Neonatal Services, The Rosie Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Arch Dis Child Fetal Neonatal Ed. 2018 Jul;103(4):F307-F311. doi: 10.1136/archdischild-2017-313493. Epub 2017 Oct 27.
To investigate the frequency and cause of neonatal ventilator alarms. Neonatal ventilators frequently alarm and also disturb babies, parents and nurses. If frequent they may cause alarm fatigue and be ignored. The number, frequency and details of neonatal ventilator alarms are unreported.
We developed programs for retrieving and analysing ventilator data each second on alarms and ventilation parameters from 46 babies ventilated with Dräger Babylog VN500 ventilators using various modes.
A mean of 60 hours was recorded per baby. Over 116 days, 27 751 alarms occurred. On average, that was 603 per baby and 10 per hour. Median (IQR) alarm duration was 10 (4-21) s. Type, frequency and duration varied between infants. Some babies had >10% of their time with alarms. Eight alarm types caused ~99% of all alarms. Three alarms, 'MV <low limit', 'MV >high limit' and 'respiratory rate >high limit', caused 46.6%, often due to inappropriate settings. 49.9% were due to a low expired tidal volume during volume guarantee ventilation, often due to the maximum pressure being set too low. 26 106 (94.1%) of all alarms lasted <1 min. However, 86 alarms lasted >10 min and 16 alarms >1 hour. Similar alarms were frequently clustered, sometimes >100/hour.
Frequent ventilator alarms are caused by physiological variability in the respiratory rate or minute volume, inappropriate alarm limits or too low maximum peak inflating pressure during volume-targeted ventilation. While most alarms were very short, sometimes alarms were ignored by neonatal intensive care unit staff for long periods.
调查新生儿呼吸机报警的频率和原因。新生儿呼吸机经常报警，也会打扰婴儿、父母和护士。如果频繁发生，可能会导致报警疲劳而被忽视。新生儿呼吸机报警的数量、频率和详细信息尚未报道。
我们开发了程序，每秒从使用各种模式的 46 名使用 Dräger Babylog VN500 呼吸机通气的婴儿中检索和分析呼吸机数据和通气参数的报警。
每个婴儿平均记录 60 小时。在 116 天内，共发生 27751 次报警。平均每个婴儿 603 次，每小时 10 次。中位数（IQR）报警持续时间为 10（4-21）秒。婴儿之间的报警类型、频率和持续时间各不相同。一些婴儿有超过 10%的时间处于报警状态。8 种报警类型导致了~99%的所有报警。三种报警，“MV <低限”、“MV >高限”和“呼吸频率 >高限”，导致 46.6%，通常是由于设置不当。49.9%是由于在容积保证通气期间呼出潮气量低，通常是由于最大压力设置得太低。26106（94.1%）的所有报警持续时间<1 分钟。然而，86 次报警持续时间>10 分钟，16 次报警持续时间>1 小时。相似的报警经常聚集在一起，有时每小时超过 100 次。
频繁的呼吸机报警是由呼吸频率或分钟通气量的生理变异性、报警限设置不当或容积目标通气时最大峰值充气压力过低引起的。虽然大多数报警时间很短，但有时新生儿重症监护病房工作人员会忽略报警很长一段时间。
