Chikoro cheHutano Sayenzi uye Welfare, Helen McArdle Institute of Nursing and Nursing, University of Sunderland, Sunderland, UK.
Nicholas Harland, Chikoro cheUtano Sainzi uye Welfare, Helen McArdle Institute of Nursing and Nursing, University of Sunderland City Campus, Chester Road, Sunderland SR1 3SD, UK.
Chikoro cheHutano Sayenzi uye Welfare, Helen McArdle Institute of Nursing and Nursing, University of Sunderland, Sunderland, UK.
Nicholas Harland, Chikoro cheUtano Sainzi uye Welfare, Helen McArdle Institute of Nursing and Nursing, University of Sunderland City Campus, Chester Road, Sunderland SR1 3SD, UK.
Shandisa chinongedzo chiri pazasi kugovera yakazara chinyorwa chinyorwa chechinyorwa ichi neshamwari dzako uye vaunoshanda navo.Dzidza zvimwe.
Iyo COVID-19 Oximetry@Home sevhisi yakavhurwa munyika yese.Izvi zvinobvumira varwere vane njodzi yakanyanya vane hunyoro hweCCIDID-19 zviratidzo kuti vagare pamba uye vawane pulse oximeter yekuyera mweya yavo yeokisijeni (SpO2) kaviri kusvika katatu pazuva kwemavhiki maviri.Varwere vanorekodha kuverenga kwavo nemaoko kana nemagetsi uye vanotariswa neboka rekiriniki.Sarudzo yekiriniki yekushandisa algorithm yakavakirwa paSpO2 kuverenga mukati meiyo nhete, uko 1-2 poindi shanduko inogona kukanganisa kutarisira.Muchinyorwa chino, takakurukura zvinhu zvakawanda zvinokanganisa kuverenga kweSpO2, uye vamwe vanhu "vakajairwa" vachave ne "yakaderera yakajairwa" mamakirwo ekiriniki manejimendi pasina matambudziko anozivikanwa ekufema.Takakurukura nezvekuoma kwedambudziko iri zvichienderana nemabhuku akakodzera, uye takafunga kuti izvi zvingakanganisa sei kushandiswa kweOximetry@home service, iyo inogona kukanganisa chinangwa chayo;kuderedza kurapwa kwakatarisana.
Kune akawanda mabhenefiti ekugadzirisa mashoma akaomarara eCCIDID-19 kesi munharaunda, kunyangwe izvi zvinorambidza kushandiswa kwemidziyo yekurapa senge thermometers, stethoscopes, uye pulse oximeters panguva yekuongorora.Nekudaro, sezvo chiyero chemurwere pulse oximetry kumba chinobatsira mukudzivirira kushanya kwedhipatimendi rekukurumidzira (Torjesen, 2020) uye nekuzivikanwa kweasymptomatic hypoxia, zvisinei, NHS England inokurudzira kuti nyika yese Ipise iyo "Spo2 Measurement@Home" sevhisi (NHSE , 2020a)) Kune varwere vane hunyoro hweCCIDID-19 zviratidzo asi njodzi yakanyanya yekuderera kwechirwere, pulse oximeter inogona kushandiswa kwemazuva gumi nemana ekurapwa, kuitira kuti 2-3 nguva pazuva Kuzviongorora kweiyo oxygen saturation (SpO2) .
Varwere vanotaurwa kuOximetry@Home sevhisi vanowanzo rairwa kushandisa app kana bepa diary kurekodha zvavakaona.Iyo app inogona kupa otomatiki mhinduro / kurudziro, kana chiremba anotarisisa data.Kana zvichidikanwa, murapi anogona kubata murwere, asi kazhinji chete panguva dzenguva dzekushanda.Varwere vanoudzwa nzira yekududzira mhedzisiro yavo kuitira kuti vagone kuzvimiririra pazvinenge zvichidikanwa, sekutsvaga rubatsiro rwechimbichimbi.Nekuda kwenjodzi yakanyanya yekuwedzera chirwere ichi, vanhu vanopfuura makore makumi matanhatu neshanu uye / kana vane akawanda comorbidities anotsanangurwa seanonetseka zvakanyanya vari kuve chinangwa cheiyi nzira (NHSE, 2020a).
