Anirudha Das1, Maroun Mhanna1, Amy Teleron-Khorshad1, John Houdek2, Nitin Kumar1, Douglas Gunzler3, Marc Collin4. 1. a Department of Pediatrics , Metro Health Medical Center, Case Western Reserve University , Cleveland , OH , USA . 2. b Information Services, The MetroHealth System , Cleveland , OH , USA . 3. c Center for Health Care Research & Policy, Metro Health Medical Center, Case Western Reserve University , Cleveland , OH , USA , and. 4. d Division of Neonatology, Department of Pediatrics, Metro Health Medical Center, Case Western Reserve University , Cleveland , OH , USA.
Abstract
BACKGROUND: It is vital to maintain the saturation of peripheral oxygenation (SpO2) in a targeted range in extremely premature infants to improve survival without significant morbidities. OBJECTIVES: To compare manual versus automated monitor documentations of daily upper and lower values of SpO2 in premature infants. METHODS: In a prospective observational study, the highest and lowest daily SpO2 manually recorded values from electronic medical records were compared with automatically recorded values from bedside cardiorespiratory monitors. RESULTS: Eighteen infants were monitored for 605 patient days, with a mean birth weight of 859 ± 183 g, and gestational age of 26.0 ± 1.3 wks. Within the lowest SpO2 values, manually recorded values were consistently higher than the simultaneous automatically recorded monitor values. The highest SpO2 point differences in documentation was seen in patients with SpO2 range ≤ 70% (16 ± 13 points), followed by 71-80% (10 ± 7 points) and 81-90% (7 ± 4 points); p < 0.01. CONCLUSIONS: The difference between manually and automatically recorded SpO2 is large in lower SpO2 ranges and small in higher SpO2 ranges. Automated oxygen administering systems should be considered to reduce potential errors.
BACKGROUND: It is vital to maintain the saturation of peripheral oxygenation (SpO2) in a targeted range in extremely premature infants to improve survival without significant morbidities. OBJECTIVES: To compare manual versus automated monitor documentations of daily upper and lower values of SpO2 in premature infants. METHODS: In a prospective observational study, the highest and lowest daily SpO2 manually recorded values from electronic medical records were compared with automatically recorded values from bedside cardiorespiratory monitors. RESULTS: Eighteen infants were monitored for 605 patient days, with a mean birth weight of 859 ± 183 g, and gestational age of 26.0 ± 1.3 wks. Within the lowest SpO2 values, manually recorded values were consistently higher than the simultaneous automatically recorded monitor values. The highest SpO2 point differences in documentation was seen in patients with SpO2 range ≤ 70% (16 ± 13 points), followed by 71-80% (10 ± 7 points) and 81-90% (7 ± 4 points); p < 0.01. CONCLUSIONS: The difference between manually and automatically recorded SpO2 is large in lower SpO2 ranges and small in higher SpO2 ranges. Automated oxygen administering systems should be considered to reduce potential errors.
Entities:
Keywords:
Automated; manual; monitor; neonatal; prematurity; saturation of peripheral oxygenation