Zusammenfassung
Die im arteriellen Blut vorhandene Sauerstoffmenge kann mittels Messung der Sättigung (SaO2, in %) oder des Partialdrucks (paO2, in mm Hg oder kPa) von Sauerstoff erfasst werden. Zur Charakterisierung des Schweregrades einer Hypoxämie (SaO2 < 90 %, paO2 < 60 mm Hg) wird in der Notfallmedizin die einfacher, nämlich pulsoximetrisch messbare SpO2 der Blutgasanalyse vorgezogen, zumal die Sauerstoffbindungskurve für die dort häufig anzutreffenden SO2-Werte zwischen 40 und 90 % eine nahezu lineare Beziehung zum paO2 ergibt. Für die Detektion und Differenzierung von Störungen des respiratorischen Gasaustausches sowie zur Indikationsstellung und Verlaufskontrolle einer Langzeitsauerstofftherapie ist hingegen die Blutgasanalyse unerlässlich. Die Behandlung mit O2 sollte in einem für das Krankheitsbild und den Patienten festgelegten Zielkorridor von SaO2- bzw. paO2-Werten erfolgen, um unerwünschte Effekte einer Hypoxämie, aber auch einer Hyperoxämie zu vermeiden.
Abstract
The amount of oxygen (O2) in arterial blood can be assessed by measurement of oxygen saturation (SaO2, in %) or oxygen partial pressure (PaO2, in mm Hg or kPa). To characterize the severity of hypoxemia (SaO2 < 90%, PaO2 < 60 mm Hg) in emergency cases the easy measurement of SO2 by pulse oximetry (SpO2) is preferred to blood gas analysis, which appears to be justified due to the linear relationship between SaO2 and PaO2 for SaO2 values between 40 and 90% on the O2 dissociation curve. The more sensitive PaO2 measured in blood gas analysis has to be used for the detection and analysis of mild disturbances of respiratory gas exchange as well as for the indications and follow-up of long-term oxygen therapy. The treatment with O2 should be carried out within a target corridor for SaO2 or PaO2 predetermined for the disease and the patient in order to avoid the undesired effects of hypoxemia and hyperoxemia.
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J. Gottlieb, Hannover
H. Worth, Fürth
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Worth, H. Messen und Bewerten von Störungen der Oxygenation. Pneumologe 19, 3–9 (2022). https://doi.org/10.1007/s10405-021-00423-z
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DOI: https://doi.org/10.1007/s10405-021-00423-z