普通护理病房患者经脉搏血氧饱和度测定得出的呼吸频率
Pulse oximetry-derived respiratory rate in general care floor patients.
作者信息
Addison Paul S, Watson James N, Mestek Michael L, Ochs James P, Uribe Alberto A, Bergese Sergio D
机构信息
Covidien Respiratory and Monitoring Solutions, Edinburgh, Scotland, UK,
出版信息
J Clin Monit Comput. 2015 Feb;29(1):113-20. doi: 10.1007/s10877-014-9575-5. Epub 2014 May 6.
Respiratory rate is recognized as a clinically important parameter for monitoring respiratory status on the general care floor (GCF). Currently, intermittent manual assessment of respiratory rate is the standard of care on the GCF. This technique has several clinically-relevant shortcomings, including the following: (1) it is not a continuous measurement, (2) it is prone to observer error, and (3) it is inefficient for the clinical staff. We report here on an algorithm designed to meet clinical needs by providing respiratory rate through a standard pulse oximeter. Finger photoplethysmograms were collected from a cohort of 63 GCF patients monitored during free breathing over a 25-min period. These were processed using a novel in-house algorithm based on continuous wavelet-transform technology within an infrastructure incorporating confidence-based averaging and logical decision-making processes. The computed oximeter respiratory rates (RRoxi) were compared to an end-tidal CO2 reference rate (RRETCO2). RRETCO2 ranged from a lowest recorded value of 4.7 breaths per minute (brpm) to a highest value of 32.0 brpm. The mean respiratory rate was 16.3 brpm with standard deviation of 4.7 brpm. Excellent agreement was found between RRoxi and RRETCO2, with a mean difference of -0.48 brpm and standard deviation of 1.77 brpm. These data demonstrate that our novel respiratory rate algorithm is a potentially viable method of monitoring respiratory rate in GCF patients. This technology provides the means to facilitate continuous monitoring of respiratory rate, coupled with arterial oxygen saturation and pulse rate, using a single non-invasive sensor in low acuity settings.
呼吸频率被认为是普通护理病房(GCF)监测呼吸状态的一项重要临床参数。目前,间歇性手动评估呼吸频率是GCF的护理标准。该技术存在几个与临床相关的缺点,包括:(1)它不是连续测量;(2)容易出现观察者误差;(3)对临床工作人员来说效率低下。我们在此报告一种算法,该算法旨在通过标准脉搏血氧仪提供呼吸频率来满足临床需求。从63名GCF患者队列中采集了手指光电容积脉搏波图,这些患者在25分钟的自由呼吸期间接受监测。在一个包含基于置信度的平均和逻辑决策过程的基础设施内,使用基于连续小波变换技术的新型内部算法对这些数据进行处理。将计算得出的血氧仪呼吸频率(RRoxi)与呼气末二氧化碳参考频率(RRETCO2)进行比较。RRETCO2范围从记录的最低值每分钟4.7次呼吸(brpm)到最高值32.0 brpm。平均呼吸频率为16.3 brpm,标准差为4.7 brpm。发现RRoxi与RRETCO2之间具有极好的一致性,平均差值为-0.48 brpm,标准差为1.77 brpm。这些数据表明,我们的新型呼吸频率算法是监测GCF患者呼吸频率的一种潜在可行方法。该技术提供了一种手段,可在低 acuity 设置中使用单个非侵入性传感器促进对呼吸频率以及动脉血氧饱和度和脉搏率的连续监测。