Zimmet Amanda M, Sullivan Brynne A, Fairchild Karen D, Moorman J Randall, Isler Joseph R, Wallman-Stokes Aaron W, Sahni Rakesh, Vesoulis Zachary A, Ratcliffe Sarah J, Lake Douglas E
Department of Medicine, University of Virginia, Charlottesville, VA, USA.
Department of Pediatrics, University of Virginia, Charlottesville, VA, USA.
Pediatr Res. 2021 Jul;90(1):125-130. doi: 10.1038/s41390-021-01428-3. Epub 2021 Mar 25.
Continuous heart rate (HR) and oxygenation (SpO) metrics can be useful for predicting adverse events in very low birth weight (VLBW) infants. To optimize the utility of these tools, inter-site variability must be taken into account.
For VLBW infants at three neonatal intensive care units (NICUs), we analyzed the mean, standard deviation, skewness, kurtosis, and cross-correlation of electrocardiogram HR, pulse oximeter pulse rate, and SpO. The number and durations of bradycardia and desaturation events were also measured. Twenty-two metrics were calculated hourly, and mean daily values were compared between sites.
We analyzed data from 1168 VLBW infants from birth through day 42 (35,238 infant-days). HR and SpO metrics were similar at the three NICUs, with mean HR rising by ~10 beats/min over the first 2 weeks and mean SpO remaining stable ~94% over time. The number of bradycardia events was higher at one site, and the duration of desaturations was longer at another site.
Mean HR and SpO were generally similar among VLBW infants at three NICUs from birth through 6 weeks of age, but bradycardia and desaturation events differed in the first 2 weeks after birth. This highlights the importance of developing predictive analytics tools at multiple sites.
HR and SpO analytics can be useful for predicting adverse events in VLBW infants in the NICU, but inter-site differences must be taken into account in developing predictive algorithms. Although mean HR and SpO patterns were similar in VLBW infants at three NICUs, inter-site differences in the number of bradycardia events and duration of desaturation events were found. Inter-site differences in bradycardia and desaturation events among VLBW infants should be considered in the development of predictive algorithms.
连续心率（HR）和氧合（SpO）指标有助于预测极低出生体重（VLBW）婴儿的不良事件。为优化这些工具的效用，必须考虑不同地点之间的差异。
针对三个新生儿重症监护病房（NICU）中的VLBW婴儿，我们分析了心电图HR、脉搏血氧仪脉搏率和SpO的均值、标准差、偏度、峰度及互相关性。还测量了心动过缓和血氧饱和度降低事件的数量及持续时间。每小时计算22项指标，并比较各地点之间的每日均值。
我们分析了1168例VLBW婴儿从出生至第42天（共35238婴儿日）的数据。三个NICU的HR和SpO指标相似，前两周平均HR升高约10次/分钟，平均SpO随时间保持在94%左右稳定。一个地点的心动过缓事件数量较多，另一个地点的血氧饱和度降低持续时间较长。
从出生至6周龄，三个NICU中VLBW婴儿的平均HR和SpO总体相似，但出生后前两周的心动过缓和血氧饱和度降低事件有所不同。这凸显了在多个地点开发预测分析工具的重要性。
HR和SpO分析有助于预测NICU中VLBW婴儿的不良事件，但在开发预测算法时必须考虑不同地点之间的差异。虽然三个NICU中VLBW婴儿的平均HR和SpO模式相似，但发现心动过缓事件数量和血氧饱和度降低事件持续时间存在地点间差异。在开发预测算法时应考虑VLBW婴儿心动过缓和血氧饱和度降低事件的地点间差异。
