Longitudinal Analysis of Continuous Pulse Oximetry as Prognostic Factor in Neonatal Respiratory Distress

2020 ◽  
Author(s):  
Gonzalo Solís-García ◽  
Elena Maderuelo-Rodríguez ◽  
Teresa Perez-Pérez ◽  
Laura Torres-Soblechero ◽  
Ana Gutiérrez-Vélez ◽  
...  
Keyword(s):  
Heart Rate ◽  
Intensive Care ◽  
Respiratory Distress ◽  
Oxygen Saturation ◽  
Continuous Monitoring ◽  
Vital Signs ◽  
Epidemiological Data ◽  
Monitoring Data ◽  
Joint Models ◽  
Neonatal Icu

Objective Analysis of longitudinal data can provide neonatologists with tools that can help predict clinical deterioration and improve outcomes. The aim of this study is to analyze continuous monitoring data in newborns, using vital signs to develop predictive models for intensive care admission and time to discharge. Study Design We conducted a retrospective cohort study, including term and preterm newborns with respiratory distress patients admitted to the neonatal ward. Clinical and epidemiological data, as well as mean heart rate and saturation, at every minute for the first 12 hours of admission were collected. Multivariate mixed, survival and joint models were developed. Results A total of 56,377 heart rate and 56,412 oxygen saturation data were analyzed from 80 admitted patients. Of them, 73 were discharged home and 7 required transfer to the intensive care unit (ICU). Longitudinal evolution of heart rate (p < 0.01) and oxygen saturation (p = 0.01) were associated with time to discharge, as well as birth weight (p < 0.01) and type of delivery (p < 0.01). Longitudinal heart rate evolution (p < 0.01) and fraction of inspired oxygen at admission at the ward (p < 0.01) predicted neonatal ICU (NICU) admission. Conclusion Longitudinal evolution of heart rate can help predict time to transfer to intensive care, and both heart rate and oxygen saturation can help predict time to discharge. Analysis of continuous monitoring data in patients admitted to neonatal wards provides useful tools to stratify risks and helps in taking medical decisions. Key Points

IoT Based Pulse Oximeter

2021 ◽  
Vol 9 (8) ◽  
pp. 2946-2951
Author(s):  
G Sidhartha
Keyword(s):  
Heart Rate ◽  
Signal Processing ◽  
Oxygen Saturation ◽  
Data Transmission ◽  
Pulse Oximeter ◽  
Mobile Application ◽  
Preventive Measures ◽  
Vital Signs ◽  
Home Treatment ◽  
Portable Devices

Abstract: In recent times, we have realized the importance of vital signs such as Oxygen saturation and heart rate i.e beats per minute (BPM) due to the covid-19 situation worldwide. SpO2 and BPM are being used as preliminary indicators for testing a person’s health, the drop in the oxygen saturation is perceived as one of the symptoms of a person suffering from coronavirus. Oximeters are portable devices that are used to measure the SpO2 and BPM of a person. Timely measurements of oxygen saturation can aid in taking preventive measures. This paper discusses the construction and development of an IoT-based pulse oximeter that is capable of transmitting the reading obtained to any remote location wirelessly. The proposed system uses Arduino as the microcontroller which is used for signal processing and Esp-01 as the Wifi platform to enable remote data transmission. The data is communicated remotely through Blynk mobile application. This project is aimed at reducing the manual effort undergone in regularly updating the oxygen saturation to the doctor, in the case of a person undergoing home treatment. Though an oximeter is not a screening te st, it is a primary indicator of a person’s health. Keywords: Heart rate, SpO2, IoT, Arduino, BLYNK server, Red, IR.

scholarly journals Characterization of Dexmedetomidine Dosing and Safety in Neonates and Infants

