重症监护病房（ICU）中左心室辅助装置（LVAD）治疗期间的心电图警报
ECG alarms during left ventricular assist device (LVAD) therapy in the ICU.
作者信息
Watanakeeree Kevin, Suba Sukardi, Mackin Lynda A, Badilini Fabio, Pelter Michele M
机构信息
Assistant Unit Director, Emergency Department, UCSF Medical Center, United States.
PhD Graduate, ECG Monitoring Research Lab, Department of Physiological Nursing, United States.
出版信息
Heart Lung. 2021 Nov-Dec;50(6):763-769. doi: 10.1016/j.hrtlng.2021.03.080. Epub 2021 Jul 2.
BACKGROUND
In hospitalized patients with left ventricular assist device (LVAD), electrical interference and low amplitude QRS complexes are common, which could impact the accuracy of electrocardiographic (ECG) arrhythmia detection and create technical alarms. This could contribute to provider alarm fatigue and threaten patient safety.
OBJECTIVES
We examined three LVAD patients in the cardiac intensive care unit (ICU) to determine: 1) the frequency and accuracy of audible arrhythmia alarms; 2) occurrence rates of technical alarms; and 3) alarm burden (# alarms/hour of monitoring) METHODS: Secondary analysis.
RESULTS
During 593 h, there were 549 audible arrhythmia alarms and 98% were false. There were 25,232 technical alarms and 93% were for artifact, which was configured as an inaudible text alert.
CONCLUSION
False-arrhythmia and technical alarms are frequent in LVAD patients. Future studies are needed to identify both clinical and algorithm-based strategies to improve arrhythmia detection and reduce technical alarms in LVAD patients.
背景
在植入左心室辅助装置（LVAD）的住院患者中，电干扰和低振幅QRS波群很常见，这可能会影响心电图（ECG）心律失常检测的准确性并引发技术警报。这可能导致医护人员出现警报疲劳并威胁患者安全。
目的
我们对心脏重症监护病房（ICU）的三名LVAD患者进行了检查，以确定：1）可听性心律失常警报的频率和准确性；2）技术警报的发生率；3）警报负担（每小时监测的警报数量）。方法：二次分析。
结果
在593小时的监测期间，有549次可听性心律失常警报，其中98%为误报。有25232次技术警报，其中93%是由伪差引起的，伪差被设置为不可听的文本警报。
结论
LVAD患者中频繁出现假性心律失常和技术警报。未来需要开展研究，以确定基于临床和算法的策略，以改善LVAD患者的心律失常检测并减少技术警报。
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