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医院病房中呼吸频率的非接触式连续监测:一项临床验证研究。

Contactless and continuous monitoring of respiratory rate in a hospital ward: a clinical validation study.

作者信息

Toften Ståle, Kjellstadli Jonas T, Kværness Jørn, Pedersen Line, Laugsand Lars E, Thu Ole K F

机构信息

Department of Research and Data Science, Vitalthings AS, Trondheim, Norway.

God Klinisk Forskning, Oppdal, Norway.

出版信息

Front Physiol. 2024 Nov 27;15:1502413. doi: 10.3389/fphys.2024.1502413. eCollection 2024.

Abstract

INTRODUCTION

Continuous monitoring of respiratory rate in hospital wards can provide early detection of clinical deterioration, thereby reducing mortality, reducing transfers to intensive care units, and reducing the hospital length of stay. Despite the advantages of continuous monitoring, manually counting every 1-12 h remains the standard of care in most hospital wards. The objective of this study was to validate continuous respiratory rate measurements from a radar-based contactless patient monitor [Vitalthings Guardian M10 (Vitalthings AS, Norway)] in a hospital ward.

METHODS

An observational study (clinicaltrials.gov: NCT06083272) was conducted at the emergency ward of a university hospital. Adult patients were monitored during rest with Vitalthings Guardian M10 in both a stationary and mobile configuration simultaneously with a reference device [Nox T3s (Nox Medical, Alpharetta, GA, United States)]. The agreement was assessed using Bland-Altman 95% limits of agreement. The sensitivity and specificity of clinical alarms were evaluated using a Clarke Error grid modified for continuous monitoring of respiratory rate. Clinical aspects were further evaluated in terms of trend analysis and examination of gaps between valid measurements.

RESULTS

32 patients were monitored for a median duration of 42 min [IQR (range) 35-46 (30-59 min)]. The bias was 0.1 and 0.0 breaths min and the 95% limits of agreement ranged from -1.1 to 1.2 and -1.1 to 1.1 breaths min for the stationary and mobile configuration, respectively. The concordances for trends were 96%. No clinical alarms were missed, and no false alarms or technical alarms were generated. No interval without a valid measurement was longer than 5 min.

CONCLUSION

Vitalthings Guardian M10 measured respiratory rate accurately and continuously in resting patients in a hospital ward.

摘要

引言

在医院病房持续监测呼吸频率可实现对临床病情恶化的早期检测,从而降低死亡率、减少转入重症监护病房的次数并缩短住院时间。尽管持续监测具有诸多优势,但在大多数医院病房中,每1 - 12小时手动计数仍为护理标准。本研究的目的是在医院病房中验证基于雷达的非接触式患者监护仪[Vitalthings Guardian M10(Vitalthings AS,挪威)]所测得的呼吸频率。

方法

在一家大学医院的急诊科进行了一项观察性研究(clinicaltrials.gov:NCT06083272)。成年患者在休息时使用Vitalthings Guardian M10进行固定和移动配置监测,同时使用参考设备[Nox T3s(Nox Medical,美国佐治亚州阿尔法利塔)]。使用布兰德 - 奥特曼95%一致性界限评估一致性。使用针对呼吸频率持续监测修改后的克拉克误差网格评估临床警报的敏感性和特异性。从趋势分析和有效测量之间间隔的检查方面进一步评估临床情况。

结果

对32名患者进行了监测,中位持续时间为42分钟[四分位间距(范围)35 - 46(30 - 59分钟)]。固定配置和移动配置的偏差分别为0.1次/分钟和0.0次/分钟,95%一致性界限分别为 - 1.1至1.2次/分钟和 - 1.1至1.1次/分钟。趋势一致性为96%。未遗漏任何临床警报,未产生误报或技术警报。无有效测量的间隔时间均未超过5分钟。

结论

Vitalthings Guardian M10在医院病房中能准确、持续地测量静息患者的呼吸频率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9415/11631942/2f9e6a4f0814/fphys-15-1502413-g001.jpg

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