2015 ◽  
Vol 20 (2) ◽  
pp. 112-118 ◽  
Author(s):  
Lauren M. Estkowski ◽  
Jennifer L. Morris ◽  
Elizabeth A. Sinclair
Keyword(s):  
Blood Pressure ◽  
Intensive Care Unit ◽  
Heart Rate ◽  
Intensive Care ◽  
Systolic Blood Pressure ◽  
Vital Signs ◽  
Pediatric Intensive Care ◽  
Neonates And Infants ◽  
To Receive

OBJECTIVES: To describe and compare off-label use and cardiovascular (CV) adverse effects of dexmedetomidine in neonates and infants in the pediatric intensive care unit (PICU). METHODS: Patients younger than 12 months with corrected gestational ages of at least 37 weeks who were receiving continuous infusion of dexmedetomidine at a tertiary pediatric referral center between October 2007 and August 2012 were assessed retrospectively. Patients were excluded if dexmedetomidine was used for procedural sedation, postoperative CV surgery, or if postanesthesia infusion weaning orders existed at the time of PICU admission. RESULTS: The median minimum dexmedetomidine dose was similar between infants and neonates at 0.2 mcg/kg/hr (IQR, 0.17–0.3) versus 0.29 mcg/kg/hr (IQR, 0.2–0.31), p = 0.35. The median maximum dose was higher for infants than neonates (0.6 mcg/kg/hr [IQR, 0.4–0.8] vs. 0.4 mcg/kg/hr [IQR, 0.26–0.6], p &lt; 0.01). Additional sedative use was more common in infants than neonates (75/99 [76%] vs. 15/28 [54%], p = 0.02). At least 1 episode of hypotension was noted in 34/127 (27%) patients and was similar between groups. An episode of bradycardia was identified more frequently in infants than neonates (55/99 [56%] vs. 2/28 [7%], p &lt; 0.01). Significant reduction in heart rate and systolic blood pressure was noted when comparing baseline vital signs to lowest heart rate and systolic blood pressure during infusion (p &lt; 0.01). CONCLUSIONS: Dexmedetomidine dose ranges were similar to US Food and Drug Administration–labeled dosages for intensive care unit sedation in adults. More infants than neonates experienced a bradycardia episode, but infants were also more likely to receive higher dosages of dexmedetomidine and additional sedatives.

scholarly journals The Effect of Live Spontaneous Harp Music on Patients in the Intensive Care Unit

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Ann Marie Chiasson ◽  
Ann Linda Baldwin ◽  
Carrol Mclaughlin ◽  
Paula Cook ◽  
Gulshan Sethi
Keyword(s):  
Blood Pressure ◽  
Intensive Care Unit ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Intensive Care ◽  
Oxygen Saturation ◽  
Respiratory Rate ◽  
Rest Period ◽  
Underlying Mechanism ◽  
To Receive

This study was performed to investigate the effect of live, spontaneous harp music on individual patients in an intensive care unit (ICU), either pre- or postoperatively. The purpose was to determine whether this intervention would serve as a relaxation or healing modality, as evidenced by the effect on patient’s pain, heart rate, respiratory rate, blood pressure, oxygen saturation, and heart rate variability. Each consenting patient was randomly assigned to receive either a live 10-minute concert of spontaneous music played by an expert harpist or a 10-minute rest period. Spontaneous harp music significantly decreased patient perception of pain by 27% but did not significantly affect heart rate, respiratory rate, oxygen saturation, blood pressure, or heart rate variability. Trends emerged, although being not statistically significant, that systolic blood pressure increased while heart rate variability decreased. These findings may invoke patient engagement, as opposed to relaxation, as the underlying mechanism of the decrease in the patients’ pain and of the healing benefit that arises from the relationship between healer, healing modality, and patient.