Ongororo yevarwere muOximetry@Home sevhisi ndeyekutanga kuyera mweya yavo yeokisijeni kuburikidza nepulse oximeter SpO2, uyezve kufunga zvimwe zviratidzo nezviratidzo.Uchishandisa dzvuku, amber, uye girini (RAG) ratings, kana SpO2 yemurwere iri 92% kana pasi, murwere anoiswa mutsvuku, uye kana SpO2 yavo iri 93% kana 94%, inoiswa seamber, kana SpO2 yavo. iri 95% kana kupfuura, ivo vanoiswa segirini.Kazhinji, varwere vegirini chete ndivo vanokodzera kushandisa Oximetry@Home (NHSE, 2020b).Nekudaro, zvakasiyana-siyana zvisina-chirwere-zvine chekuita nechirwere zvinogona kukanganisa iyo SpO2 mamakisi, uye izvi zvinhu zvinogona kusatariswa munzira.Muchinyorwa chino, takakurukura zvakasiyana siyana zvinokanganisa SpO2 izvo zvinogona kukanganisa varwere kuwana Oximetry@Home masevhisi.Izvi zvinhu zvinogona kuvhiringa chinangwa chayo chekudzikisa kumanikidzwa kwemabasa ekurapa akatarisana.
Nhamba inogamuchirwa ye "yakajairika" yeropa oxygen saturation yakayerwa nepulse oximeter (SpO2) i95% -99%.Kunyangwe kuvepo kwemagwaro akadai seWorld Health Organisation Pulse Oximetry Training Manual (WHO, 2011), chirevo ichi chiripo pose zvekuti zvinyorwa zvekurapa hazviwanzozvitaura.Paunenge uchitsvaga data regulatory paSpO2 muvanhu vasiri vekurapa, ruzivo rudiki runowanikwa.Muchidzidzo chevanhu 791 vane makore makumi matanhatu nemashanu zvichikwira (Rodríguez-Molinero et al., 2013), mushure mekufunga zvakasiyana seCOPD, avhareji 5% SpO2 mamakisi yaive 92%, zvichiratidza kuyerwa kwe5% Kuzadzwa kweokisijeni yeropa rehuwandu. yakaderera zvikuru pane iyoyo pasina tsananguro ipi neipi inozivikanwa yezvokurapa.Mune imwe ongororo ye458 vanhu vane makore 40-79 (Enright & Sherrill, 1998), iyo oxygen saturation range isati yaitwa 6-mineti yekufamba bvunzo yaive 92% -98% mu5th percentile, uye mu95th percentile.Yekutanga percentile i93% -99% percentile.Zvidzidzo zviviri izvi hazvina kunyora maitiro akashandiswa kuyera SpO2 zvakadzama.
Ongororo yehuwandu hwevanhu zviuru zvishanu nemazana mashanu nevaviri muNorway (Vold et al., 2015) yakawana kuti 11.5% yevanhu vaive neSpO2 pazasi kana yakaenzana ne95% yakaderera kana yakaderera muganho wezvakajairwa.Muchidzidzo ichi, vanhu vashoma chete vane yakaderera SpO2 vanonzi vane asima (18%) kana COPD (13%), nepo ruzhinji rwevanhu vane nhamba yakakosha BMI vakapfuura makumi maviri neshanu (77%) uye vaive vakakura Vamwe vane makore makumi manomwe kana vakuru (46%).MuUnited Kingdom, 24.4% yenyaya dzakaongororwa COVID-19 pakati paMay naNyamavhuvhu 2020 dzaive makore makumi matanhatu kana kupfuura, uye 15% vaive nemakore makumi manomwe kana kupfuura[8] (Ministry of Health and Social Care, 2020).Kunyange zvazvo chidzidzo cheNorway chinoratidza kuti 11.5% yevanhu chero ipi zvayo inogona kuva neSpO2 yakaderera, uye zvizhinji zvezviitiko izvi hazvizivikanwi chirwere chekufema, zvinyorwa zvinoratidza kuti panogona kunge kune "mamiriyoni" eCOPD isina kuongororwa (Bakerly & Cardwell, 2016) Uye zvichida. mitengo yakakwira yeasina kuwanikwa kufutisa hypoventilation syndromes (Masa et al., 2019).Chikamu chakakosha chezvisingatsananguriki "zvishoma zvakajairika" zvibodzwa zveSpO2 zvinowanikwa muzvidzidzo zvehuwandu zvinogona kunge zvine chirwere chekufema chisina kuwanikwa.
