在重症监护病房内,心室慢动脉和住院死亡率在重症监护病房
Priya A Prasad1,2, Jonas L Isaksen3, Yumiko Abe-Jones1
1Department of Medicine, Division of Hospital Medicine, School of Medicine, University of California, San Francisco, San Francisco, California.
Heart rhythm O2
|November 30, 2023
概括
不断的心电图 (ECG) 监测心室动脉障 (VT) 经常会引发错误的警报. 一个新的算法识别了与死亡率相关的高风险VT,与目前的床边监视器不同,但需要进一步验证.
科学领域:
- 心脏病学 心脏病学
- 关键护理医学 关键护理医学
- 医疗器械技术 医疗器械技术
背景情况:
- 持续的心电图 (ECG) 监测对于在重症监护病房 (ICU) 检测腹腔动心 (VT) 是至关重要的.
- 当前床边心电图监视器的频繁错误报警可能会导致报警疲劳,并可能掩盖真正的关键事件.
研究的目的:
- 为了比较30天住院死亡率与VT警报传统床边心电图监视器与ICU患者的新算法相比.
- 评估不同类型的静脉瘤警报在预测患者结果方面的临床意义.
主要方法:
- 进行了一项回顾性队列研究,涉及城市学术医疗中心的成年ICU患者.
- 使用生存分析来评估VT警报 (床边监视器,新算法和真实VT) 与30天住院死亡率之间的关联.
- 分析了来自5679个ICU入院的数据.
主要成果:
- 虽然30.1%的患者经历了当前床边监视器的警报,但这些并没有与30天死亡率的增加有关 (aHR1.06).
- 来自新的,未注释的算法 (14.3%的患者) 和真正注释的静脉治疗 (11.6%的患者) 的警报与30天住院死亡率的增加显著相关 (aHR分别为1.38和1.39).
- 整体30天住院死亡率为8.9% (503名患者).
结论:
- 来自新算法和真实静脉动脉的静脉动脉 (VT) 警报与更高的30天住院死亡率有关.
- 目前的床边心电图监测器VT警报似乎与死亡率的增加无关,这表明错误报警率很高.
- 这种新的算法在识别高风险静脉治疗方面表现有前途,但需要进行前性验证以确认其临床实用性.
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