{"id":3316,"date":"2023-03-03T09:04:45","date_gmt":"2023-03-03T09:04:45","guid":{"rendered":"https:\/\/oxyone.it\/2023\/03\/03\/precision-des-debitmetres-medicaux-doxygene-une-etude-multicentrique-sur-le-terrain\/"},"modified":"2025-12-18T11:10:14","modified_gmt":"2025-12-18T11:10:14","slug":"precision-des-debitmetres-medicaux-doxygene-une-etude-multicentrique-sur-le-terrain","status":"publish","type":"post","link":"https:\/\/oxyone.it\/fr\/precision-des-debitmetres-medicaux-doxygene-une-etude-multicentrique-sur-le-terrain\/","title":{"rendered":"Precision of medical oxygen measurements: a multicentre test on the terrain<\/font><\/font>"},"content":{"rendered":"\n
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\n \n Pr\u00e9cision des d\u00e9bitm\u00e8tres m\u00e9dicaux : une \u00e9tude multicentrique sur le terrain <\/span>\n\n \n \n <\/span>\n <\/h1>\n<\/div>\n\n <\/div>\n <\/div>\n <\/div>\n
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The precision of 476 oxygen (Precision of medical oxygen measurements) test meters has been analyzed with the aid of a massive thermal test in domestic homes in France and Belgium. Differing oxygen intakes (2 to 15 l\/min) in the patient’s chest have been evaluated. If you consider the \u00e9chantillon in its ensemble, the precision of the d\u00e9bit d\u00e9livr\u00e9 is acceptable, but the precision is mediocre. The variability of the debt delivered between the devices is the greatest where a feasible debt is required. Les d\u00e9bitmetres de oxygene \u00e0 pression \u00e0 compens\u00e9e pour ces faibles d\u00e9bits se sont r\u00e9v\u00e9l\u00e9s r\u00e9cis\u00e9s r\u00e9cis\u00e9s que leurs homologues non compens\u00e9s. This souligne studies the need to individually adapt the oxygen debt so that the patient must pass from one debt to the other.<\/span><\/span><\/p>\n

In Europe, the precision of the measurement devices connected to the wall-mounted medical gas distribution systems is regulated by the ISO 15002 norms. less than 5 l\/min, and more than 10% above that. The conditions in the settings to be evaluated are very standard: temperature of 23\u00b0C (\u00b1 2\u00b0C) and atmospheric pressure of 1013 hPa.<\/span><\/span><\/em><\/p> <\/div>\n<\/div>\n <\/div>\n

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Precision of medical oxygen measurements is regularly administered in the products of chronic and chronic patients. In 2008, 18% of patients hospitalized in Grande-Bretagne receive daily oxygen [1]. Le d\u00e9bit d’oxyg\u00e8ne appropriated various considerablement d’une situation \u00e0 l’autre. Les patients dont les \u00e9changes gazeux sont gravement alt\u00e9r\u00e9s peuvent avoir besoin d’une strong concentration d’oxyg\u00e8ne \u00e0 l’inspiration. In this case, to generally use a non-respiratory mask (or reservoir mask), you need an oxygen intake of just 12-15 l\/min [2]. For other patients, an oxygen intake of between 2 and 10 l\/min, via a nasal ponction or a simple mask, is generally sufficient to ensure adequate oxygenation [2] . Cependant, l’oxyg\u00e9noth\u00e9rapie peut \u00eatre d\u00e9l\u00e9t\u00e8re. They are used concomitantly with bl\u00e9omycine [3] or paraquat (1,1 dim\u00e9thyl 4,4′ bipyridyl) to cause irreversible pulmonary fibrosis leading to death [4] . High inspiratory oxygen fractions are associated with premature fibroplasia [5] or atlectasia for d\u00e9nitrog\u00e9nation of oxygen [6] . R\u00e9cemment, certain authors ont \u00e9galement montr\u00e9 that hyperoxie can induce a cerebral and myocardial vasoconstriction potentially harmful to ischemic diseases [7]. An objective reason for oxygen therapy is that atteindre a saturation of h\u00e9moglobine (SpO2) comprises between 94 and 98% [2].<\/span><\/span><\/p>\n

It is estimated that 2000 to 4000 days of oxygen consumption are most likely [1]. The precision of the oxygen flow administration system is therefore important.<\/span><\/span><\/p> <\/div>\n<\/div>\n <\/div>\n <\/div>\n <\/div>\n

