RESUMO
BACKGROUND: Monitoring oxygen saturation in shocked patients is a challenging nursing procedure. Shock syndrome alters peripheral tissue perfusion and hinders peripheral capillary oxygen saturation (SpO2) measurements. Our study aimed to find a solution to this problem. The pharynx is expected to be an accurate SpO2 measurement site in shocked patients. We clinically evaluated the pharyngeal SpO2 measurements against the arterial oxygen saturation (SaO2) measurements. METHODS: A prospective cohort research design was used. This study included 168 adult shocked patients. They were admitted to five intensive care units from March to December 2020 in an Egyptian hospital. A wrap oximeter sensor was attached to the posterior surface of an oropharyngeal airway (OPA) by adhesive tape. The optical component of the sensor adhered to the pharyngeal surface after the OPA insertion. Simultaneous pharyngeal peripheral capillary oxygen saturation (SpO2) and arterial oxygen saturation (SaO2) measurements were recorded. The pharyngeal SpO2 was clinically evaluated. Also, variables associated with the SpO2 bias were evaluated for their association with the pharyngeal SpO2 bias. RESULTS: The pharyngeal SpO2 bias was - 0.44% with - 1.65 to 0.78% limits of agreement. The precision was 0.62, and the accuracy was 0.05. The sensitivity to detect mild and severe hypoxemia was 100%, while specificity to minimize false alarm of hypoxemia was 100% for mild hypoxemia and 99.4% for severe hypoxemia. None of the studied variables were significantly associated with the pharyngeal SpO2 bias. CONCLUSION: The pharyngeal SpO2 has a clinically acceptable bias, which is less than 0.5% with high precision, which is less than 2%.
RESUMO
OBJECTIVE: This study was designed to evaluate the role of music therapy on the level of stress in children undergoing repair of congenital heart disease. DESIGN: Prospective, randomized, double-blind, controlled clinical trial. SETTING: Children's university hospital. PARTICIPANTS: Fifty children aged 4 to 12 years undergoing repair of congenital heart disease. INTERVENTIONS: Patients were randomized into 2 equal groups (control group and music group); in the control group, patients listened to a blank CD, and in the music group, patients listened to a recorded CD of music and songs preferred by the child. Demographic data, clinical data, and preoperative vital signs were recorded. Baseline stress markers (blood glucose and cortisol levels) were sampled. Patients were assessed intraoperatively until extubation for vital signs and stress markers and after extubation for pain and sedation scales. An interview was conducted within the first postoperative week with the patients and their parents for assessment of post-traumatic stress disorder and negative postoperative behavior changes. MEASUREMENTS AND MAIN RESULTS: There were no significant differences in demographic characteristics, clinical data, vital signs, preoperative and at-extubation blood glucose levels, and preoperative blood cortisol levels between groups. Significant differences were found between groups in blood glucose levels and cortisol levels at all intraoperative times, but only in cortisol blood levels at extubation. Significant differences were found in pain score, sedation score, occurrence of child post-traumatic stress disorder, and occurrence of negative postoperative behavior. CONCLUSION: Listening to favorable music by children undergoing repair for congenital heart disease resulted in less stress and more relaxation.