Evaluation of graphic cardiovascular display in a high-fidelity simulator
Evaluation of graphic cardiovascular display in a high-fidelity simulator
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DOI：
10.1213/01.ane.0000085298.03143.cd
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发表时间：
2003-11-01
影响因子：
5.7
通讯作者：
Weinger, MB
中科院分区：
文献类型：
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作者：
Agutter, J;Drews, F;Weinger, MB
麻醉中的“人为错误”可以归因于患者监护仪提供的误导性信息或医生未能识别模式。监测数据的图形表示可以为检测、诊断和治疗提供更好的支持。我们设计了一种图形显示器来显示血流动力学变量。20名麻醉师被要求照顾一名模拟病人。一半的参与者使用图形心血管显示器；另一半使用Datex AS/3监护仪。一种情况是全髋关节置换术，并对不匹配的血液产生输血反应。第二种方案是根治性前列腺切除术，术中出现1.5 L的失血和心肌缺血。使用图形显示器的受试者检测到心肌缺血的时间比不使用显示器的受试者早2分钟。开始治疗的时间更早(2.5分钟比4.9分钟)。在髋关节置换方案中，两组之间没有显著差异。当使用图形显示时，病例结束时，收缩压偏离基线较小，中心静脉压更接近基线，动脉血氧饱和度较高。这项研究支持了这样一种假设，即在具有紧急特征和功能关系的显示器中以图形方式提供临床信息可以提高临床医生在模拟环境中检测、诊断、管理和治疗关键心血管事件的能力。
"Human error" in anesthesia can be attributed to misleading information from patient monitors or to the physician's failure to recognize a pattern. A graphic representation of monitored data may provide better support for detection, diagnosis, and treatment. We designed a graphic display to show hemodynamic variables. Twenty anesthesiologists were asked to assume care of a simulated patient. Half the participants used the graphic cardiovascular display; the other half used a Datex As/3 monitor. One scenario was a total hip replacement with a transfusion reaction to mismatched blood. The second scenario was a radical prostatectomy with 1.5 L of blood loss and myocardial ischemia. Subjects who used the graphic display detected myocardial ischemia 2 min sooner than those who did not use the display. Treatment was initiated sooner (2.5 versus 4.9 min). There were no significant differences between groups in the hip replacement scenario. Systolic blood pressure deviated less from baseline, central venous pressure was closer to its baseline, and arterial oxygen saturation was higher at the end of the case when the graphic display was used. The study lends some support for the hypothesis that providing clinical information graphically in a display designed with emergent features and functional relationships can improve clinicians' ability to detect, diagnose, manage, and treat critical cardiovascular events in a simulated environment.