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\n \n Le studio <\/span>\n\n \n \n <\/span>\n <\/h1>\n<\/div>\n\n <\/div>\n <\/div>\n <\/div>\n
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Cette \u00e9tude de terrain a \u00e9t\u00e9 men\u00e9e dans 8 h\u00f4pitaux (nombre de lits > 250). Les d\u00e9bitm\u00e8tres d’oxyg\u00e8ne (TT) avec tube de Thorpe (plage : 0 \u00e0 15 l\/min) ont \u00e9t\u00e9 \u00e9tudi\u00e9s dans les unit\u00e9s pour adultes o\u00f9 l’oxyg\u00e8ne est fr\u00e9quemment administr\u00e9 (unit\u00e9 de soins intensifs, unit\u00e9 d’urgence, unit\u00e9 respiratoire, cardiologie, chirurgie) [1] . Le TT \u00e9valu\u00e9 \u00e9tait celui utilis\u00e9 en routine dans ces services et attribu\u00e9 au patient suivant n\u00e9cessitant une oxyg\u00e9noth\u00e9rapie.<\/p>\n

Tout d’abord, la pression dans la canalisation locale a \u00e9t\u00e9 v\u00e9rifi\u00e9e. Le TT a ensuite \u00e9t\u00e9 branch\u00e9 sur la prise d’une pi\u00e8ce inoccup\u00e9e et positionn\u00e9 verticalement comme l’aurait fait une infirmi\u00e8re. Diff\u00e9rents d\u00e9bits de gaz (2 \u00e0 15 l\/min) ont \u00e9t\u00e9 \u00e9valu\u00e9s dans un ordre al\u00e9atoire. Le d\u00e9bit a \u00e9t\u00e9 r\u00e9gl\u00e9 en alignant le centre de la boule du flotteur avec la ligne indicatrice de d\u00e9bit appropri\u00e9e (valeur nominale) [10]. Chaque d\u00e9bit a \u00e9t\u00e9 mesur\u00e9 deux fois et la moyenne a \u00e9t\u00e9 calcul\u00e9e pour chaque TT. Tous les r\u00e9glages et mesures ont \u00e9t\u00e9 effectu\u00e9s par la m\u00eame personne.<\/p>\n

Un soin particulier a \u00e9t\u00e9 apport\u00e9 pour \u00e9viter les erreurs de parallaxe. Les d\u00e9bits d’oxyg\u00e8ne ont \u00e9t\u00e9 mesur\u00e9s \u00e0 l’aide d’un d\u00e9bitm\u00e8tre massique thermique calibr\u00e9. <\/p>\n

Le d\u00e9bit d’oxyg\u00e8ne a \u00e9t\u00e9 mesur\u00e9 apr\u00e8s avoir stabilis\u00e9 la lecture pendant 5 secondes. Plusieurs types de TT ont \u00e9t\u00e9 constat\u00e9s lors de nos \u00e9valuations. Ils ont \u00e9t\u00e9 class\u00e9s en deux groupes selon qu’ils \u00e9taient compens\u00e9s en pression (PCTT : Timeter\u2122, Caudalimeter\u2122, RTM3\u2122, RTM2\u2122, Taema\u2122) ou non (NPCTT : Non-Pressure Compensated Thorpe Tube).<\/p> <\/div>\n<\/div>\n\n

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\n \n R\u00e9sultats <\/span>\n\n \n \n <\/span>\n <\/h1>\n<\/div>\n\n <\/div>\n <\/div>\n <\/div>\n
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476 d\u00e9bitm\u00e8tres d’oxyg\u00e8ne ont \u00e9t\u00e9 analys\u00e9s dans 8 h\u00f4pitaux (3 en France, 5 en Belgique) pour un total de 13 328 mesures et 12 marques diff\u00e9rentes de TT ont \u00e9t\u00e9 trouv\u00e9es (Tableau 1). En France comme en Belgique, le TT \u00e0 pression compens\u00e9e repr\u00e9sentait la majorit\u00e9 des rotam\u00e8tres (70 % et 66 % respectivement). En moyenne, le d\u00e9bit d\u00e9livr\u00e9 correspondait \u00e0 la valeur nominale (VN) avec une valeur m\u00e9diane allant de 94% \u00e0 100% de la VN selon le d\u00e9bit consid\u00e9r\u00e9.<\/p>\n