Pamusoro pekusiyana kwese, zvimwe zvinhu zveprotocol inoshandiswa kuyera SpO2 zvinogona kukanganisa mhedzisiro.Pane mutsauko wakakosha pakati peyero yakatorwa pakuzorora uye kuyerwa kwakatorwa wakagara (Ceylan et al., 2015).Uye zvakare, pamwe nezera uye kufutisa zvinhu, SpO2 inogona kuderera mukati me5-15 maminetsi ekuzorora (Mehta naParmar, 2017), kunyanya panguva yekufungisisa (Bernardi et al., 2017).Tembiricha yemakumbo ine chekuita neambient tembiricha inogona zvakare kuve nenhamba yakakosha mhedzisiro (Khan et al., 2015), sekushushikana, uye kuvapo kwekushushikana kunogona kuderedza zvibodzwa neicho chizere (Ardaa et al., 2020).Pakupedzisira, zvinonyatsozivikanwa kuti kukanganisa kwakajairwa kwe pulse oximeter kuyerwa ndeye ± 2% kana ichienzaniswa neyakawiriraniswa arterial blood gas kuyerwa SaO2 (American Thoracic Society, 2018), asi kubva pakuona kwekiriniki, kubva pakuona kunoshanda, nekuti Hapana nzira yekutora mutsauko uyu muakaunti, inofanirwa kuyerwa uye kuitwa pane yakasarudzika.
Shanduko muSpO2 nekufamba kwenguva uye kuyerwa kwakadzokororwa ndeimwe dambudziko, uye kune ruzivo rushoma pamusoro peizvi mune vasiri vekurapa.Saizi diki yemuenzaniso (n = 36) chidzidzo chakaongorora shanduko yeSpO2 mukati meawa imwe [16] (Bhogal & Mani, 2017), asi haina kuzivisa kusiyanisa panguva yekuyerwa kwakadzokororwa kwemavhiki akati wandei, sezviri muOximetry@ Munguva yeKumba.
Munguva yemazuva gumi nemana yeOximetry@Home monitoring nguva, SpO2 yakayerwa katatu pazuva, izvo zvinogona kuwanda kune varwere vanonetsekana, uye zviyero makumi mana nemaviri zvinogona kutorwa.Kunyangwe tichifunga kuti iyo imwechete yekuyera protocol inoshandiswa mune imwe neimwe uye mamiriro ekiriniki akadzikama, pane chikonzero chekutenda kuti pane imwe mutsauko mune izvi zviyero.Zvidzidzo zvevanhu vachishandisa chiyero chimwe chete zvinoratidza kuti 11.5% yevanhu vanogona kunge vane SpO2 ye95% kana pasi.Nekufamba kwenguva, nekufamba kwenguva, mukana wekuwana kuverenga kwakaderera panguva yekudzokororwa kuyerwa kunoitika nekufamba kwenguva COVID -19 zano rinogona kunge rakakwira kupfuura 11.5%.
Iyo algorithm kuseri kweOximetry@Home sevhisi inoratidza kuti mibairo isina kunaka inobatanidzwa neakaderera SpO2 zvibodzwa [17] (Shah et al., 2020);avo vane SpO2 inowira ku93% kusvika 94% vanofanira kuongororwa chiso nechiso uye kutariswa kuti vapiwe, 92% Uye pasi vanofanira kuwana rubatsiro rwekukurumidzira rwechipiri.Nekuitwa kweOximetry@Home sevhisi munyika yese, yakadzokororwa SpO2 zviyero zvinotorwa nevarwere kumba zvinova chinhu chakakosha pakutsanangura mamiriro avo ekiriniki.
SpO2 kuyerwa kunowanzoitwa mukati menguva pfupi yenguva kana oximeter yaiswa.Murwere anogara pasina kuzorora kwenguva yakati.Kufamba kubva panzvimbo yekumirira kuenda kunzvimbo yekiriniki kuchavhiringidza muviri zvakasara.Nekushandiswa kweiyo Oximetry@Home sevhisi, iyo NHS YouTube vhidhiyo (2020) yakaburitswa.Vhidhiyo inokurudzira kuti varwere vanotora zviyero kumba varare pasi kwemaminitsi mashanu, voisa oximeter, uye vobva vawana kuverenga kwakagadzikana 1 miniti mushure mekuiswa.Vhidhiyo iyi yekubatanidza yakatenderedzwa kuburikidza neramangwana NHS yekubatana kwepuratifomu peji ine chekuita nemunhu arikumisikidza Oximetry@Home sevhisi, asi hazviratidzike kuratidza kuti izvi zvinogona kupa zvishoma kuverenga zvichienzaniswa nekuverenga kwakatorwa agere.Zvakakosha kucherechedza kuti imwe vhidhiyo yedzidzo yehutano yeNHS muEngland mubepanhau reDaily Mail inokurudzira protocol yakasiyana zvachose, inoverengerwa wakagara (Daily Mail, 2020).
