Reliability of respiratory function monitor interpretation for neonatal resuscitation.
Reliability of respiratory function monitor interpretation for neonatal resuscitation.
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新生儿复苏呼吸功能监测仪解释的可靠性。
DOI：
10.1136/archdischild-2022-324369
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Hsu,JesseY
中科院分区：
文献类型：
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作者：
Foglia,ElizabethE;Weinberg,DanielleD;TePas,ArjanB;Dekker,Janneke;Hsu,JesseY
呼吸功能监测仪（RFM）是提高产房正压通气（PPV）充气质量的潜在工具。RFM计算、显示和记录有关潮汐量、面罩泄漏、气道阻塞和自发呼吸的数据。虽然呼吸信号的视觉解释是该方法不可或缺的一部分，但这些评估的可靠性尚不清楚。研究的目的是确定RFM信号解释的内部和内部可靠性。这是一项使用NewLife Box RFM （Advanced Life Diagnostics, Weener, Germany）对早产儿PPV复苏期间记录的RFM文件的观察性研究。四名评分员使用Pulmochart （Advanced Life Diagnostics）软件对16份RFM记录进行了两次审查。评级员手动确认或调整自动触发器，指示每次通货膨胀的开始和结束。评估了压力和流量波形模式，以确定每次充气的特征如下：PPV充气没有同时发生自发呼吸（默认）；PPV充气伴随着叠加的自发呼吸（在充气过程中伴随着最初的呼气）；PPV膨胀伴随着叠加的自发呼吸（在膨胀过程中伴随着最初的吸气）；持续气道正压通气（CPAP）下自主呼吸；移除或置换口罩。使用R V. 4.1。0，通货膨胀分类的总体和类别特定kappa值评估内部和内部的可靠性。我们使用线性混合效应模型来估计评分者、评审顺序及其相互作用的固定效应。呼出潮汐量（Vte）测量的水内可靠性使用类内相关性（ICC）进行评估。p值< 0.05认为有统计学意义。分析数据集有8368次通货膨胀。通货膨胀分类的内部kappa值范围为0.597至0.655（表1）。通膨分类的总体kappa为0.402，并按通膨类型排序。在识别CPAP的自发呼吸方面有大量的内部一致性（kappa 0.797），在分类非自发的PPV充气方面有中度一致性
A respiratory function monitor (RFM) is a potential tool to enhance the quality of positive pressure ventilation (PPV) inflations in the delivery room. 1 The RFM calculates, displays and records data about tidal volumes, mask leak, airway obstruction and presence of spontaneous breathing. Although visual interpretation of respiratory signals is integral to this methodology, the reliability of these assessments is unknown. The study objectives were to determine the intrarater and inter-rater reliability of RFM signal interpretation.This was an observational study of RFM files recorded during PPV resuscitation of preterm infants using the NewLife Box RFM (Advanced Life Diagnostics, Weener, Germany). Four raters reviewed 16 RFM recordings twice using Pulmochart (Advanced Life Diagnostics) software. Raters manually confirmed or adjusted automated triggers indicating start and end of each inflation. Pressure and flow waveform patterns were assessed to characterise each inflation as follows: PPV inflation without a coinciding spontaneous breath (default); PPV inflation with a superimposed spontaneous breath (with initial expiration during the inflation); PPV inflation with a superimposed spontaneous breath (with initial inspiration during the inflation); spontaneous breath on continuous positive airway pressure (CPAP); mask removal or displacement. Using R V. 4.1. 0, overall and categoryspecific kappa values of inflation classification assessed intrarater and inter-rater reliability. 2 We used a linear mixed-effects model to estimate fixed effects of raters, review order and their interactions. The intrarater reliability for exhaled tidal volume (Vte) measurements was assessed using the intraclass correlation (ICC). A p value< 0.05 was considered statistically significant. The analytical data set had 8368 inflations. Intrarater kappa values for inflation categorisation ranged from 0.597 to 0.655 (table 1). Overall kappa for inflation classification across raters was 0.402 and ranged by inflation type. There was substantial intrarater agreement for identifying spontaneous breaths on CPAP (kappa 0.797) and moderate agreement for classifying PPV inflations without spontaneous