Durbin Charles G
Department of Anesthesiology, University of Virginia, Charlottesville, Virginia.
Respir Care. 2016 Aug;61(8):1110-21. doi: 10.4187/respcare.04931. Epub 2016 Jul 19.
This paper will present a focused and personal history of physiologic monitoring, beginning with the discovery of modern anesthesia and its development from a technical practice to a scientific discipline. Emphasis will be on the essence of monitoring in the anesthesia evolution, and this work will attempt to answer the question of how to evaluate the impact of monitoring on patient outcome. Understanding that monitors are passive and that only caregivers using monitors can impact outcome is at the crux of this approach to analysis. The limited quality data involving monitoring analysis, including that from pulse oximetry, will be discussed and critiqued. The invention and rapid spread of pulse oximetry will be highlighted and used as an example throughout, but the principles developed will apply to other monitors and patient monitoring in general. The problems created by monitoring alarms will also be discussed.
本文将呈现一段聚焦且个人化的生理监测史，始于现代麻醉的发现及其从一项技术实践发展成为一门科学学科的历程。重点将放在麻醉演进过程中监测的本质，并且这项工作将试图回答如何评估监测对患者预后的影响这一问题。理解监测设备是被动的，只有使用这些设备的医护人员才能影响预后，这是这种分析方法的关键所在。将讨论并批判包括脉搏血氧饱和度测定法在内的、涉及监测分析的有限质量数据。脉搏血氧饱和度测定法的发明及其迅速普及将在文中自始至终被着重强调并用作示例，但所阐述的原则总体上适用于其他监测设备及患者监测。还将讨论监测警报所带来的问题。