Mumunhu asingazivikanwe kazhinji, zvibodzwa zvakaderera zve95%, kunyangwe kudonha kwepoindi imwe nekuda kwehutachiona hweCCIDID-19 kunogona kukonzera muyero weAmber, zvichitungamira mukutarisirwa kwekiriniki.Izvo zvisina kujeka ndezvekuti imwe pfungwa yekudzikira ichaita kuti kurapwa kwakananga kwekiriniki kuve kushandiswa kwakanaka kwezviwanikwa pakati pevanhu vane yakaderera pre-morbid zvibodzwa.
Kunyangwe iyo algorithm yenyika inotaurawo nezvekudonha kweSpO2, sezvo ruzhinji rwemakesi asina kunyora pre-chirwere SpO2 mamakisi, chinhu ichi hachigone kuongororwa kusati kwambodonha kwekutanga kunokonzerwa nehutachiona hwakakonzera kuongororwa kweSpO2.Kubva pamaonero ekuita sarudzo, hazvizivikanwe nekiriniki kana mwero wakakwana wekuzadza/perfusion pamunhu paagere unofanirwa kushandiswa sehwaro hwekuchengetwa kwematishu, kana kuti iyo yakaderedzwa saturation/perfusion level kana wakarara mushure mekuzorora unofanirwa kushandiswa se baseline.Pari kuita sepasina gwara rakatenderanwa nenyika panyaya iyi.
SpO2% inomanikidza inowanikwa pachena paramende yekuongorora COVID-19.NHS England yakatenga 370,000 oximeters kuti ishandiswe nevarwere vakawanda kuti iendeswe kumasevhisi.
Izvo zvinhu zvinotsanangurwa zvinogona kukonzera akawanda single-point SpO2 kuyerwa kwekuchinja, kukonzeresa kutarisana nemurwere kuongororwa mukutarisira kwekutanga kana madhipatimendi ekukurumidzira.Nokufamba kwenguva, zviuru zvevarwere munharaunda vanogona kutariswa kweSpO2, izvo zvinogona kutungamirira kunhamba huru yezvisingakoshi zvekutarisana nekutarisana.Kana iko kukanganiswa kwezvinhu zvinokanganisa kuverenga kweSpO2 muCCIDID-19 kesi kunoongororwa uye kuiswa mumamiriro ehuwandu-yakavakirwa kiriniki uye zviyero zvemhuri, kukanganisa kwacho kwakakosha zvakanyanya, kunyanya kune avo "vakapotsa mamirioni" Iyo yakakosha SpO2 inowanzoitika.Pamusoro pezvo, iyo Oximetry@Home sevhisi inonyanya kusarudza vanhu vane chibodzwa chekucheka nekunanga vanhu vanopfuura makore makumi matanhatu neshanu uye avo vanogona kunge vaine BMI yepamusoro yakabatana necomorbidities.Ongororo dzakaratidza kuti “yakaderera” huwandu hwevanhu huchaita ingangoita 11.5% yevanhu vese, asi nekuda kwesarudzo yeOximetry@Home service, chikamu ichi chinoita sechakakwira zvakanyanya.
Sezvo zvinhu zvakanyorwa kuti zvinopesvedzera zvibodzwa zveSpO2 zviri kubasa, varwere vane zvibodzwa zvakaderera, kunyanya avo vane 95% zvibodzwa, vanogona kufamba pakati pegirinhi neamber ratings kakawanda.Chiito ichi chinogona kutoitika pakati peyero yekiriniki yekudzidzira kuyerwa kana kutumirwa kuOximetry@Home uye kuyerwa kwekutanga apo murwere anoshandisa 6-miniti yakarara pasi protocol kumba.Kana murwere achinzwa kusanzwa zvakanaka, kushushikana panguva yekuyerwa kunogonawo kuderedza avo vane kucheka-kubvisa mamakisi pazasi 95% uye kutsvaga kutarisirwa.Izvi zvinogona kukonzera kuwanda kusingakoshi kutarisisa chiso nechiso, kuisa imwe dzvinyiriro pamasevhisi asvika kana kupfuura kugona.
Kunyangwe kunze kweiyo yakatumwa Oximetry@Home nzira uye zvekurapa izvo zvinopa varwere maoximeters, mishumo yenhau pamusoro pekubatsira kwepulse oximeter yakapararira, uye hazvizivikanwe kuti vangani vanhu vangave vane pulse oximeter mukupindura COVID -19 denda, kunyangwe kune vatengesi vakawanda vakasiyana vanopa michina yakachipa uye mishumo yemidziyo yakatengeswa kunze (CNN, 2020), nhamba iyi inogona kunge inosvika mazana ezviuru.Zvinhu zvinotsanangurwa munyaya ino zvinogonawo kukanganisa vanhu ava uye kuisa imwe dzvinyiriro pabasa.
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Nguva yekutumira: Jul-15-2021