MORE INTELLIGENCE IN THE NEWBORN ICU: A COMPUTER ASSISTED MONITORING SYSTEM

Abstract

Despite the age of computer technology, most of the data from continuous physiologic measurements in intensive care nurseries is still entered intermittently by hand into the charts. We have developed a computer-assisted bedside monitoring system which provides continuous recording, storage, and data analysis. Heart rate, respiratory rate, mean airway pressure, inspired oxygen, systemic arterial and venous pressure, skin surface PO₂ (P_sO₂), PCO₂, and intracranial pressure are sampled every second. The computer hardware allows continuous data from 4 infants for 80 hours on each disk. In addition, the range of acceptable values for each variable can be defined and the computer analyzes all events outside of these ranges, A and B in Fig. Analysis includes frequency, duration, severity (area under curve) of each event. Pattern recognition of artifacts has allowed their elimination from analysis.

We have studied 37 patients for a total of 147 days. Applications include on-line analysis of the effectivenesss of interventions. "Re-run" data has provided a review of the courses preceding cardiorespiratory arrest, intraventricular hemorrhage and pneumothorax. We conclude that this system allows previously impossible continuous on-line recording, storage, and analysis of multiple physiologic variables.

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