Institute for Medical Engineering & Science, Massachusetts Institute of Technology, Cambridge, MA, USA.
Nihon Kohden Innovation Center, Cambridge, MA, USA.
J Perinatol. 2018 Aug;38(8):1030-1038. doi: 10.1038/s41372-018-0095-x. Epub 2018 May 8.
To characterize the rate of monitoring alarms by alarm priority, signal type, and developmental age in a Level-IIIB Neonatal Intensive Care Unit (NICU) population.
Retrospective analysis of 2,294,687 alarm messages from Philips monitors in a convenience sample of 917 NICU patients, covering 12,001 patient-days. We stratified alarm rates by alarm priority, signal type, postmenstrual age (PMA) and birth weight (BW), and reviewed and adjudicated over 21,000 critical alarms.
Of all alarms, 3.6% were critical alarms, 55.0% were advisory alarms, and 41.4% were device alerts. Over 60% of alarms related to oxygenation monitoring. The average alarm rate (±SEM) was 177.1 ± 4.9 [median: 135.9; IQR: 89.2-213.3] alarms/patient-day; the medians varied significantly with PMA and BW (p < 0.001) in U-shaped patterns, with higher rates at lower and higher PMA and BW. Based on waveform reviews, over 99% of critical arrhythmia alarms were deemed technically false.
The alarm burden in this NICU population is very significant; the average alarm rate significantly underrepresents alarm rates at low and high PMA and BW. Virtually all critical arrhythmia alarms were artifactual.
描述三级新生儿重症监护病房（NICU）人群中根据报警优先级、信号类型和发育年龄对监测报警的监测率。
对飞利浦监护仪的 2,294,687 条报警信息进行回顾性分析，便利抽样选取了 917 例 NICU 患者，共 12,001 例患者日。我们根据报警优先级、信号类型、胎龄（PMA）和出生体重（BW）对报警率进行分层，并对超过 21,000 个关键报警进行了审查和裁决。
所有报警中，3.6%为关键报警，55.0%为提示报警，41.4%为设备报警。超过 60%的报警与氧合监测有关。平均报警率（±SEM）为 177.1±4.9[中位数：135.9；四分位距：89.2-213.3]报警/患者日；中位数与 PMA 和 BW 显著相关（p<0.001），呈 U 形模式，在较低和较高的 PMA 和 BW 时，报警率较高。基于波形审查，超过 99%的关键心律失常报警被认为是技术上的假报警。
该 NICU 人群的报警负担非常大；平均报警率显著低估了低 PMA 和高 PMA 及 BW 时的报警率。几乎所有关键心律失常报警都是人为的。
