Accurate automated apnea analysis in preterm infants.
Accurate automated apnea analysis in preterm infants.
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DOI：
10.1055/s-0033-1343769
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发表时间：
2014-02
影响因子：
2
通讯作者：
Kattwinkel J
中科院分区：
文献类型：
--
作者：
Vergales BD;Paget-Brown AO;Lee H;Guin LE;Smoot TJ;Rusin CG;Clark MT;Delos JB;Fairchild KD;Lake DE;Moorman R;Kattwinkel J
2006年，早产儿呼吸暂停（AOP）共识小组将呼吸暂停发作的不准确计数确定为AOP研究进展的主要障碍。我们比较了AOP的护理记录与临床验证的计算机算法检测到的事件，该算法从标准床边监护仪检测呼吸暂停。波形，生命体征和报警数据连续收集从所有极低出生体重儿入院超过25个月的时间，分析中枢性呼吸暂停，心动过缓，和去饱和（ABD）事件，并与从图表收集的护理文件比较。我们的算法将呼吸暂停定义为> 10秒，如果伴有心动过缓和去饱和。在3，019例护士记录的事件中，只有68%的患者有算法检测到的ABD事件。在5，275例算法检测到的> 30秒的长时间呼吸暂停事件中，只有26%在1小时内有护士记录的文件。在算法检测到的> 10秒的长时间呼吸暂停事件中，仅74%的事件发出了监护仪警报。在分析的747天内，整个新生儿重症监护室共有8，190，418个任何描述的监护仪报警，或每名护士每2至3分钟发出一次报警。一个自动化的计算机算法，连续ABD定量是一个更可靠的工具，比医疗记录，以解决重要的研究问题，确定了2006年AOP共识小组。
In 2006 the apnea of prematurity (AOP) consensus group identified inaccurate counting of apnea episodes as a major barrier to progress in AOP research. We compare nursing records of AOP to events detected by a clinically validated computer algorithm that detects apnea from standard bedside monitors. Waveform, vital sign, and alarm data were collected continuously from all very low-birth-weight infants admitted over a 25-month period, analyzed for central apnea, bradycardia, and desaturation (ABD) events, and compared with nursing documentation collected from charts. Our algorithm defined apnea as > 10 seconds if accompanied by bradycardia and desaturation. Of the 3,019 nurse-recorded events, only 68% had any algorithm-detected ABD event. Of the 5,275 algorithm-detected prolonged apnea events > 30 seconds, only 26% had nurse-recorded documentation within 1 hour. Monitor alarms sounded in only 74% of events of algorithm-detected prolonged apnea events > 10 seconds. There were 8,190,418 monitor alarms of any description throughout the neonatal intensive care unit during the 747 days analyzed, or one alarm every 2 to 3 minutes per nurse. An automated computer algorithm for continuous ABD quantitation is a far more reliable tool than the medical record to address the important research questions identified by the 2006 AOP consensus group.