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Neonatologie Scan 2025; 14(01): 55-67
DOI: 10.1055/a-2177-6573
CME-Fortbildung

Rotes Licht auf zyanotischer Haut

Grundlagen und Interpretation der Pulsoxymetrie bei Frühgeborenen
Christian A. Maiwald
,
Axel R. Franz
,
Christian E. Schwarz
,
Christian F. Poets
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Die Pulsoxymetrie zur kontinuierlichen Überwachung der arteriellen Sauerstoffsättigung und ggf. Steuerung der Sauerstoffzufuhr ist auf neonatologischen Stationen nicht mehr wegzudenken. Wie bei jeder Medizintechnik gibt es jedoch technische Voraussetzungen für die korrekte Anwendung, und man benötigt Hintergrundwissen für die korrekte Interpretation der Messergebnisse.
Kernaussagen

  • Ohne Puls keine Pulsoxymetrie. Messwerte ohne suffiziente Kreislaufverhältnisse sind ungenau oder sogar falsch.

  • Die Pulsoxymetrie (SpO2) entspricht einer indirekten Messmethode zur vereinfachten Abschätzung des Verhältnisses von oxygeniertem zu Gesamthämoglobin im arteriellen Blut (SaO2).

  • Indirekte Messmethoden beinhalten immer eine etwas höhere Streubreite der Messwerte.

  • SpO2-Werte <70% sind nicht anhand von SaO2-Werten validiert und deshalb noch ungenauer als Werte im Normalbereich.

  • In der Neonatologie sollte niemals unbedacht zusätzlicher Sauerstoff ohne eine pulsoxymetrische Überwachung verabreicht werden.

  • SpO2-Zielbereiche müssen an die entsprechende Messmethode/Technik vor Ort und die Ergebnisse (lokale Mortalität und ROP-Rate) angepasst werden, um gerade bei extrem Frühgeborenen Schaden zu vermeiden.

  • Vorsicht ist bei Änderungen an der SpO2-Messmethode geboten, da sie unbemerkt Auswirkungen auf die verabreichte Menge an Sauerstoff haben können.

  • Eine weitere Verbesserung der Messqualität (weniger Streubreite in den Ergebnissen) ist zu wünschen, führt jedoch per so noch nicht automatisch zu einer besseren Patientenversorgung mit besseren Outcomedaten bei Frühgeborenen. Dafür ist immer noch die fachliche Einschätzung und Abwägung aller einfließenden Informationen in die Therapieentscheidung notwendig.

Schlüsselwörter

Pulsoxymetrie - Frühgeborene - Pulsoximetrie - SpO2


Publication History

Article published online:
25 February 2025

© 2025. Thieme. All rights reserved.

Georg Thieme Verlag KG
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