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[婴儿心肺监护仪SpiroGuard C的评估。新型传感器和智能报警管理系统改善呼吸事件记录]

[Evaluation of the cardiorespiratory monitor SpiroGuard C for infants. Improved registration of respiratory events by new sensors and intelligent alarm management system].

作者信息

Urschitz M S, Eichler F, Popow C, Ipsiroglu O S

机构信息

Abteilung für Neonatologie, angeborene Störungen und Intensivmedizir, Universitätsklinik für Kinder und Jugendheilkunde, Wien, Osterreich.

出版信息

Wien Klin Wochenschr. 2000 Mar 10;112(5):226-33.

PMID:10763536
Abstract

OBJECTIVES

The SpiroGuard C is a commercially available cardiorespiratory monitor working with field plethysmography, wireless signal transmission and a novel alarm management system. In order to determine the recognition rates for central, mixed and obstructive apneas, a prospective clinical trial was performed comparing frequency and kind of signals from the monitor with those simultaneously registered by polysomnographic studies.

DESIGN

Normal respiratory and alarm signals of the monitor under investigation were integrated into a polysomnographic setting. All central, mixed and obstructive apneas lasting more than 10 seconds as well as all alarms obtained from the monitor were evaluated.

RESULTS

47 series of monitor recordings could be evaluated in parallel to polysomnographic studies: the detection rate for central apneas was 298/328 (90.85%), for mixed apneas 9/41 (21.95%) and for obstructive apneas 0/36 (0%). Out of the total of 708 registered alarms 359 (50.71%) were false alarms, 307 (43.36%) were apnea-related and 42/708 (5.93%) were alarms due to technical problems. 177 of the 359 false alarms (49.30%) occurred during apneas that were shorter than 10 seconds, 119 (33.15%) were related to bad signal quality, and 55 (15.32%) were caused by movement artifacts.

CONCLUSION

The recognition rate for central apneas was high (> 90%), while sensitivity for mixed and obstructive apneas was not satisfactory. Approximately half of the alarms were false alarms. These could be reduced by setting the apnea detection time to > 15 seconds, by tighter fastening of the respiration belt (improving the signal transmission), and by turning off the instrument when the child is awake and physically active. The wireless system renders the SpiroGuard C an attractive alternative for home monitoring.

摘要

目的

SpiroGuard C是一款市售的心肺监测仪,采用现场容积描记法、无线信号传输和新型警报管理系统。为了确定中枢性、混合性和阻塞性呼吸暂停的识别率,进行了一项前瞻性临床试验,比较了该监测仪的信号频率和类型与多导睡眠图研究同时记录的信号。

设计

将被研究监测仪的正常呼吸和警报信号整合到多导睡眠图设置中。对所有持续超过10秒的中枢性、混合性和阻塞性呼吸暂停以及监测仪发出的所有警报进行评估。

结果

可以将47组监测记录与多导睡眠图研究并行评估:中枢性呼吸暂停的检测率为298/328(90.85%),混合性呼吸暂停为9/41(21.95%),阻塞性呼吸暂停为0/36(0%)。在总共708次记录的警报中,359次(50.71%)为误报,307次(43.36%)与呼吸暂停相关,42/708(5.93%)是由于技术问题发出的警报。359次误报中有177次(49.30%)发生在短于10秒的呼吸暂停期间,119次(33.15%)与信号质量差有关,55次(15.32%)由运动伪影引起。

结论

中枢性呼吸暂停的识别率较高(>90%),而混合性和阻塞性呼吸暂停的敏感性不令人满意。大约一半的警报是误报。通过将呼吸暂停检测时间设置为>15秒、更紧地系好呼吸带(改善信号传输)以及在儿童清醒且身体活动时关闭仪器,可以减少误报。无线系统使SpiroGuard C成为家庭监测的一个有吸引力的选择。

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引用本文的文献

1
[Reliability of home monitoring with event recording compared with polysomnography in infants].
Wien Klin Wochenschr. 2004 Apr 30;116(7-8):279-80; author reply 280-1. doi: 10.1007/BF03041060.
2
[Reliability of home monitoring with event-recording compared with polysomnography in infants].
Wien Klin Wochenschr. 2003 Jul 15;115(12):421-8. doi: 10.1007/BF03040435.