Diagnostic Accuracy of Respiratory Distress Observation Scales as Surrogates of Dyspnea Self-report in Intensive Care Unit Patients

2015 ◽  
Vol 123 (4) ◽  
pp. 830-837 ◽  
Author(s):  
Romain Persichini ◽  
Frédérick Gay ◽  
Matthieu Schmidt ◽  
Julien Mayaux ◽  
Alexandre Demoule ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Heart Rate ◽  
Intensive Care ◽  
Facial Expression ◽  
Respiratory Distress ◽  
Validation Cohort ◽  
Self Report ◽  
Neck Muscle ◽  
Icu Patients ◽  
Derivation Cohort

Abstract Background: Dyspnea, like pain, can cause major suffering in intensive care unit (ICU) patients. Its evaluation relies on self-report; hence, the risk of being overlooked when verbal communication is impaired. Observation scales incorporating respiratory and behavioral signs (respiratory distress observation scales [RDOS]) can provide surrogates of dyspnea self-report in similar clinical contexts (palliative care). Methods: The authors prospectively studied (single center, 16-bed ICU, large university hospital) 220 communicating ICU patients (derivation cohort, 120 patients; separate validation cohort, 100 patients). Dyspnea was assessed by dyspnea visual analog scale (D-VAS) and RDOS calculated from its eight components (heart rate, respiratory rate, nonpurposeful movements, neck muscle use during inspiration, abdominal paradox, end-expiratory grunting, nasal flaring, and facial expression of fear). An iterative principal component analysis and partial least square regression process aimed at identifying an optimized D-VAS correlate (intensive care RDOS [IC-RDOS]). Results: In the derivation cohort, RDOS significantly correlated with D-VAS (r = 0.43; 95% CI, 0.29 to 0.58). A five-item IC-RDOS (heart rate, neck muscle use during inspiration, abdominal paradox, facial expression of fear, and supplemental oxygen) significantly better correlated with D-VAS (r = 0.61; 95% CI, 0.50 to 0.72). The median area under the receiver operating curve of IC-RDOS to predict D-VAS was 0.83 (interquartile range, 0.81 to 0.84). An IC-RDOS of 2.4 predicted D-VAS of 4 or greater with equal sensitivity and specificity (72%); an IC-RDOS of 6.3 predicted D-VAS of 4 or greater with 100% specificity. Similar results were found in the validation cohort. Conclusions: Combinations of observable signs correlate with dyspnea in communicating ICU patients. Future studies in noncommunicating patients will be needed to determine the responsiveness to therapeutic interventions and clinical usefulness.

scholarly journals Reliability of heart rate and respiration rate measurements with a wireless accelerometer in postbariatric recovery

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0247903
Author(s):  
Fleur Jacobs ◽  
Jai Scheerhoorn ◽  
Eveline Mestrom ◽  
Jonna van der Stam ◽  
R. Arthur Bouwman ◽  
...  
Keyword(s):  
Heart Rate ◽  
Respiration Rate ◽  
Gold Standard ◽  
Continuous Monitoring ◽  
Wearable Sensors ◽  
Vital Signs ◽  
Patient Monitor ◽  
Standard Patient ◽  
Bariatric Patients ◽  
Vital Parameters

Recognition of early signs of deterioration in postoperative course could be improved by continuous monitoring of vital parameters. Wearable sensors could enable this by wireless transmission of vital signs. A novel accelerometer-based device, called Healthdot, has been designed to be worn on the skin to measure the two key vital parameters respiration rate (RespR) and heart rate (HeartR). The goal of this study is to assess the reliability of heart rate and respiration rate measured by the Healthdot in comparison to the gold standard, the bedside patient monitor, during the postoperative period in bariatric patients. Data were collected in a consecutive group of 30 patients who agreed to wear the device after their primary bariatric procedure. Directly after surgery, a Healthdot was attached on the patients’ left lower rib. Vital signs measured by the accelerometer based Healthdot were compared to vital signs collected with the gold standard patient monitor for the period that the patient stayed at the post-anesthesia care unit. Over all patients, a total of 22 hours of vital signs obtained by the Healthdot were recorded simultaneously with the bedside patient monitor data. 87.5% of the data met the pre-defined bias of 5 beats per minute for HeartR and 92.3% of the data met the pre-defined bias of 5 respirations per minute for RespR. The Healthdot can be used to accurately derive heart rate and respiration rate in postbariatric patients. Wireless continuous monitoring of key vital signs has the potential to contribute to earlier recognition of complications in postoperative patients. Future studies should focus on the ability to detect patient deterioration in low-care environments and at home after discharge from the hospital.

