Anaesthesiology Department, V.U. University Medical Centre/Institute for Cardiovascular Research, Amsterdam, the Netherlands.
Anaesthesia. 2013 Aug;68(8):804-10. doi: 10.1111/anae.12289. Epub 2013 Jun 7.
Alarms are key components of peri-operative monitoring devices, but a high false-alarm rate may lead to desensitisation and neglect. The objective of this study was to quantify the number of alarms and assess the value of these alarms during moderate-risk surgery. For this purpose, we analysed documentation of anaesthesia workstations during 38 surgical procedures. Alarms were classified on technical validity and clinical relevance. The median (IQR [range]) alarm density per procedure was 20.8 (14.5-34.2 [3.7-85.6]) alarms.h⁻¹ (1 alarm every 2.9 min) and increased during induction and emergence of anaesthesia, with up to one alarm per 0.99 min during these periods (p < 0.001). Sixty-four per cent of all alarms were clinically irrelevant, whereas 5% of all alarms required immediate intervention. The positive predictive value of an alarm during induction and emergence was 20% (95% CI 16-24%) and 11% (95% CI 8-14%), respectively. This study shows that peri-operative alarms are frequently irrelevant, with a low predictive value for an emerging event requiring clinical intervention.
报警是围手术期监测设备的关键组成部分，但高假警率可能导致脱敏和忽视。本研究的目的是量化中度风险手术期间的报警数量并评估这些报警的价值。为此，我们分析了 38 例手术中麻醉工作站的记录。根据技术有效性和临床相关性对报警进行分类。每例手术的中位数（IQR[范围]）报警密度为 20.8（14.5-34.2[3.7-85.6]）警报/小时（1 个警报每 2.9 分钟），并在麻醉诱导和苏醒期间增加，在此期间，每 0.99 分钟出现一个警报（p < 0.001）。所有报警中 64%为临床无关，而所有报警中 5%需要立即干预。诱导和苏醒期间报警的阳性预测值分别为 20%（95%CI 16-24%）和 11%（95%CI 8-14%）。本研究表明，围手术期报警经常是无关的，对于需要临床干预的新出现事件的预测价值较低。
