El-Kafrawy Ula, Taylor R J
Neonatal Intensive Care Unit, Royal Bolton Hospital, Bolton, UK.
Department of Medical Physics, Salford Royal NHS Foundation Trust, Salford, UK.
J Neonatal Perinatal Med. 2016;9(4):377-383. doi: 10.3233/NPM-161623.
To determine the accuracy of weighing ventilated infants on incubator scales and whether the accuracy can be improved by the addition of a ventilator tube compensator (VTC) device to counterbalance the force exerted by the ventilator tubing.
Body weights on integral incubator scales were compared in ventilated infants (with and without a VTC), with body weights on standalone electronic scales (true weight). Individual and series of trend weights were obtained on the infants. The method of Bland and Altman was used to assess the introduced bias.
The study included 60 ventilated infants; 66% of them weighed <1000 g. A total of 102 paired-weight datasets for 30 infants undergoing conventional ventilation and 30 undergoing high frequency oscillator ventilation (HFOV) supported by a SensorMedics oscillator, (with and without a VTC) were obtained. The mean differences and (95% CI for the bias) between the integral and true scale weighing methods was 60.8 g (49.1 g to 72.5 g) without and -2.8 g (-8.9 g to 3.3 g) with a VTC in HFOV infants; 41.0 g (32.1 g to 50.0 g) without and -5.1 g (-9.3 g to -0.8 g) with a VTC for conventionally ventilated infants. Differences of greater than 2% were considered clinically relevant and occurred in 93.8% without and 20.8% with a VTC in HFOV infants and 81.5% without and 27.8% with VTC in conventionally ventilated infants.
The use of the VTC device represents a substantial improvement on the current practice for weighing ventilated infants, particularly in the extreme preterm infants where an over- or underestimated weight can have important clinical implications for treatment. A large-scale clinical trial to validate these findings is needed.
确定使用暖箱秤称量通气婴儿体重的准确性，以及是否可以通过添加呼吸机管道补偿装置（VTC）来抵消呼吸机管道施加的力以提高准确性。
比较通气婴儿（使用和不使用VTC）在暖箱内置秤上的体重与独立电子秤上的体重（真实体重）。获取婴儿的个体体重和系列趋势体重。采用Bland和Altman方法评估引入的偏差。
该研究纳入了60名通气婴儿；其中66%体重<1000g。共获得了102对体重数据集，涉及30名接受传统通气的婴儿和30名接受SensorMedics振荡器支持的高频振荡通气（HFOV）的婴儿（使用和不使用VTC）。在HFOV婴儿中，暖箱内置秤与真实秤称量方法之间的平均差异及（偏差的95%置信区间）在不使用VTC时为60.8g（49.1g至72.5g），使用VTC时为-2.8g（-8.9g至3.3g）；在传统通气婴儿中，不使用VTC时为41.0g（32.1g至50.0g），使用VTC时为-5.1g（-9.3g至-0.8g）。差异大于2%被认为具有临床相关性，在HFOV婴儿中，不使用VTC时为93.8%，使用VTC时为20.8%；在传统通气婴儿中，不使用VTC时为81.5%，使用VTC时为27.8%。
VTC装置的使用相较于目前称量通气婴儿体重的方法有显著改进，尤其是在极早产儿中，体重高估或低估可能对治疗产生重要临床影响。需要进行大规模临床试验来验证这些发现。
