Department of Paediatrics and Child Health, University of Otago Wellington, Wellington, New Zealand.
Department of Medicine, University of Otago Wellington, Wellington, New Zealand.
Acta Paediatr. 2018 Aug;107(8):1362-1369. doi: 10.1111/apa.14293. Epub 2018 Mar 26.
To create editing guidelines for artefact removal in preterm infant pulse oximetry recordings.
38 preterm infants ready for discharge home from the neonatal intensive care unit underwent 24-hour pulse oximetry recording using the Masimo Rad-8 device. An expert panel determined editing rules based on clinical protocols. For each recording, three reports were generated, 'raw' no editing, 'auto' using the software editing feature and 'manual' reviewed and edited according to the rules. Primary outcome measures were desaturation indices including desaturation index 3% and 4%. Secondary measures included heart rate, mean oxygen saturation and time below 90%.
While all oximetry outcomes differed significantly between editing modes, the majority were not considered likely to influence clinical management. Use of the auto editing compared to no editing did alter by >5%: Time spent <90% oxygen saturation and Desaturation index 4% >10 seconds. The use of manual editing removed extremely low pulse values that were considered unphysiological in this group of otherwise healthy infants.
We recommend that oximetry recordings to determine cardiorespiratory stability in newborn infants ready for discharge from the neonatal unit have software editing features applied. This will remove artefact without consuming time in a busy unit.
制定早产儿脉搏血氧仪记录中伪影去除的编辑指南。
38 名即将从新生儿重症监护病房出院的早产儿使用 Masimo Rad-8 设备进行 24 小时脉搏血氧仪记录。一个专家小组根据临床方案确定了编辑规则。对于每个记录，生成了三个报告，“原始”无编辑、“自动”使用软件编辑功能和“手动”根据规则进行审查和编辑。主要结局指标包括饱和度指数，包括 3%和 4%的饱和度指数。次要指标包括心率、平均氧饱和度和低于 90%的时间。
虽然所有血氧仪结果在编辑模式之间均有显著差异，但大多数结果不太可能影响临床管理。与不编辑相比，自动编辑改变了>5%：低于 90%氧饱和度的时间和 4%的饱和度指数>10 秒。手动编辑去除了在这群其他健康婴儿中被认为是生理上不相关的极低脉冲值。
我们建议对准备从新生儿病房出院的新生儿进行脉搏血氧仪记录，以确定心肺稳定性，应用软件编辑功能。这将在忙碌的病房中节省时间，去除伪影。