scholarly journals Just the Facts: Diagnosis and management of small bowel obstruction

CJEM ◽  
2020 ◽  
Vol 22 (5) ◽  
pp. 648-651
Author(s):  
Brit Long ◽  
Elisha Targonsky ◽  
Alex Koyfman
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Oxygen Saturation ◽  
Respiratory Rate ◽  
Small Bowel Obstruction ◽  
Vital Signs ◽  
Oral Temperature ◽  
Include Blood Pressure

A 63-year-old female patient presents with abdominal pain, vomiting, and abdominal distention. She has previously had a cholecystectomy and hysterectomy. She has had no prior similar episodes, and denies fever, hematemesis, or diarrhea. She takes no medications. Vital signs include blood pressure 123/61 mm Hg, heart rate 97, oral temperature 37.2°C, respiratory rate 18, oxygen saturation 97% on room air. Her abdomen is diffusely tender and distended.

scholarly journals Just the Facts: What are the roles of oxygen escalation and noninvasive ventilation in COVID-19?

CJEM ◽  
2020 ◽  
Vol 22 (5) ◽  
pp. 587-590
Author(s):  
Brit Long ◽  
Stephen Y. Liang ◽  
Christopher Hicks ◽  
Michael Gottlieb
Keyword(s):  
Respiratory Distress ◽  
Oxygen Saturation ◽  
Family Member ◽  
Noninvasive Ventilation ◽  
Vital Signs ◽  
X Ray ◽  
Chest X Ray

A 37-year-old female presents with cough, fever, dyspnea, and myalgias for five days after recent contact with a family member with confirmed 2019 coronavirus disease (COVID-19). Her vital signs include T 38.3° C, HR 108, BP 118/70 mm Hg, RR 26 breaths per minute, and oxygen saturation 67% on room air. She is not in respiratory distress currently and is protecting her airway. Her chest X-ray reveals bilateral airspace opacities. You plan to immediately intervene and address her hypoxia.

Auricall®. A new device for a non-invasive, wireless, continuous monitoring of oxygen saturation and heart rate in patients with heart failure

2008 ◽  
Vol 129 (1) ◽  
pp. 141-143 ◽  
Author(s):  
Isabella Sudano ◽  
Andreas J. Flammer ◽  
Frank Hermann ◽  
Thomas Syburra ◽  
Priska Kaiser ◽  
...  
Keyword(s):  
Heart Failure ◽  
Heart Rate ◽  
Oxygen Saturation ◽  
Continuous Monitoring ◽  
New Device ◽  
Non Invasive ◽  
Patients With Heart Failure

scholarly journals Clinical validation study of the SignCare Vital Signs Monitor of Fundación Cardiovascular de Colombia

2016 ◽  
Vol 64 (3) ◽  
pp. 459
Author(s):  
Leonardo Andrés Rodríguez-Salazar ◽  
Edna Magaly Gamboa-Delgado ◽  
Sherneyko Plata Rangel ◽  
Oscar Alberto Mantilla-Prada ◽  
Eugenio Sarmiento-Caraballo ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Clinical Trials ◽  
Oxygen Saturation ◽  
Adult Population ◽  
Vital Signs ◽  
Saturation Temperature ◽  
Access To Health Services ◽  
Noninvasive Blood Pressure ◽  
Qualitative Detection

