From the Department of Anesthesia, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands.
Anesthesiology. 2018 Feb;128(2):293-304. doi: 10.1097/ALN.0000000000001895.
Vital parameter data collected in anesthesia information management systems are often used for clinical research. The validity of this type of research is dependent on the number of artifacts.
In this prospective observational cohort study, the incidence of artifacts in anesthesia information management system data was investigated in children undergoing anesthesia for noncardiac procedures. Secondary outcomes included the incidence of artifacts among deviating and nondeviating values, among the anesthesia phases, and among different anesthetic techniques.
We included 136 anesthetics representing 10,236 min of anesthesia time. The incidence of artifacts was 0.5% for heart rate (95% CI: 0.4 to 0.7%), 1.3% for oxygen saturation (1.1 to 1.5%), 7.5% for end-tidal carbon dioxide (6.9 to 8.0%), 5.0% for noninvasive blood pressure (4.0 to 6.0%), and 7.3% for invasive blood pressure (5.9 to 8.8%). The incidence of artifacts among deviating values was 3.1% for heart rate (2.1 to 4.4%), 10.8% for oxygen saturation (7.6 to 14.8%), 14.1% for end-tidal carbon dioxide (13.0 to 15.2%), 14.4% for noninvasive blood pressure (10.3 to 19.4%), and 38.4% for invasive blood pressure (30.3 to 47.1%).
Not all values in anesthesia information management systems are valid. The incidence of artifacts stored in the present pediatric anesthesia practice was low for heart rate and oxygen saturation, whereas noninvasive and invasive blood pressure and end-tidal carbon dioxide had higher artifact incidences. Deviating values are more often artifacts than values in a normal range, and artifacts are associated with the phase of anesthesia and anesthetic technique. Development of (automatic) data validation systems or solutions to deal with artifacts in data is warranted.
麻醉信息管理系统中收集的生命参数数据通常用于临床研究。此类研究的有效性取决于伪影的数量。
在这项前瞻性观察队列研究中,我们调查了在接受非心脏手术麻醉的儿童中,麻醉信息管理系统数据中的伪影发生率。次要结局包括在偏离值和非偏离值、麻醉各阶段以及不同麻醉技术中,伪影的发生率。
我们纳入了 136 例麻醉,代表 10236 分钟的麻醉时间。心率的伪影发生率为 0.5%(95%CI:0.4 至 0.7%),氧饱和度为 1.3%(1.1 至 1.5%),呼气末二氧化碳为 7.5%(6.9 至 8.0%),非侵入性血压为 5.0%(4.0 至 6.0%),有创血压为 7.3%(5.9 至 8.8%)。偏离值的伪影发生率为心率 3.1%(2.1 至 4.4%),氧饱和度 10.8%(7.6 至 14.8%),呼气末二氧化碳 14.1%(13.0 至 15.2%),非侵入性血压 14.4%(10.3 至 19.4%),有创血压 38.4%(30.3 至 47.1%)。
并非麻醉信息管理系统中的所有值都是有效的。目前儿科麻醉实践中存储的伪影发生率在心率和氧饱和度方面较低,而无创和有创血压和呼气末二氧化碳的伪影发生率较高。偏离值比正常范围内的值更容易出现伪影,且伪影与麻醉阶段和麻醉技术有关。需要开发(自动)数据验证系统或解决数据中的伪影问题的解决方案。