Department of Neonatology, University Children's Hospital, , Tuebingen, Germany.
Arch Dis Child Fetal Neonatal Ed. 2013 Nov;98(6):F524-7. doi: 10.1136/archdischild-2012-303369. Epub 2013 May 28.
Treatment decisions for apnoea of prematurity (AOP) are usually based on nursing staff's documentation of pulse oximeter and heart rate alarms.
In an observational study, to compare the accuracy of oxygen saturation (SpO2) and heart rate alarm documentation, and the resulting interventions by nursing staff, with objectively registered events using polysomnographic and video recording.
Data on 21 preterm neonates (12 male) with a diagnosis of AOP were analysed. Nursing staff's desaturation (<80% SpO2) and bradycardia (<80/min) alarm documentation was compared with events registered objectively using simultaneous polysomnography. Interventions by nursing staff were evaluated using 24 h video recordings and compared with their chart documentation. Nursing staff had been unaware that the polygraphic and video recordings would be used subsequently for this purpose.
Median (minimum-maximum) postnatal age was 15.5 (3-65) days. 968 SpO2 desaturation events and 415 bradycardias were documented by polysomnography. Nursing staff registered 23% of these desaturation events, and 60% of bradycardias (n=223, and n=133, respectively). Intraclass correlation coefficient (95% CI) between objectively measured desaturation events and those documented by nursing staff was 0.14 (-0.31 to 0.53); and for bradycardias 0.51 (0.11 to 0.78). 225 nursing staff interventions were registered on video, of which 87 (39%) were documented.
The alarm documentation by neonatal intensive care unit staff does not appear to be sufficiently accurate to permit further understanding and treatment of AOP. It is unclear if the alarms missed here would have led to clinical consequences had they been documented.
早产儿呼吸暂停（AOP）的治疗决策通常基于护理人员对脉搏血氧仪和心率报警的记录。
在一项观察性研究中，比较护理人员记录的氧饱和度（SpO2）和心率报警的准确性，以及护理人员的干预措施，与使用多导睡眠图和视频记录客观记录的事件。
对 21 例诊断为 AOP 的早产儿（男 12 例）的数据进行了分析。将护理人员的低氧血症（<80% SpO2）和心动过缓（<80 次/分钟）报警记录与同时进行的多导睡眠图客观记录的事件进行比较。使用 24 小时视频记录评估护理人员的干预措施，并将其与图表记录进行比较。护理人员并不知道随后多导睡眠图和视频记录将用于此目的。
中位（最小-最大）胎龄为 15.5（3-65）天。多导睡眠图记录了 968 次 SpO2 下降事件和 415 次心动过缓。护理人员记录了这些低氧血症事件的 23%，心动过缓的 60%（分别为 n=223 和 n=133）。客观测量的低氧血症事件与护理人员记录的事件之间的组内相关系数（95%CI）为 0.14（-0.31 至 0.53）；而心动过缓的组内相关系数为 0.51（0.11 至 0.78）。在视频上记录了 225 次护理人员干预措施，其中 87 次（39%）有记录。
新生儿重症监护病房护理人员的报警记录似乎不够准确，无法进一步了解和治疗 AOP。尚不清楚如果记录了这些遗漏的警报，它们是否会导致临床后果。
