在重症监护室使用可穿戴生命体征贴片的可行性研究。

IF 2 3区 医学 Q2 ANESTHESIOLOGY
Guylian Stevens, Michiel Larmuseau, Annelies Van Damme, Henk Vanoverschelde, Jan Heerman, Pascal Verdonck
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引用次数: 0

摘要

多项研究和综述论文认为,预警系统对临床结果、患者安全和临床表现具有积极影响。尽管大量证据证实了预警系统应用的有效性,但长期存在的障碍阻碍了预警系统与临床实践的无缝结合。值得注意的是,国家预警评分等预警系统将多方面的临床状况简化为单一的数字指数,从而有可能忽略关键的临床指标和患者健康状况的细微波动。此外,EWS 在临床环境中的最佳应用仍然难以捉摸。人工评估 EWS 参数需要耗费医护人员大量的时间。要解决这些障碍,就必须采用创新方法。在这方面,可穿戴医疗技术有望成为能够持续监测住院病人生命体征的解决方案。为了克服使用预警评分的障碍,可穿戴医疗技术有可能持续监测住院病人的生命体征。然而,一个基本的问题是,其可靠性与目前使用的黄金标准是否具有可比性。这一问题凸显了对可穿戴医疗技术进行严格评估和验证的必要性,以确定其在增强现有临床实践方面的功效。这项前瞻性单中心研究旨在评估 Vivalink 心脏贴片与根特 AZ Maria Middelares 医院使用的心电图监控系统相比,心率和呼吸率测量结果的准确性。具体来说,研究重点是评估十名手术后重症监护室(ICU)患者从 Vivalink 心电贴片获得的数据与现有心电图监测系统获得的数据之间的一致性。在这些患者中,有五名在手术后接受了机械通气,其余五名则没有。研究首先比较了 Vivalink 心脏贴片和心电图监控系统记录的数据。随后,将从 Vivalink 心脏贴片和心电图监测系统获得的数据与从通气机获得的信息进行对比,从而全面分析了贴片在重症监护室环境中监测生命体征的性能。在心率方面,Vivalink 心电贴片平均在 85.11±10.81% 的测量时间内与心电监护系统的误差在 5% 的范围内。在呼吸频率方面,测量时间为 40.55±17.28%。斯皮尔曼相关系数显示,心率的相关性非常高,为 ρ = 0.9 8,呼吸频率的相关性适中,为 ρ = 0.66。与通气呼吸频率(通气机)相比,Vivalink 和基于心电图的监测系统的相关性均为ρ = 0.68。 Vivalink 心脏贴片测量的心率与医院的心电图监测系统测量的心率之间具有很高的相关性。在呼吸频率方面,Vivalink 心脏贴片、心电图监控系统和呼吸机的数据之间的相关性为中等。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Feasibility study of the use of a wearable vital sign patch in an intensive care unit setting.

Feasibility study of the use of a wearable vital sign patch in an intensive care unit setting.

Multiple studies and review papers have concluded that early warning systems have a positive effect on clinical outcomes, patient safety and clinical performances. Despite the substantial evidence affirming the efficacy of EWS applications, persistent barriers hinder their seamless integration into clinical practice. Notably, EWS, such as the National Early Warning Score, simplify multifaceted clinical conditions into singular numerical indices, thereby risking the oversight of critical clinical indicators and nuanced fluctuations in patients' health status. Furthermore, the optimal deployment of EWS within clinical contexts remains elusive. Manual assessment of EWS parameters exacts a significant temporal toll on healthcare personnel. Addressing these impediments necessitates innovative approaches. In this regard, wearable medical technologies emerge as promising solutions capable of continual monitoring of hospitalized patients' vital signs. To overcome the barriers of the use of early warning scores, wearable medical technology has the potential to continuously monitor vital signs of hospitalised patients. However, a fundamental inquiry arises regarding the comparability of their reliability to the current used golden standards. This inquiry underscores the imperative for rigorous evaluation and validation of wearable medical technologies to ascertain their efficacy in augmenting extant clinical practices. This prospective, single-center study aimed to evaluate the accuracy of heart rate and respiratory rate measurements obtained from the Vivalink Cardiac patch in comparison to the ECG-based monitoring system utilized at AZ Maria Middelares Hospital in Ghent. Specifically, the study focused on assessing the concordance between the data obtained from the Vivalink Cardiac patch and the established ECG-based monitoring system among a cohort of ten post-surgical intensive care unit (ICU) patients. Of these patients, five were undergoing mechanical ventilation post-surgery, while the remaining five were not. The study proceeded by initially comparing the data recorded by the Vivalink Cardiac patch with that of the ECG-based monitoring system. Subsequently, the data obtained from both the Vivalink Cardiac patch and the ECG-based monitoring system were juxtaposed with the information derived from the ventilation machine, thereby providing a comprehensive analysis of the patch's performance in monitoring vital signs within the ICU setting. For heart rate, the Vivalink Cardiac patch was on average within a 5% error range of the ECG-based monitoring system during 85.11±10.81% of the measured time. For respiratory rate this was during 40.55±17.28% of the measured time. Spearman's correlation coefficient showed a very high correlation of ρ = 0.9 8 for heart rate and a moderate correlation of ρ = 0.66 for respiratory rate. In comparison with the ventilated respiratory rate (ventilation machine) the Vivalink and ECG-based monitoring system both had a moderate correlation of ρ = 0.68 . A very high correlation was found between the heart rate measured by the Vivalink Cardiac patch and that of the ECG-based monitoring system of the hospital. Concerning respiratory rate the correlation between the data from the Vivalink Cardiac patch, the ECG-based monitoring system and the ventilation machine was found to be moderate.

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来源期刊
CiteScore
4.30
自引率
13.60%
发文量
144
审稿时长
6-12 weeks
期刊介绍: The Journal of Clinical Monitoring and Computing is a clinical journal publishing papers related to technology in the fields of anaesthesia, intensive care medicine, emergency medicine, and peri-operative medicine. The journal has links with numerous specialist societies, including editorial board representatives from the European Society for Computing and Technology in Anaesthesia and Intensive Care (ESCTAIC), the Society for Technology in Anesthesia (STA), the Society for Complex Acute Illness (SCAI) and the NAVAt (NAVigating towards your Anaestheisa Targets) group. The journal publishes original papers, narrative and systematic reviews, technological notes, letters to the editor, editorial or commentary papers, and policy statements or guidelines from national or international societies. The journal encourages debate on published papers and technology, including letters commenting on previous publications or technological concerns. The journal occasionally publishes special issues with technological or clinical themes, or reports and abstracts from scientificmeetings. Special issues proposals should be sent to the Editor-in-Chief. Specific details of types of papers, and the clinical and technological content of papers considered within scope can be found in instructions for authors.
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