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Vital sign metrics of VLBW infants in three NICUs: implications for predictive algorithms.
Zimmet, Amanda M; Sullivan, Brynne A; Fairchild, Karen D; Moorman, J Randall; Isler, Joseph R; Wallman-Stokes, Aaron W; Sahni, Rakesh; Vesoulis, Zachary A; Ratcliffe, Sarah J; Lake, Douglas E.
Afiliación
  • Zimmet AM; Department of Medicine, University of Virginia, Charlottesville, VA, USA.
  • Sullivan BA; Department of Pediatrics, University of Virginia, Charlottesville, VA, USA.
  • Fairchild KD; Department of Pediatrics, University of Virginia, Charlottesville, VA, USA. kdf2n@virginia.edu.
  • Moorman JR; Department of Medicine, University of Virginia, Charlottesville, VA, USA.
  • Isler JR; Department of Pediatrics, Columbia University, New York, NY, USA.
  • Wallman-Stokes AW; Department of Pediatrics, Columbia University, New York, NY, USA.
  • Sahni R; Department of Pediatrics, Columbia University, New York, NY, USA.
  • Vesoulis ZA; Department of Pediatrics, Washington University St. Louis, St. Louis, MO, USA.
  • Ratcliffe SJ; Department of Public Health Science, University of Virginia, Charlottesville, VA, USA.
  • Lake DE; Department of Medicine, University of Virginia, Charlottesville, VA, USA.
Pediatr Res ; 90(1): 125-130, 2021 07.
Article en En | MEDLINE | ID: mdl-33767372
BACKGROUND: Continuous heart rate (HR) and oxygenation (SpO2) metrics can be useful for predicting adverse events in very low birth weight (VLBW) infants. To optimize the utility of these tools, inter-site variability must be taken into account. METHODS: For VLBW infants at three neonatal intensive care units (NICUs), we analyzed the mean, standard deviation, skewness, kurtosis, and cross-correlation of electrocardiogram HR, pulse oximeter pulse rate, and SpO2. The number and durations of bradycardia and desaturation events were also measured. Twenty-two metrics were calculated hourly, and mean daily values were compared between sites. RESULTS: We analyzed data from 1168 VLBW infants from birth through day 42 (35,238 infant-days). HR and SpO2 metrics were similar at the three NICUs, with mean HR rising by ~10 beats/min over the first 2 weeks and mean SpO2 remaining stable ~94% over time. The number of bradycardia events was higher at one site, and the duration of desaturations was longer at another site. CONCLUSIONS: Mean HR and SpO2 were generally similar among VLBW infants at three NICUs from birth through 6 weeks of age, but bradycardia and desaturation events differed in the first 2 weeks after birth. This highlights the importance of developing predictive analytics tools at multiple sites. IMPACT: HR and SpO2 analytics can be useful for predicting adverse events in VLBW infants in the NICU, but inter-site differences must be taken into account in developing predictive algorithms. Although mean HR and SpO2 patterns were similar in VLBW infants at three NICUs, inter-site differences in the number of bradycardia events and duration of desaturation events were found. Inter-site differences in bradycardia and desaturation events among VLBW infants should be considered in the development of predictive algorithms.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Algoritmos / Unidades de Cuidado Intensivo Neonatal / Recién Nacido de muy Bajo Peso / Signos Vitales Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Male / Newborn Idioma: En Revista: Pediatr Res Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Algoritmos / Unidades de Cuidado Intensivo Neonatal / Recién Nacido de muy Bajo Peso / Signos Vitales Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Male / Newborn Idioma: En Revista: Pediatr Res Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos