Background The change in venous oxygen saturation occurs earlier, and even its reduction is faster than arterial oxygen saturation. The aim of this study was to validate SvO2 and PvO2 for O2 content measurement in children hospitalized with respiratory distress. Materials and Methods In this cross-sectional study, 80 children who were admitted with respiratory distress were included in the study according to the study inclusion and exclusion criteria. Baseline characteristics such as age and gender were recorded in the data collection form, designed by the researcher. In order to determine the amount of SaO2 and PaO2 the arterial blood sample was prepared, venous blood sample was prepared to determine the amount of hemoglobin, SvO2 and PvO2. The gold standard for the determination of O2 content was the arterial blood sample. All samples were examined by a blood gas analyzer and then calculated using the formula of O2 content values. For SvO2 and PvO2 validation, we used diagnostic analysis methods including sensitivity, specificity, positive and negative predictive values. Cut-point value for SvO2 and PvO2 were 76. 50 and 44. 30, respectively. Results In this study, the patients’ mean age was 5. 15 ± 4. 20 years. 62. 5% (n=50) were male and 38. 5% (n=30) were female. The values of arterial and venous O2 content were 14. 13 ± 3. 05 and 11. 95 ± 3. 04 from a total of 80 patients. SvO2 and PvO2 for measuring O2 content had a sensitivity of 80. 5 and 71. 80%, respectively, and specificity of 80. 5 and 78%, respectively. Conclusion SvO2 and PvO2 have good validity for evaluating O2 content in patients admitted to PICU. So that SvO2 had a sensitivity and specificity of over 80%, and PvO2 had a sensitivity and specificity of over 70%.

Background: Liver transplant is the only definitive treatment for many patients with end stage liver disease. Presence and severity of preoperative pulmonary disease directly affect the rate of postoperative complications of the liver transplantation. Arterial blood gas (ABG) measurement, performed in many transplant centers, is considered as a traditional method to diagnose hypoxemia. Because ABG measurement is invasive and painful, pulse oximetry, a bedside, noninvasive and inexpensive technique, has been recommended as an alternative source for the ABG measurement.Objectives: The aim of this study was to evaluate the efficacy of pulse oximetry as a screening tool in hypoxemia detection in liver transplant candidates and to compare the results with ABGs.Patients and Methods: Three hundred and ninety transplant candidates (237 males and 153 females) participated in this study. Arterial blood gas oxyhemoglobin saturation (SaO2) was recorded and compared with pulse oximetry oxyhemoglobin saturation (SpO2) results for each participants. The area under the curve (AUC) of receiver operating characteristic (ROC) curves was calculated by means of nonparametric methods to evaluate the efficacy of pulse oximetry to detect hypoxemia.Results: Roc-derived SpO2 threshold of ≤94% can predict hypoxemia (PaO2<60 mmHg) with a sensitivity of 100% and a specificity of 95%. Furthermore, there are associations between the ROC-derived SpO2 threshold of ≤97% and detection of hypoxemia (PaO2<70 mmHg) with a sensitivity of 100% and a specificity of 46%. The accuracy of pulse oximetry was not affected by the severity of liver disease in detection of hypoxemia.Conclusions: Provided that SpO2 is equal to or greater than 94%, attained from pulse oximetry can be used as a reliable and accurate substitute for the ABG measurements to evaluate hypoxemia in patients with end stage liver disease.

Background: Pulse oximetry is a valuable tool for monitoring animals during anesthesia and assessing the adequacy of administered oxygen therapy. Aims: To compare the pulse oximeter readings obtained by the Garmin Fenix 5X plus (GF5Xp) smartwatch and transmittance pulse oximetry (TPO) in anesthetized dogs. Methods: Twelve clinical canine patients requiring anesthesia for castration were prospectively enrolled in this study. The animals were premedicated with intramuscular dexmedetomidine at a dose of 5 µg/kg. Anesthesia was induced through intravenous administration of propofol and maintained using sevoflurane. The arterial hemoglobin oxygen saturation (SpO2) readings obtained from the tongue using TPO (238 readings) were compared with measurements taken over the lateral side of the tibia using a GF5Xp smart wearable device (238 readings). This comparison was performed using a Bland-Altman plot, where the differences (%) between the methods were plotted against their mean SpO2 (Gold standard - Device), and the limits of agreement were represented as the mean ± 1.96 times the standard deviation. Results: The SpO2 levels in dogs were overestimated by the GF5Xp relative to the readings obtained by the TPO, with the bias of -0.3% (95% CI: -3.1%-2.5%). Conclusion: GF5Xp may be interchangeable with TPO in dogs. Further studies are required to validate the accuracy of the GF5Xp in non-anesthetized dogs or dogs outside the physiological range.

