Since the first appearance of the severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) earlier this year, clinicians and researchers alike have been faced with dynamic, daily challenges of recognizing, understanding, and treating the coronavirus disease 2019 (COVID-19) due to SARS-CoV-2. Those who are moderately to severely ill with COVID-19 are likely to develop acute hypoxemic respiratory failure and require administration of supplemental oxygen. Assessing the need to initiate or titrate oxygen therapy is largely dependent on evaluating the patient’s existing blood oxygenation status, either by direct arterial blood sampling or by transcutaneous arterial oxygen saturation monitoring, also referred to as pulse oximetry. While the sampling of arterial blood for measurement of dissolved gases provides a direct measurement, it is technically challenging to obtain, is painful to the patient, and can be time and resource intensive. Pulse oximetry allows for non-invasive, real-time, continuous monitoring of the percent of hemoglobin molecules that are saturated with oxygen, and usually closely predicts the arterial oxygen content. As such, it was particularly concerning when patients with severe COVID-19 requiring endotracheal intubation and mechanical ventilation within one of our intensive care units were observed to have significant discordance between their predicted arterial oxygen content via pulse oximetry and their actual measured oxygen content. We offer these preliminary observations along with our speculative causes as a timely, urgent clinical need. In the setting of a COVID-19 intensive care unit, entering a patient room to obtain a fresh arterial blood gas sample not only takes exponentially longer to do given the time required for donning and doffing of personal protective equipment (PPE), it involves the consumption of already sparce PPE, and it increases the risk of viral exposure to the nurse, physician, or respiratory therapist entering the room to obtain the sample. As such, technology similar to pulse oximetry which can be applied to a patients finger, and then continuously monitored from outside the room is essential in preventing a particularly dangerous situation of unrealized hypoxia in this critically-ill patient population. Additionally, it would appear that conventional two-wavelength pulse oximetry may not accurately predict the arterial oxygen content of blood in these patients. This discordance of oxygenation measurements poses a critical concern in the evaluation and management of the acute hypoxemic respiratory failure seen in patients with COVID-19.

自今年早些时候首次出现严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 以来，临床医生和研究人员都面临着识别、理解和治疗 2019 年冠状病毒病 (COVID- 19) 由于 SARS-CoV-2。中度至重度 COVID-19 患者可能会出现急性低氧性呼吸衰竭，需要补充氧气。评估是否需要启动或滴定氧疗很大程度上取决于评估患者现有的血氧状态，无论是通过直接动脉血采样还是通过经皮动脉血氧饱和度监测，也称为脉搏血氧饱和度。虽然用于测量溶解气体的动脉血采样提供了直接测量，获得它在技术上具有挑战性，对患者来说是痛苦的，并且可能是时间和资源密集型的。脉搏血氧仪允许无创、实时、连续监测氧饱和的血红蛋白分子的百分比，通常可以准确预测动脉氧含量。因此，当我们观察到重症 COVID-19 患者在我们的一个重症监护病房内需要气管插管和机械通气时，他们的预测动脉氧含量之间存在显着差异，这尤其令人担忧 并且通常密切预测动脉氧含量。因此，当我们观察到重症 COVID-19 患者在我们的一个重症监护病房内需要气管插管和机械通气时，他们的预测动脉氧含量之间存在显着差异，这尤其令人担忧 并且通常密切预测动脉氧含量。因此，当我们观察到重症 COVID-19 患者在我们的一个重症监护病房内需要气管插管和机械通气时，他们的预测动脉氧含量之间存在显着差异，这尤其令人担忧通过脉搏血氧仪及其实际测量的氧含量。我们将这些初步观察结果连同我们的推测原因作为及时、紧急的临床需求提供。在 COVID-19 重症监护病房的环境中，考虑到穿脱个人防护设备 (PPE) 所需的时间，进入病房以获取新鲜的动脉血气样本不仅需要成倍增长，而且还涉及消耗已经很少的 PPE，并且增加了进入房间获取样本的护士、医生或呼吸治疗师接触病毒的风险。因此，类似于脉搏血氧仪的技术可以应用于患者的手指，然后在病房外进行持续监测对于防止这一危重患者群体出现特别危险的缺氧情况至关重要。此外，似乎传统的双波长脉搏血氧仪可能无法准确预测这些患者血液中的动脉氧含量。这种氧合测量的不一致对 COVID-19 患者急性低氧性呼吸衰竭的评估和管理造成了严重关注。