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.
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N.K.: Substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data; Drafting the article or revising it critically for important intellectual content; and Final approval of the version to be published. A.W.: Substantial contributions to acquisition and analysis of data. R.M.: Substantial contributions to analysis and interpretation of data. Revising the article critically for important intellectual content. V.S.: Substantial contributions in conception, drafting the article, and revising it critically for important intellectual content.
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Warburton, A., Monga, R., Sampath, V. et al. Continuous pulse oximetry and respiratory rate trends predict short-term respiratory and growth outcomes in premature infants. Pediatr Res 85, 494–501 (2019). https://doi.org/10.1038/s41390-018-0269-4
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DOI: https://doi.org/10.1038/s41390-018-0269-4
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