Hörnchen H, Betz R, Siller V, Roebruck P
J Perinat Med. 1983;11(1):26-31. doi: 10.1515/jpme.1983.11.1.26.
Cardiorespirography is a well-known method of continuous monitoring in neonatal intensive care. Apneic attacks, bradycardia and tachycardia are registered. In our experience we connected a cardiorespirography recorder to a microprocessor system. The processor consisted of a hardware part including a program (software) and a printer which provided printouts of alarm events. As alarm situations, which cause an alarm printout, we defined: 1. apneic episodes (duration 10, 20 or 30 seconds) 2. tachycardiac (beat-to-beat rate greater than 180/minute) 3. V-shaped and U-shaped bradycardia (beat-to-beat heart rate less than 80/min) and combinations. The reliability of the system of recognizing and classifying alarm situations was tested by comparing the alarm printouts with the simultaneously recorded cardiorespirograms. Fifty eight 12 hour records of 41 patients were evaluated. Six hundred alarm situations were counted. The alarm printouts were found in concordance with the cardiograms in all tachycardia alarms. Nearly all bradycardia (V-shaped, U-shaped bradycardia, combination of bradycardia and apnea) were correctly classified. A preset apnea duration of 10 seconds resulted in many false positive alarm printouts. With 20 second apnea time only few false positive alarms were seen, but nine apneic attacks were not recognized. Altogether 81.5% of alarm printouts were correct, 16.8% were false alarms, or V-shaped bradycardia were really U-bradycardia. Only 2% of all alarms were not recognized by the microprocessor system. We suggest to combine the microprocessor with a special alarm recorder, which is able to store beat-to-beat heart rate and respiration wave before alarm situations.
心肺呼吸描记术是新生儿重症监护中一种广为人知的连续监测方法。可记录呼吸暂停发作、心动过缓和心动过速情况。根据我们的经验，我们将一台心肺呼吸描记器与一个微处理器系统相连。该处理器由一个硬件部分组成，包括一个程序（软件）和一台打印机，打印机可提供警报事件的打印输出。作为会引发警报打印输出的警报情况，我们定义为：1. 呼吸暂停发作（持续时间为10秒、20秒或30秒）；2. 心动过速（逐搏心率大于180次/分钟）；3. V形和U形心动过缓（逐搏心率小于80次/分钟）以及多种情况的组合。通过将警报打印输出与同时记录的心肺呼吸图进行比较，测试了该系统识别和分类警报情况的可靠性。对41名患者的58份12小时记录进行了评估。共统计出600次警报情况。在所有心动过速警报中，发现警报打印输出与心电图一致。几乎所有的心动过缓（V形、U形心动过缓、心动过缓和呼吸暂停的组合）都被正确分类。预设呼吸暂停持续时间为10秒会导致许多误报打印输出。呼吸暂停时间为20秒时，仅出现了少数误报，但有9次呼吸暂停发作未被识别。总体而言，81.5%的警报打印输出是正确的，16.8%是误报，或者V形心动过缓实际上是U形心动过缓。微处理器系统仅未识别出所有警报中的2%。我们建议将微处理器与一种特殊的警报记录器相结合，该记录器能够在警报情况发生前存储逐搏心率和呼吸波。
