection of data from a relatively large general surgery population, indicate that the value of perioperative monitoring with Pulse Oximetry is questionable in relation to improved reliable outcomes, effectiveness and efficiency. Routine continuous Pulse Oximetry monitoring did not reduce transfer to the ICU and did not decrease mortality, and it is unclear whether any real benefit was derived from the application of this technology for patients recovering from cardiothoracic surgery in a general care area.
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Pulse Oximetry for perioperative monitoring
Cochrane Database of Systematic Reviews, 2014Co-Authors: Tom Pedersen, A M Moller, Karen Hovhannisyan, Amanda Nicholson, Andrew F Smith, Sharon R LewisAbstract:Background This is an update of a review last published in Issue 9, 2009, of The Cochrane Library. Pulse Oximetry is used extensively in the perioperative period and might improve patient outcomes by enabling early diagnosis and, consequently, correction of perioperative events that might cause postoperative complications or even death. Only a few randomized clinical trials of Pulse Oximetry during anaesthesia and in the recovery room have been performed that describe perioperative hypoxaemic events, postoperative cardiopulmonary complications and cognitive dysfunction. Objectives To study the use of perioperative monitoring with Pulse Oximetry to clearly identify adverse outcomes that might be prevented or improved by its use.The following hypotheses were tested.1. Use of Pulse Oximetry is associated with improvement in the detection and treatment of hypoxaemia.2. Early detection and treatment of hypoxaemia reduce morbidity and mortality in the perioperative period.3. Use of Pulse Oximetry per se reduces morbidity and mortality in the perioperative period.4. Use of Pulse Oximetry reduces unplanned respiratory admissions to the intensive care unit (ICU), decreases the length of ICU readmission or both. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (2013, Issue 5), MEDLINE (1966 to June 2013), EMBASE (1980 to June 2013), CINAHL (1982 to June 2013), ISI Web of Science (1956 to June 2013), LILACS (1982 to June 2013) and databases of ongoing trials; we also checked the reference lists of trials and review articles. The original search was performed in January 2005, and a previous update was performed in May 2009. Selection criteria We included all controlled trials that randomly assigned participants to Pulse Oximetry or no Pulse Oximetry during the perioperative period. Data collection and analysis Two review authors independently assessed data in relation to events detectable by Pulse Oximetry, any serious complications that occurred during anaesthesia or in the postoperative period and intraoperative or postoperative mortality. Main results The last update of the review identified five eligible studies. The updated search found one study that is awaiting assessment but no additional eligible studies. We considered studies with data from a total of 22,992 participants that were eligible for analysis. These studies gave insufficient detail on the methods used for randomization and allocation concealment. It was impossible for study personnel to be blinded to participant allocation in the study, as they needed to be able to respond to Oximetry readings. Appropriate steps were taken to minimize detection bias for hypoxaemia and complication outcomes. Results indicated that hypoxaemia was reduced in the Pulse Oximetry group, both in the operating theatre and in the recovery room. During observation in the recovery room, the incidence of hypoxaemia in the Pulse Oximetry group was 1.5 to three times less. Postoperative cognitive function was independent of perioperative monitoring with Pulse Oximetry. A single study in general surgery showed that postoperative complications occurred in 10% of participants in the Oximetry group and in 9.4% of those in the control group. No statistically significant differences in cardiovascular, respiratory, neurological or infectious complications were detected in the two groups. The duration of hospital stay was a median of five days in both groups, and equal numbers of in-hospital deaths were reported in the two groups. Continuous Pulse Oximetry has the potential to increase vigilance and decrease pulmonary complications after cardiothoracic surgery; however, routine continuous monitoring did not reduce transfer to an ICU and did not decrease overall mortality. Authors' conclusions These studies confirmed that Pulse Oximetry can detect hypoxaemia and related events. However, we found no evidence that Pulse Oximetry affects the outcome of anaesthesia for patients. The conflicting subjective and objective study results, despite an intense methodical collection of data from a relatively large general surgery population, indicate that the value of perioperative monitoring with Pulse Oximetry is questionable in relation to improved reliable outcomes, effectiveness and efficiency. Routine continuous Pulse Oximetry monitoring did not reduce transfer to the ICU and did not decrease mortality, and it is unclear whether any real benefit was derived from the application of this technology for patients recovering from cardiothoracic surgery in a general care area.
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Pulse Oximetry for perioperative monitoring.
