1998 OPEN FORUM Abstracts
THE IMPACT OF OXIMETRY ON CARDIOPULMONARY PROFILE AND ARTERIAL BLOOD GAS UTILIZATION
H. Lody Page RRT, BA, V. Harter RRT, BA, J.L. Smith, MD, Pulmonary and Critical Care Medicine, Penn State Geisinger Medical Center, Danville, PA
Background: Titration and monitoring of therapy of critically ill patients requires frequent sampling of arterial and mixed venous blood as well as measurements of intravascular pressures and thermodilution cardiac output. Repetition of these tests is both expensive and laborious but justified to maintain appropriate oxygenation, ventilation, and oxygen delivery. Oximetry is proposed as a practical alternative to serial analysis of arterial and mixed venous blood gas analyses in critically ill patients. However, questions remain concerning the impact of oximetric technology on patient care.
Methods: We retrospectively reviewed oximetric usage in an adult medical-surgical ICU over a 13 year period (1983-1996). Total admissions and total arterial blood gases (ABG), pulmonary artery (PA) catheters, cardiopulmonary profiles (CPP), cardiac outputs(CO), and cutaneous pulse oximeters (CPO) utilized over this period were numerated. The number of PA catheters inserted was standardized as total number of PA catheters/total admissions. The number of CPP performed per PA catheter was standardized as total number of CPP/total PA catheters inserted. The number of ABGs was standardized as number of ABGs/total admissions. The number of CPO (ear and finger) utilized was standardized as total number of patients using ear/finger oximeters per day/total admissions. Plots of standardized rates per year were made.
Results: The use of oximetric pulmonary artery catheters steadily increased while the number of cardiopulmonary profiles performed per catheter decreased (Fig. 1). Similarly, use of cutaneous pulse oximetry increased and utilization of serial arterial blood gas analysis declined (Fig. 2). APACHE II scores did not significantly change from 1983-1996.
Conclusion: Oximetric technology can reduce the need for time and labor intensive cardiopulmonary profiles and arterial blood gas analysis without adversely affecting patient outcome.
(See original for figure)
The 44th International Respiratory Congress Abstracts-On-Disk®, November 7 - 10, 1998, Atlanta, Georgia.