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En moyenne, 35 % \u00b1 7 % des d\u00e9bitm\u00e8tres ont \u00e9t\u00e9 consid\u00e9r\u00e9s comme impr\u00e9cis. Lorsque les PCTT ont \u00e9t\u00e9 compar\u00e9s aux NPCTT, aucune diff\u00e9rence statistiquement significative n’a \u00e9t\u00e9 observ\u00e9e au niveau des valeurs m\u00e9dianes ou des intervalles. Le pourcentage de dispositifs en dehors de la fourchette est acceptable selon ISO 15002 et CGA. \u00c0 faible d\u00e9bit, la PCTT est plus performante que la NPCTT, alors que l’inverse est vrai \u00e0 fort d\u00e9bit (p < 0.05).<\/p> <\/div>\n<\/div>\n <\/div>\n <\/div>\n <\/div>\n

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\n \n Conclusions <\/span>\n\n \n \n <\/span>\n <\/h1>\n<\/div>\n\n <\/div>\n <\/div>\n <\/div>\n
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Lorsque le d\u00e9bitm\u00e8tre quitte l’usine, sa pr\u00e9cision dans des conditions normales est garantie par le fabricant. Avec le temps et l’usage, sa pr\u00e9cision peut s’alt\u00e9rer et la pr\u00e9cision du d\u00e9bit d\u00e9livr\u00e9 dans un environnement hospitalier peut diff\u00e9rer de la valeur originale. Cette \u00e9tude est la premi\u00e8re \u00e9tude multicentrique d’envergure \u00e9valuant la pr\u00e9cision des d\u00e9bitm\u00e8tres d’oxyg\u00e8ne muraux dans des conditions d’utilisation courantes. L’objectif de cette \u00e9tude n’\u00e9tait pas d’\u00e9valuer une quelconque n\u00e9gligence et la m\u00e9thode utilis\u00e9e pour ajuster le d\u00e9bit \u00e9tait strictement conforme aux instructions du fabricant. Notre analyse montre qu’en moyenne, les d\u00e9bits d’oxyg\u00e8ne d\u00e9livr\u00e9s sont proches du d\u00e9bit d’oxyg\u00e8ne souhait\u00e9 (valeur nominale).<\/p>\n

Il est donc important de disposer d’appareils pr\u00e9cis et fiables, en particulier lorsque l’analyse des gaz du sang n’est pas directement accessible. Ce probl\u00e8me d’approvisionnement peut \u00eatre critique lors d’un transport extrahospitalier ou lorsque l’oxyg\u00e9noth\u00e9rapie est utilis\u00e9e pour augmenter la mobilit\u00e9 et le temps de marche.<\/p> <\/div>\n<\/div>\n <\/div>\n <\/div>\n <\/div>\n

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Accuracy of Medical Oxygen Flowmeters<\/a>: A Multicentric Field Study

 Fr\u00e9d\u00e9ric Duprez <\/span><\/span>1,2,3*<\/span><\/span><\/sup> , Maria Barile <\/span><\/span>2<\/span><\/span><\/sup> , Thierry Bonus <\/span><\/span>2<\/span><\/span><\/sup> , Gr\u00e9gory Cuvelier <\/span><\/span>3<\/span><\/span><\/sup> , Sandra Ollieuz <\/span><\/span>2<\/span><\/span><\/sup> , Shahram Mashayekhi <\/span><\/span>2<\/span><\/span><\/sup> , Alexandre Legrand <\/span><\/span>1*<\/span><\/span><\/sup><\/pre>\n<\/div>\n<\/div>\n
1<\/span><\/span><\/sup> Department of Physiology and Pharmacology, University of Mons, Mons, Belgium <\/span><\/span>

2<\/span><\/span><\/sup> Intensive Care Unit, Center Hospitalier Epicura, Hornu, Belgium <\/span><\/span>

3<\/span><\/span><\/sup> Laboratory of Motion, Haute Ecole Condorcet, Tournai, Belgium <\/span><\/span>

Email: <\/span><\/span>*<\/span><\/span><\/sup> frederic.duprez@condorcet.be, <\/span><\/span>*<\/span><\/span><\/sup> alexandre.legrand@umons.ac.be <\/span><\/span>

Copyright \u00a9 2014 by authors and Scientific Research Publishing Inc. <\/span><\/span>

This work is licensed under the Creative Commons Attribution International License (CC BY). <\/span><\/span>

http:\/\/creativecommons.org\/licenses\/by\/4.0\/<\/span><\/span><\/pre>    <\/div>\n<\/div>\n        <\/div>\n                        <\/div>\n        <\/div>\n        <\/div>\n\n\n\n\n
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