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一种新型非穿戴式片状监测仪(Nemuri SCAN)的可行性和临床实用性:呼吸频率增加对临终患者的预后价值。

Feasibility and Clinical Usefulness of a Novel Nonwearable Sheet-Type Monitor (Nemuri SCAN): Prognostic Value of Increased Respiratory Rate in Actively Dying Patients.

机构信息

Graduate School of Medicine, Osaka University, Osaka, Japan.

Department of Palliative Care, Senri-Chuo Hospital, Osaka, Japan.

出版信息

J Palliat Med. 2021 Nov;24(11):1634-1640. doi: 10.1089/jpm.2020.0508. Epub 2021 Mar 17.

Abstract

The objective of this study was to explore the feasibility of monitoring actively dying patients hospitalized in a palliative care unit using a nonwearable sheet-type monitor that measured the state of sleep and vital signs per minute. In addition, we aimed to clarify the incidence of increased respiratory rate and its relationship with survival time. This study was conducted at a 51-bed palliative care unit in Japan from April 2018 through October 2019. Actively dying patients hospitalized in the palliative care unit were eligible to participate. Increased respiratory rate was measured by Nemuri SCAN, and patient's information was extracted from their medical records. In this study, 23 patients were monitored until death; 19 patients with an observational period of 7 days or longer (163 patient days in total) were included in this analysis. There were no adverse events due to use of the nonwearable device. The cumulative incidence of increased respiratory rate (defined as more than 30 respiratory rate per minute) was 63.16% during the observational period, and the mean time between appearance of increased respiratory rate and death was 4.17 ± 4.04 days. This study clearly shows that hospitalized actively dying patients can be monitored using a nonwearable sheet-type monitor that measures sleeping state and vital signs per minute. Further studies are needed to utilize these noninvasive continuous monitoring devices in daily clinical practice.

摘要

本研究旨在探讨使用非穿戴式片状监测仪每分钟监测睡眠状态和生命体征来监测住院姑息治疗病房中处于主动濒死状态患者的可行性。此外,我们旨在阐明呼吸频率增加的发生率及其与生存时间的关系。

本研究于 2018 年 4 月至 2019 年 10 月在日本的一个 51 床姑息治疗病房进行。有资格参加的是住院姑息治疗病房中处于主动濒死状态的患者。通过 Nemuri SCAN 测量呼吸频率增加,从患者的病历中提取患者信息。

在这项研究中,有 23 名患者接受监测直至死亡;19 名观察期为 7 天或更长时间的患者(总共 163 个患者日)被纳入本分析。使用非穿戴式设备没有发生不良事件。观察期间,呼吸频率增加(定义为每分钟超过 30 次呼吸)的累积发生率为 63.16%,呼吸频率增加出现到死亡的平均时间为 4.17±4.04 天。

本研究清楚地表明,住院主动濒死患者可以使用非穿戴式片状监测仪每分钟监测睡眠状态和生命体征进行监测。需要进一步的研究来将这些非侵入性连续监测设备应用于日常临床实践中。

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