Venkatesh Sampath1, Navin Kumar2, Alyssa Warburton3, Ranjan Monga3. 1. Division of Neonatology, Children's Mercy Hospital, 2401 Gillham Road, Kansas, MO, 64108, USA. 2. Division of Neonatology, Hurley Children's Hospital, Flint, MI, 48503, USA. nkumar1@hurleymc.com. 3. Division of Neonatology, Hurley Children's Hospital, Flint, MI, 48503, USA.
Abstract
BACKGROUND: To examine the correlation between interval vital signs recorded by nursing staff and continuous monitor recordings, and to determine whether aggregated monitor recordings can better predict impending escalation of respiratory support in premature infants. METHOD: Preterm infants on noninvasive respiratory support or room air (RA) were prospectively enrolled. Nursing-and monitor-recorded pulse oximetry (SpO2) and respiratory rates (RR) data were recorded daily. RESULTS: Ninety four infants were recruited with median gestational age of 32 weeks and birth weight of 1848 g. > 3 × 106 data points were analyzed over 2204 patient days. Median events/day recorded was 8 (nursing) and 1424 (monitor) per infant. We did not find a strong correlation between monitor- and nursing events of tachypnea (RR > 70) and hypoxia (SpO2 < 90%). Infants with monitor-recorded hypoxia for > 5%/day (p < 0.0001) or tachypnea for > 30%/day (p < 0.0001) were more likely to require an increase in respiratory support within next 3 days. Monitor-recorded hypoxia and tachypnea were also associated with poor weight gain. CONCLUSIONS: Monitor-recorded trends for tachypnea and oxygen saturations < 90% were able to predict short-term respiratory outcomes, and were associated with growth outcomes. This study emphasizes the potential for monitor-recorded data to augment clinical decision making at the bedside.
BACKGROUND: To examine the correlation between interval vital signs recorded by nursing staff and continuous monitor recordings, and to determine whether aggregated monitor recordings can better predict impending escalation of respiratory support in premature infants. METHOD: Preterm infants on noninvasive respiratory support or room air (RA) were prospectively enrolled. Nursing-and monitor-recorded pulse oximetry (SpO2) and respiratory rates (RR) data were recorded daily. RESULTS: Ninety four infants were recruited with median gestational age of 32 weeks and birth weight of 1848 g. > 3 × 106 data points were analyzed over 2204 patient days. Median events/day recorded was 8 (nursing) and 1424 (monitor) per infant. We did not find a strong correlation between monitor- and nursing events of tachypnea (RR > 70) and hypoxia (SpO2 < 90%). Infants with monitor-recorded hypoxia for > 5%/day (p < 0.0001) or tachypnea for > 30%/day (p < 0.0001) were more likely to require an increase in respiratory support within next 3 days. Monitor-recorded hypoxia and tachypnea were also associated with poor weight gain. CONCLUSIONS: Monitor-recorded trends for tachypnea and oxygen saturations < 90% were able to predict short-term respiratory outcomes, and were associated with growth outcomes. This study emphasizes the potential for monitor-recorded data to augment clinical decision making at the bedside.