Arterial Oxygen Saturation Measurement of Tissue Oxygenation

Low tissue oxygenation caused by any cardiorespiratory defect will result in an overproduction of erythropoietin and a consequent erythrocytosis. Pulse oximetry is the most convenient measure of arterial oxygen saturation. The oxygen saturation level should be 92 percent or greater; any less has been taken to indicate a causal relationship with an absolute erythrocytosis.96 Nocturnal arterial desaturation with normal daytime values, however, were observed in 20 percent of patients who would otherwise have been classified as idiopathic erythrocytosis88 and symptoms that suggest the sleep-apnea syndrome such as daytime somnolence, excessive snoring, and waking unre-freshed should prompt sleep studies. A chest x-ray should be performed routinely to look for parenchymal lung abnormali ties. Occasionally pulmonary function tests and an echocardiogram may be necessary to further investigate respiratory or cardiac problems.

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