Christine L Mai, Sara Burns, David A August, Somaletha T Bhattacharya, Ariel Mueller, Timothy T Houle, Thomas A Anderson, Jacquelin Peck
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This study aimed to evaluate two objective measures-cardiac index (CI) and heart rate (HR) in comparison with validated subjective assessments, the modified Yale Preoperative Anxiety Scale (mYPAS) and the numeric rating scale (NRS).<i>Approach.</i>In this prospective, observational cohort study, children ages 5-17 undergoing ambulatory endoscopy under general anesthesia underwent simultaneous measurement of objective and subjective measures at various time points: baseline, intravenous placement, two-minutes post-IV placement, when departing the preoperative bay, and one-minute prior to anesthesia induction.<i>Main Results.</i>Of the 86 enrolled patients, 77 had analyzable CI data and were included in the analysis. The median age was 15 years (interquartile range 13, 16), 55% were female, and most were American Society of Anesthesiologists (ASA) Physical Status 2 (64%), and had previous endoscopies (53%). HR and CI correlated overall (<i>r</i>= 0.65, 95% CI: 0.62, 0.69;<i>p</i>< 0.001), as did NRS and mYPAS (<i>r</i>= 0.39, 95% CI: 0.34, 0.44;<i>p</i>< 0.001). The correlation between HR and CI was stronger with NRS (<i>r</i>= 0.24, 95% CI: 0.19, 0.29;<i>p</i>< 0.001; and<i>r</i>= 0.13, 95% CI: 0.07, 0.19;<i>p</i>< 0.001, respectively) than with mYPAS (<i>r</i>= 0.06, 95% CI: 0.00, 0.11;<i>p</i>= 0.046; and<i>r</i>= 0.08, 95% CI: 0.02, 0.14;<i>p</i>= 0.006, respectively). 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引用次数: 0
摘要
目的:
接受医疗手术的儿科患者经常会出现术前焦虑,这会影响术后效果。虽然医护人员会主观评估焦虑,但客观量化工具仍然有限。本研究旨在评估两种客观测量方法--心脏指数(CI)和心率(HR)--与经过验证的主观评估方法(改良耶鲁术前焦虑量表(mYPAS)和数字评定量表(NRS))的比较结果。
Approach:
In this prospective, observational cohort study, children ages 5-17 under Ambulatory Endoscopy under general anesthesia undergone simultaneously measurement of objective and subjective measures at various time points: baseline, intravenous placement, two-minutes post-minutes IV placement, when departureing the preoperative bay, and one-minute prior to anesthesia induction.在这项前瞻性、观察性队列研究中,5-17 岁的儿童在全身麻醉下接受流动内窥镜检查,在不同的时间点同时进行客观和主观测量:基线、静脉注射、静脉注射后两分钟、离开术前室时以及麻醉诱导前一分钟。
主要结果:
在 86 名登记的患者中,77 人有可分析的 CI 数据并纳入分析。中位年龄为 15 岁(IQR 13,16),55% 为女性,大多数为 ASA 2(64%),曾接受过内窥镜检查(53%)。HR 与 CI 整体相关(r=0.56,95% CI:0.62,0.69;p
Cardiac index as a surrogate marker for anxiety in pediatric patients undergoing ambulatory endoscopy: a prospective cohort study.
Objective.Pediatric patients undergoing medical procedures often grapple with preoperative anxiety, which can impact postoperative outcomes. While healthcare providers subjectively assess anxiety, objective quantification tools remain limited. This study aimed to evaluate two objective measures-cardiac index (CI) and heart rate (HR) in comparison with validated subjective assessments, the modified Yale Preoperative Anxiety Scale (mYPAS) and the numeric rating scale (NRS).Approach.In this prospective, observational cohort study, children ages 5-17 undergoing ambulatory endoscopy under general anesthesia underwent simultaneous measurement of objective and subjective measures at various time points: baseline, intravenous placement, two-minutes post-IV placement, when departing the preoperative bay, and one-minute prior to anesthesia induction.Main Results.Of the 86 enrolled patients, 77 had analyzable CI data and were included in the analysis. The median age was 15 years (interquartile range 13, 16), 55% were female, and most were American Society of Anesthesiologists (ASA) Physical Status 2 (64%), and had previous endoscopies (53%). HR and CI correlated overall (r= 0.65, 95% CI: 0.62, 0.69;p< 0.001), as did NRS and mYPAS (r= 0.39, 95% CI: 0.34, 0.44;p< 0.001). The correlation between HR and CI was stronger with NRS (r= 0.24, 95% CI: 0.19, 0.29;p< 0.001; andr= 0.13, 95% CI: 0.07, 0.19;p< 0.001, respectively) than with mYPAS (r= 0.06, 95% CI: 0.00, 0.11;p= 0.046; andr= 0.08, 95% CI: 0.02, 0.14;p= 0.006, respectively). The correlation with mYPAS for both HR and CI varied significantly in both direction and magnitude across the different time points.Significance.A modest yet discernable correlation exists between objective measures (HR and CI) and established subjective anxiety assessments.
期刊介绍:
Physiological Measurement publishes papers about the quantitative assessment and visualization of physiological function in clinical research and practice, with an emphasis on the development of new methods of measurement and their validation.
Papers are published on topics including:
applied physiology in illness and health
electrical bioimpedance, optical and acoustic measurement techniques
advanced methods of time series and other data analysis
biomedical and clinical engineering
in-patient and ambulatory monitoring
point-of-care technologies
novel clinical measurements of cardiovascular, neurological, and musculoskeletal systems.
measurements in molecular, cellular and organ physiology and electrophysiology
physiological modeling and simulation
novel biomedical sensors, instruments, devices and systems
measurement standards and guidelines.