The Cochrane database of systematic reviews, 2009Co-Authors: Tom Pedersen, A M Moller, Karen HovhannisyanAbstract:Pulse Oximetry is extensively used in the perioperative period and might improve patient outcomes by enabling an early diagnosis and, consequently, correction of perioperative events that might cause postoperative complications or even death. Only a few randomized clinical trials of Pulse Oximetry during anaesthesia and in the recovery room have been performed that describe perioperative hypoxaemic events, postoperative cardiopulmonary complications, and cognitive dysfunction. The objective of this review was to assess the effects of perioperative monitoring with Pulse Oximetry and to clearly identify the adverse outcomes that might be prevented or improved by the use of Pulse Oximetry. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2009, Issue 2), MEDLINE (1966 to May 2009), EMBASE (1980 to May 2009), CINAHL (1982 to May 2009), ISI Web of Science (1956 to May 2009), LILACS (1982 to May 2009), and databases of ongoing trials; and checked the reference lists of trials and review articles. We included all controlled trials that randomized patients to either Pulse Oximetry or no Pulse Oximetry during the perioperative period. Two authors independently assessed data in relation to events detectable by Pulse Oximetry, any serious complications that occurred during anaesthesia or in the postoperative period, and intra- or postoperative mortality. Searching identified five reports. We considered the studies with data from a total of 22,992 patients that were eligible for analysis. Results indicated that hypoxaemia was reduced in the Pulse Oximetry group, both in the operating theatre and in the recovery room. During observation in the recovery room, the incidence of hypoxaemia in the Pulse Oximetry group was 1.5 to three times less. Postoperative cognitive function was independent of perioperative monitoring with Pulse Oximetry. The one study in general surgery showed that postoperative complications occurred in 10% of the patients in the Oximetry group and in 9.4% in the control group. No statistically significant differences were detected in cardiovascular, respiratory, neurologic, or infectious complications in the two groups. The duration of hospital stay was a median of five days in both groups, and an equal number of in-hospital deaths was registered in the two groups. Continuous Pulse Oximetry has the potential to increase vigilance and decrease pulmonary complications after cardiothoracic surgery, however routine continuous monitoring did not reduce transfer to an intensive care unit (ICU) or overall mortality. The studies confirmed that Pulse Oximetry can detect hypoxaemia and related events. However, we have found no evidence that Pulse Oximetry affects the outcome of anaesthesia for patients. The conflicting subjective and objective results of the studies, despite an intense methodical collection of data from a relatively large general surgery population, indicate that the value of perioperative monitoring with Pulse Oximetry is questionable in relation to improved reliable outcomes, effectiveness, and efficiency. Routine continuous Pulse Oximetry monitoring did not reduce either transfer to ICU or mortality, and it is unclear if there is any real benefit from the application of this technology in patients who are recovering from cardiothoracic surgery in a general care area.
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Pulse Oximetry for perioperative monitoring.
The Cochrane database of systematic reviews, 2001Co-Authors: Tom Pedersen, P Pedersen, A M MollerAbstract:Monitoring with Pulse Oximetry might improve patient outcome by enabling an early diagnosis and consequently, correction of perioperative events that might cause postoperative complications or even death. Only a few randomised clinical trials of Pulse Oximetry have been performed during anaesthesia and in the recovery room which describe perioperative hypoxaemic events, postoperative cardiopulmonary complications and cognitive dysfunction. To study the effect of perioperative monitoring with Pulse Oximetry to clearly identify the adverse outcomes that might be prevented or improved by the use of Pulse Oximetry. Trials were identified by computerised searches of the Cochrane Library, MEDLINE, EMBASE, and by checking the reference lists of trials and review articles. All controlled trials that randomised patients to either Pulse Oximetry or no Pulse Oximetry during the perioperative period, including the operating and recovery room. We collected data in relation to events detectable by Pulse Oximetry, any serious complications that occurred during anaesthesia or in the postoperative period, intra- or postoperative mortality, and duration of recovery or intensive care stay. Formal statistical synthesis of individual trials was not performed in view of the variety of outcomes studied. Searching identified six reports; four studies with data from a total of 21,773 patients were considered eligible for analysis. Only two studies specifically addressed the outcomes in question; both found no effect on the rate of postoperative complications using perioperative Pulse Oximetry. Two studies used hypoxaemia detectable by Pulse Oximetry to assess the value of perioperative monitoring, although outcomes were not given. It was found that hypoxaemia was reduced in the Pulse Oximetry group both in the operating theatre and in the recovery room. During observation in the recovery room, the incidence of hypoxaemia in the Pulse Oximetry group was 1.5-3 times less. The postoperative cognitive function using the Wechsler memory scale and continuous reaction time was independent of perioperative monitoring with Pulse Oximetry. The other study showed that postoperative complications occurred in 10% of the patients in the Oximetry group and in 9.4% in the control group. The two groups did not differ in cardiovascular, respiratory, neurologic, or infectious complications. The duration of hospital stay was a median of 5 days in both groups, and an equal number of in-hospital deaths was registered in the two groups. The studies confirmed that Pulse Oximetry can detect hypoxaemia and related events. However, we have found no evidence that Pulse Oximetry affects the outcome of anaesthesia. The conflicting subjective and objective results of the studies, despite an intense, methodical collection of data from a relatively large population, indicates that the value of perioperative monitoring with Pulse Oximetry is questionable in relation to improved reliable outcomes, effectiveness and efficiency.