Introduction: Intravenous sedation is one of methods to control anxiety in dentistry. However, due to intravenous use of potent drugs, the odds of hypoxia increases. In this study the prevalence of this complication between the two intravenous sedation methods was investigated.Materials and Methods: In this double-blind prospective clinical trial a total of 73 implant patients were evaluated in two groups. Conscious sedation was administered with a combination of midazolam/fentanyl in one group and with midazolam/ketamine in the other. SPO2 was measured in 6 stages and results were analyzed with t-test using SPSS software (a=0.05).Results: Mean of SPO2 five minutes after drug injection decreased in both groups. In midazolam/fentanyl group it decreased to 93.2% and in midazolam/ketamine group to 94.9% which indicates that the decrease in SPO2 in the first group (midazolam/fentanyl) was significantly more than other group.Conclusion: Use of intravenous sedation resulted in a decrease in SPO2 five minutes after sedation. In the midazolam/fentanyl group, it decreased to 93.2% and in the midazolam/ketamine group it decreased to 94.9%, with a significantly higher decrease in the former.

Background: Pulseoximetry is widely used in the critical care setting, currently used to guide therapeutic interventions. Few studies have evaluated the accuracy of SPO2 (pulseoximetry oxygen saturation) in intensive care unit after cardiac surgery. Our objective was to compare pulseoximetry with arterial oxygen saturation (SaO2) during clinical routine in such patients, and to examine the effect of mild acidosis on this relationship.Methods: In an observational prospective study 80 patients were evaluated in intensive care unit after cardiac surgery. SPO2 was recorded and compared with SaO2 obtained by blood gas analysis. One or serial arterial blood gas analyses (ABGs) were performed via a radial artery line while a reliable pulseoximeter signal was present. One hundred thirty seven samples were collected and for each blood gas analyses, SaO2 and SPO2 we recorded.Results: O2 saturation as a marker of peripheral perfusion was measured by Pulseoximetry (SPO2). The mean difference between arterial oxygen saturation and pulseoximetry oxygen saturation was 0.12%±1.6%. A total of 137 paired readings demonstrated good correlation (r=0.754; P<0.0001) between changes in SPO2 and those in SaO2 in samples with normal hemoglobin. Also in forty seven samples with mild acidosis, paired readings demonstrated good correlation (r=0.799; P<0.0001) and the mean difference between SaO2 and SPO2 was 0.05%±1.5%.Conclusion: Data showed that in patients with stable hemodynamic and good signal quality, changes in pulseoximetry oxygen saturation reliably predict equivalent changes in arterial oxygen saturation. Mild acidosis doesn’t alter the relation between SPO2 and SaO2 to any clinically important extent. In conclusion, the pulse oximeter is useful to monitor oxygen saturation in patients with stable hemodynamic.

Introduction: Sedative medications are widely used in intensive care unit patients. Decreased peripheral blood oxygen saturation (SPO2) is one of the common cases in patients with COVID-19. This study aimed to evaluate the effect of Dexmedetomidine on Peripheral oxygen saturation among COVID-19 pneumonia. Methods: Sixty patients were randomly divided into two intervention groups (n=30) and control (n=30). Patients in the intervention group received dexmedetomidine with a bolus dose of 1 µ, /kg/h for 10 minutes and then with a dose of 0. 2 µ, /kg/h to achieve a RASS score of-2 to +1. Patients in the control group received sedation drugs such as benzodiazepines, opium, or propofol according to the routine of the center. The well-known Richmond Stimulation and Sedation Scale (RASS) was used to evaluate patient sedation. Results: Data analysis has shown that the changes in systolic and diastolic blood pressure and breathing rate are not significantly different between the two groups of patients (P>0. 05). Patients in the intervention group have higher SPO2 compared to control group patients from 72 hours after starting Dexmedetomidine without any considerable adverse effect (P<0. 01). Conclusion: The potential sedation effect of dexmedetomidine can be attributed to the improvement in lung mechanics due to better relaxation in the thorax. Improvement in SpO2, and mental status (from agitated to calm) of patients which could be due to dexmedetomidine.