Introduction: In Colombia, due to the difficult access to health services and to geographic conditions, the implementation and innovation of telemedicine technological tools is a priority. Having a validated vital signs monitor (VSM) improves proper medical treatment and diagnosis.Objective: To design and perform clinical trials for the SignCare VSM.Materials and methods: A device for continuous monitoring of electrocardiography, respiration, oxygen saturation, temperature and noninvasive blood pressure (NIBP) was designed. This device was validated in a laboratory in order to ensure a robust prototype, close to the level of commercial medical devices. Clinical trials were performed through a cross-section study with 98 patients, whose vital signs were measured using the SignCare monitor and a commercial monitor. These two measurements were compared using Pearson’s correlation coefficients.Results: There were no statistically significant differences between the results obtained with the SignCare VSM and the commercial monitor. The highest correlations were found for the following items: heart rate by electrocardiogram (r=0.844), heart rate by oxymetry (r=0.821), body temperature (r=0.895), systolic blood pressure (r=0.780), and diastolic blood pressure (r=0.811).Conclusions: The SignCare device is as reliable as the commercial monitor in the qualitative detection of morphologic alterations of electrocardiogram records, as well as in breathing, temperature, oxygen saturation and blood pressure parameters, which makes it recommendable for clinical use in adult population.

scholarly journals DETECÇÃO EM TEMPO REAL DA FREQUÊNCIA CARDÍACA DE PESSOAS POR MEIO DA ANÁLISE DE VARIAÇÕES TEMPORAIS EM VÍDEOS

e-xacta ◽  
2016 ◽  
Vol 9 (1) ◽  
pp. 49 ◽  
Author(s):  
Kessiler Almeida Silveira Rodrigues ◽  
Moisés Henrique Ramos Pereira ◽  
Flávio Luis Cardeal Pádua
Keyword(s):  
Heart Rate ◽  
Continuous Monitoring ◽  
Vital Signs ◽  
Computational Method ◽  
Burn Victims ◽  
Non Invasive ◽  
Statistical Confidence ◽  
Common Causes ◽  
Supportive Environments

<p>As doenças cardiovasculares são, atualmente, as causas mais comuns de morbimortalidade no mundo. Na perspectiva da prevenção de doenças e agravos, tornam-se fundamentais ações que criem ambientes favoráveis à saúde e favoreçam escolhas saudáveis. Medidas de prevenção e monitoramento contínuo de sinais vitais são necessários, sendo a frequência cardíaca um sinal promissor. No entanto, tal monitoramento pode ser difícil e pouco eficiente, quando não impossível, em determinados casos, como por exemplo, vítimas de queimaduras. Este artigo propõe uma aplicação para monitoramento da frequência cardíaca não invasivo e sem a necessidade de contato, podendo ser manuseado por qualquer pessoa. Para a determinação da frequência cardíaca, a aplicação combina técnicas de processamento de imagens, tratamento de sinais fotopletismográficos e análise de variações temporais em vídeos. Os resultados obtidos demonstram que, considerando 95% de confiança estatística e um erro padrão de 1,08 batimentos por minuto, a aplicação desenvolvida possui a mesma média para aferições de batimentos cardíacos em relação a um dispositivo já consolidado no mercado para essa finalidade, mostrando-se como um método computacional promissor para medições em repouso.</p><p>Abstract </p><p>Cardiovascular diseases are currently the most common causes of morbidity and mortality worldwide. From the perspective of prevention of diseases and disorders, become fundamental actions that create supportive environments for health and promote healthy choices. Prevention and continuous monitoring of vital signs are necessary, and the heart rate a promising sign. However, such monitoring can be difficult and inefficient, if not impossible, in certain cases, such as burn victims. This paper proposes an application for monitoring heart rate non-invasive and without the need to touch and can be handled by anyone. For the determination of heart rate the application combines techniques of image processing, processing and analysis of signals photo-plethysmography temporal changes in video. The obtained results show that, considering a 95% statistical confidence and a standard error of 1.08 beats per minute, the developed application has the same average heartbeats' measurements in relation to a consolidated device on the market used for the same purpose, showing itself as a promising computational method for rest measurements.</p>

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