在2019年冠状病毒病大流行期间实施探视限制的外科重症监护病房进行室内一氧化碳监测。

Indoor CO monitoring in a surgical intensive care unit under visitation restrictions during the COVID-19 pandemic.

作者信息

Chou Ying-An, Wang Zheng-Yao, Chang Hsiang-Ching, Liu Yi-Chia, Su Pei-Fang, Huang Yen Ta, Yang Chao-Tung, Lai Chao-Han

机构信息

Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

Department of Computer Science, Tunghai University, Taichung, Taiwan.

出版信息

Front Med (Lausanne). 2023 Jul 14;10:1052452. doi: 10.3389/fmed.2023.1052452. eCollection 2023.

DOI:10.3389/fmed.2023.1052452

PMID:37521349

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10375033/

Abstract

BACKGROUND

Indoor CO concentration is an important metric of indoor air quality (IAQ). The dynamic temporal pattern of CO levels in intensive care units (ICUs), where healthcare providers experience high cognitive load and occupant numbers are frequently changing, has not been comprehensively characterized.

OBJECTIVE

We attempted to describe the dynamic change in CO levels in the ICU using an Internet of Things-based (IoT-based) monitoring system. Specifically, given that the COVID-19 pandemic makes hospital visitation restrictions necessary worldwide, this study aimed to appraise the impact of visitation restrictions on CO levels in the ICU.

METHODS

Since February 2020, an IoT-based intelligent indoor environment monitoring system has been implemented in a 24-bed university hospital ICU, which is symmetrically divided into areas A and B. One sensor was placed at the workstation of each area for continuous monitoring. The data of CO and other pollutants (e.g., PM2.5) measured under standard and restricted visitation policies during the COVID-19 pandemic were retrieved for analysis. Additionally, the CO levels were compared between workdays and non-working days and between areas A and B.

RESULTS

The median CO level (interquartile range [IQR]) was 616 (524-682) ppm, and only 979 (0.34%) data points obtained in area A during standard visitation were ≥ 1,000 ppm. The CO concentrations were significantly lower during restricted visitation (median [IQR]: 576 [556-596] ppm) than during standard visitation (628 [602-663] ppm; < 0.001). The PM2.5 concentrations were significantly lower during restricted visitation (median [IQR]: 1 [0-1] μg/m) than during standard visitation (2 [1-3] μg/m; < 0.001). The daily CO and PM2.5 levels were relatively low at night and elevated as the occupant number increased during clinical handover and visitation. The CO concentrations were significantly higher in area A (median [IQR]: 681 [653-712] ppm) than in area B (524 [504-547] ppm; < 0.001). The CO concentrations were significantly lower on non-working days (median [IQR]: 606 [587-671] ppm) than on workdays (583 [573-600] ppm; < 0.001).

CONCLUSION

Our study suggests that visitation restrictions during the COVID-19 pandemic may affect CO levels in the ICU. Implantation of the IoT-based IAQ sensing network system may facilitate the monitoring of indoor CO levels.

摘要

背景

室内一氧化碳（CO）浓度是室内空气质量（IAQ）的一项重要指标。在重症监护病房（ICU）中，医护人员面临较高的认知负荷且病房内人员数量频繁变化，CO水平的动态时间模式尚未得到全面描述。

目的

我们试图使用基于物联网（IoT）的监测系统来描述ICU中CO水平的动态变化。具体而言，鉴于新冠疫情使得全球范围内有必要限制医院探视，本研究旨在评估探视限制对ICU中CO水平的影响。

方法

自2020年2月起，在一家拥有24张床位的大学医院ICU中实施了基于物联网的智能室内环境监测系统，该ICU对称分为A区和B区。在每个区域的工作站放置一个传感器进行连续监测。检索了新冠疫情期间在标准探视政策和限制探视政策下测得的CO及其他污染物（如PM2.5）的数据进行分析。此外，还比较了工作日和非工作日以及A区和B区之间的CO水平。

结果

CO水平的中位数（四分位间距[IQR]）为616（524 - 682）ppm，在标准探视期间A区获得的仅979个（0.34%）数据点≥1000 ppm。限制探视期间的CO浓度（中位数[IQR]：576[556 - 596]ppm）显著低于标准探视期间（628[602 - 663]ppm；P<0.001）。限制探视期间的PM2.5浓度（中位数[IQR]：1[0 - 1]μg/m）显著低于标准探视期间（2[1 - 3]μg/m；P<0.001）。夜间每日的CO和PM2.5水平相对较低，在临床交接班和探视期间随着人员数量增加而升高。A区的CO浓度（中位数[IQR]：681[653 - 712]ppm）显著高于B区（524[504 - 547]ppm；P<0.001）。非工作日的CO浓度（中位数[IQR]：606[587 - 671]ppm）显著低于工作日（583[573 - 600]ppm；P<0.001）。