Introduction & Objective: Positioning is an important part of perioperative care that optimal respiratory function is a main purpose. Thus oxygen saturation measurement in routine surgical positions could be a proper index of respiratory function. Material & Methods: To determine effects of supine, prone and litatomy positions on arterial oxygen saturation, 31 healthy volunteer were positioned in each three position for ten minutes periods. Oxygen saturation was measured by pulse oximeter. Results: there was no significant difference between 3 positions in oxygen saturation. Conclusion: Absent of prone and lithotomy positions effect on oxygenation in this study may be attributed to the short time that the subjects were in each position (ten minutes). we suggest that evaluation of position effect on oxygenation require further investigation.  

Introduction: Hypertrophy of the adenoid is a relatively common problem in children that can obstruct upper airway and decrease arterial oxygen pressure and there fore. Causes the risk of obstructive sleep apnea and cardiopulmonary complications.Material and Methods: In 188 patients with symptoms of upper airway obstruction, oxygen saturation was measured using pulse oxymetry, preoperatively. SaO2 was again measured one month after adenoidectomy in those children with preoperative SaO2 less than 95%, using the pulse oximeter.Results: From 188 patients, 102 of them had preoperative SaO2 less than 95% (89-94%). 87 patients of them had postoperative follow up and their SaO2 was above 95% in all of them in two patients (P<0.001).Discussion: Arterial oxygen saturation increase was seen after adenoidectomy. And it seems that SaO2 measurement can be used as a safe and simple way to for assessing the severity of upper airway obstruction in children with adenoid hypeltrophy and also to the result of the operation effects on it.

Introduction: Due to pulmonary involvement, COVID-19 patients experience a decrease in the saturation of peripheral oxygen. These patients perceive a lot of stress and are required to comply with isolation conditions. This study was conducted with the aim of investigating the effect of remote stress management training on the saturation of peripheral oxygen of covid-19 patients. Materials and Methods: In this randomized clinical trial, the research population was all the patients with COVID-19 referred to Gharazi Hospital in Isfahan City in the winter 2021. 70 people were selected by convenience sampling method and divided into two intervention and control groups (35 people) by limited randomization method. For the intervention group, the remote stress management online training program was implemented in five 60-minute sessions over two weeks. The control group did not receive any training. The saturation of peripheral oxygen index was measured before and after training sessions. The data were analyzed using chi-square test, analysis of variance, independent and paired t-test, and analysis of covariance. Results: Mean and standard deviation of the saturation of peripheral oxygen in the pre-test and post-test in the intervention group were 93.83±2.25 and 97.82±1.05, respectively, and in the control group 94.02±2.15 and 95.16±1.99, respectively. Remote stress management training has had a significant effect on the saturation of peripheral oxygen in COVID-19 patients (p=0.001) and increased this index in the intervention group (p<0.05). Conclusion: Remote stress management training can improve the saturation of peripheral oxygen in covid-19 patients. Therefore, this method of training is recommended due to the convenience and possibility of using it in the isolation conditions of these patients.

Background: The present study was conducted to evaluate the cerebral oxygen saturation (rSO2) difference between female and male patients before induction of anesthesia and during anesthesia in neurosurgical procedures. Methods: Atotal of 120 patients scheduled for elective neurosurgeries were enrolled in this prospective cohort study. SpO2, end tidal CO2 (EtCO2), and bilateral frontal rSO2 values were recorded during (1) the baseline (BL), (2) after raising FiO2, (3) after induction of anesthesia (Ind), (4) after tracheal intubation (after intub), (5) before positioning (pre-pos), and (6) after positioning for each patient at 1, 5, 15, 30, and 60 minutes after positioning. Results: A total of 111 patients were included for statistical analysis; of whom 59 were female and 52 were male. The mean age was 45. 2 years for women and 47. 7 years for men. Hemoglobin concentration was statistically lower in female patients. (12. 5  1. 3 vs 13. 6  1. 3, P value < 0. 05). The measured values of rSO2 in every recorded time showed a statistically significant difference in rSO2 values between female and male patients from the baseline (BL) until 60 minutes after positioning. There was not any significant correlation between age and rSO2 (r =-0. 003, P = 0. 997) or BMI and rSO2 (r = 0. 05, P = 0. 965). No significant difference was obtained between right and left side rSO2. Conclusions: This study revealed that even after reducing the confounding role of hemoglobin, measured values of rSO2 were lower in the female group undergoing neurosurgical procedures.