Multicenter Study Validating Accuracy of a Continuous Respiratory Rate.pdf (original) (raw)
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Pulse oximetry-derived respiratory rate in general care floor patients
Journal of Clinical Monitoring and Computing, 2014
Respiratory rate is recognized as a clinically important parameter for monitoring respiratory status on the general care floor (GCF). Currently, intermittent manual assessment of respiratory rate is the standard of care on the GCF. This technique has several clinically-relevant shortcomings, including the following: (1) it is not a continuous measurement, (2) it is prone to observer error, and (3) it is inefficient for the clinical staff. We report here on an algorithm designed to meet clinical needs by providing respiratory rate through a standard pulse oximeter. Finger photoplethysmograms were collected from a cohort of 63 GCF patients monitored during free breathing over a 25-min period. These were processed using a novel in-house algorithm based on continuous wavelet-transform technology within an infrastructure incorporating confidence-based averaging and logical decision-making processes. The computed oximeter respiratory rates (RR oxi ) were compared to an end-tidal CO 2 reference rate (RR ETCO2 ). RR ETCO2 ranged from a lowest recorded value of 4.7 breaths per minute (brpm) to a highest value of 32.0 brpm. The mean respiratory rate was 16.3 brpm with standard deviation of 4.7 brpm. Excellent agreement was found between RR oxi and RR ETCO2 , with a mean difference of -0.48 brpm and standard deviation of 1.77 brpm. These data demonstrate that our novel respiratory rate algorithm is a potentially viable method of monitoring respiratory rate in GCF patients. This technology provides the means to facilitate continuous monitoring of respiratory rate, coupled with arterial oxygen saturation and pulse rate, using a single noninvasive sensor in low acuity settings.
Anesthesia and analgesia, 2017
Intermittent measurement of respiratory rate via observation is routine in many patient care settings. This approach has several inherent limitations that diminish the clinical utility of these measurements because it is intermittent, susceptible to human error, and requires clinical resources. As an alternative, a software application that derives continuous respiratory rate measurement from a standard pulse oximeter has been developed. We sought to determine the performance characteristics of this new technology by comparison with clinician-reviewed capnography waveforms in both healthy subjects and hospitalized patients in a low-acuity care setting. Two independent observational studies were conducted to validate the performance of the Medtronic Nellcor Respiration Rate Software application. One study enrolled 26 healthy volunteer subjects in a clinical laboratory, and a second multicenter study enrolled 53 hospitalized patients. During a 30-minute study period taking place while...
Respirology, 2014
Pulse oximetry provides a simple, non-invasive approximation of arterial oxygenation in a wide variety of clinical settings including emergency and criticalcare medicine, hospital-based and ambulatory care, perioperative monitoring, inpatient and outpatient settings, and for specific diagnostic applications. Pulse oximetry is of utility in perinatal, paediatric, adult and geriatric populations but may require use of agespecific sensors in these groups. It plays a role in the monitoring and treatment of respiratory dysfunction by detecting hypoxaemia and is effective in guiding oxygen therapy in both adult and paediatric populations. Pulse oximetry does not provide information about the adequacy of ventilation or about precise arterial oxygenation, particularly when arterial oxygen levels are very high or very low. Arterial blood gas analysis is the gold standard in these settings. Pulse oximetry may be inaccurate as a marker of oxygenation in the presence of dyshaemoglobinaemias such as carbon monoxide poisoning or methaemoglobinaemia where arterial oxygen saturation values will be overestimated. Technical considerations such as sensor position, signal averaging time and data sampling rates may influence clinical interpretation of pulse oximetry readings.
A comparison of pulse oximetry and respiratory rate in patient screening
Respiratory medicine, 1996
To examine how well respiratory rate correlates with arterial oxygen saturation status as measured by pulse oximetry, and determine whether respiratory rate measurements detect oxygen desaturation reliably. Respiratory rate (RR) and oxygen saturation (SaO2) were measured prospectively on 12,096 consecutive adult emergency department triage patients at a university medical center. Respiratory rate was measured by counting ausculated breath sounds for 1 min. Pulse oximetry was used to measure SaO2. Measurements were analysed by age (with one group for 18-19 year olds, groups for every 10 yr from age 20 to age 60, and groups for every 5 yr for subsequent ages). Pearson correlation coefficients were calculated for each age group as well as the weighted average coefficient. Cases having oxygen saturation below 90% were examined to determine how frequently they exhibited increased RR (increased RRs were defined as any rate in the upper five percentile by age. Correlation coefficients rang...
2015
Introduction: Fingertip pulse oximeters are commonly used as non-invasive modes of measuring oxygen saturation (SpO 2 ) and heart rate (HR) in critical care units. In these cases, a shorter duration of time required obtaining the measurement and time to stabilization is crucial. Objective: Our aim was to compare two new generation pulse oximeters with respect to latency in the fi rst reading and time to stabilization of SpO 2 and HR. Materials and Methods: This study was a prospective, comparative non-blinded, observational study of two fi ngertip pulse oximeters (Nonin Medical 9560 and CHOICEMMED MD300C1) in 20 in patients at Benedectine Health Center suffering from either one or more chronic diseases. SpO 2 and HR readings were collected at the time of fi rst display, 30 s, 60 s and at the time of stabilization of the reading (no more than a 1% change in SpO 2 , <3 bpm change in HR). Statistical analysis was performed with SAS 9.2 software. Results: A total of 20 subjects were ...
New-generation pulse oximetry in the care of critically Ill patients
American Journal of Critical Care
OBJECTIVE To review the published, peer-reviewed studies to date on use of the new-generation pulse oximeters, which are manufactured with algorithms to filter out patients' body motions, and describe the application of new-generation pulse oximetry in clinical practice in critical care. • METHODS MEDLINE was used to locate appropriate articles on pulse oximetry for the years 1995 to 2003. Each article was examined for scientific merit, content, and applicability to clinical practice. • RESULTS A total of 17 relevant articles on the clinical performance of the new-generation pulse oximeters were reviewed, and the data were organized into a table. • CONCLUSIONS The combination of studies done in both clinical and laboratory settings did not provide any strong and convincing evidence that the performance of any single new-generation device was superior to that of any other new-generation device. However, the clinical performance of all the newgeneration pulse oximetry devices was better than that of earlier devices.
Journal of clinical and diagnostic research : JCDR, 2017
Pulse oximetry is a widely used tool, unfortunately there is a paucity of data investigating its accuracy in Intensive Care Units (ICU) and if they are able to meet mandated FDA criteria as claimed by them in critically ill patients. To assess bias, precision and accuracy of pulse oximeters used in ICU and factors affecting them. A prospective cohort study, including 129 patients admitted to the ICU of a tertiary referral centre. Pulse oximetry and blood gas were done simultaneously. Pulse oximetry was done using two pulse oximetres: Nonin and Philips. All physiological variables like haemoglobin, lactate, use of vasopressors and blood pressure were recorded. Bland Altman curves were constructed to determine bias and limits of agreement. Effect of physiological variables on bias and difference between performance characteristics of bias was determined using SPSS. Pulse oximetry overestimated arterial oxygen saturation (SaO2) by 1.44%. There was negative correlation between bias and ...