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: 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 & 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.

Background: Cirrhosis, as the end stage of a variety of chronic liver diseases, can affect OXYGENation in patients and make them hypoxic through hepatopulmonary syndrome or portopulmonary hypertension. However, we observed that some patients referring to our center for liver transplantation had high arterial OXYGEN SATURATION. Objectives: This study was designed to investigate the presence and association of hemoglobin overSATURATION in cirrhotic patients candidate for liver transplantation. Methods: In a cross-sectional study, cirrhotic patients referring to Shiraz Organ Transplantation Center were included from 2013 to 2015. The exclusion criteria were other disorders that might affect O2 SATURATION and other causes of liver transplantation except for cirrhosis. Also, we excluded all patients with chest X-ray abnormality. Hemoglobin SATURATION was measured by arterial blood gas analysis. Patients were divided into two groups, oversaturated patients (Hb sat O2  98%) as the case group and patients with Hb sat O2 < 98% as the control group. We compared the case and control groups for the cause of cirrhosis, sex, smoking status, age, spirometry, model for end-stage liver disease (MELD) score, and the place of residence’ s altitude. After univariate analysis, logistic regression models were used for multivariate analysis and adjusted for significant and near significant (P value < 0. 2) covariates. Results: Of 495 patients, 18. 6% were oversaturated. Moreover, 64. 5% of the control group patients were males versus 58. 7% of the case group. Themeanage of the control group (40. 6 14. 7) was significantly higher than that of the case group (36. 8 15. 7) in univariate analysis (P value = 0. 02). Hemoglobin overSATURATION was significantly higher in patients with auto-immune hepatitis (AIH) than in patients with other causes of cirrhosis (P value = 0. 001). There was no significant difference between the case and control groups in other causes of cirrhosis or other factors. In multivariate analysis, just AIH remained statistically significant in the models (odds ratio = 2. 03; 95% confidence interval = 1. 13-3. 65; P value = 0. 01). After finding an association between AIH and overSATURATION, the drugs routinely used for the treatment of AIH were compared between the case and control groups. No significant difference was found between them in using prednisone, azathioprine, and cyclosporine (P values = 0. 5, 0. 6, and 0. 6, respectively). Conclusions: Based on our research, there was an association between overSATURATION in cirrhotic patients and AIH. The association was not related to the drugs used for the treatment of AIH.

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.

Introduction: OXYGEN therapy used for preterm infant disease might be associated with OXYGEN toxicity or oxidative stress. The exact OXYGEN concentration to control and maintain the arterial OXYGEN SATURATION balance is not certainly clear. We aimed to compare the efficacy of higher or lower OXYGEN SATURATIONs on the development of severe retinopathy of prematurity which is a major cause of blindness in preterm neonates.Methods: PubMed was searched for obtaining the relevant articles. A total of seven articles were included after studying the titles, abstracts, and the full text of retrieved articles at initial search. Inclusion criteria were all the English language human clinical randomized controlled trials with no time limitation, which studied the efficacy of low versus high OXYGEN SATURATION measured by pulse oximetry in preterm infants.Result: It can be suggested that lower limits of OXYGEN SATURATIONs have higher efficacy at postmesetural age of£28 weeks in preterm neonates. This relation has been demonstrated in five large clinical trials including three Boost trials, COT, and Support.Discussion: Applying higher concentrations of OXYGEN supplementations at mesentural age ≥32 weeks reduced the development of retinopathy of prematurity. Lower concentrations of OXYGEN SATURATION decreased the incidence and the development of retinopathy of prematurity in preterm neonates while applied soon after the birth.Conclusions: Targeting levels of OXYGEN SATURATION in the low or high range should be performed cautiously with attention to the postmesentural age in preterm infants at the time of starting the procedures.

Introduction: Neural based tests responses have some limitations. In these years pulse oximetry has used to measure OXYGEN SATURATION of pulpal blood circulation. Due to thickness of dental pulp, it is blood OXYGEN SATURATION may be lower than peripheral blood. This study has compared the difference of blood OXYGEN SATURATION in anterior dental pulp with peripheral blood using ear pulse oximetry probe.Method and Materials: We selected 100 healthy persons with the age of 24–34 years with normal anterior teeth. Then OXYGEN SATURATION of anterior, superior and inferior teeth and ear was measured with pulse oximetry with ear probe. Data was analyzed with independent sample test and t-paired test using SPSS software.Results: Mean OXYGEN SATURATION in ear was 98.5% (± 1.5), and 92.38 (± 3.3) in 400 selected teeth. According to t-paired test, there was no significant difference between OXYGEN SATURATION in ear and teeth. There was no significant difference of OXYGEN SATURATION between different teeth.Conclusion: In our study OXYGEN SATURATION was above 90%. As in non vital pulp OXYGEN SATURATION is zero, this point can help dentists for correct diagnosis in pulp vitality. OXYGEN SATURATION in teeth was lower than peripheral blood.

Mouth breathing might not always result in hypoxia, but can contribute to it. The aim of the present study was to determine the effect of mouth breathing on hypoxia. Based on a pilot study, 323 patients with mouth breathing were selected. Assessment of mouth breathing was based on clinical examination and questionnaires filled out by patients and their companions. The patients were also examined for further oral findings that could be attributable to mouth breathing. OXYGEN SATURATION of each case was measured by means of a pulse oximetry device. The level of 95% SATURATION was set as the limit, under which the patient was considered hypoxemic. Acquired data was analyzed for descriptive data and frequency and also by means of the Chi-square and Spearman’s correlation coefficient tests. 34.6% of the cases had normal O2 SATURATION. 65.4% of cases were hypoxemic (SATURATION level was below 95% in 42.8% and 95% in 22.6%). Most of the mouth breathing patients were male who were also more hypoxemic. A weak inverse relationship existed between the age of the patients and OXYGEN SATURATION. Deep palatal vaults (29.4%) and gingival hyperplasia (29.2%) were the most frequent intraoral findings. Concerning the effects of hypoxia on body systems, the use of pulse oximetry in suspected mouth breathing patients could be recommended in routine oral and dental examinations.