scholarly journals Accuracy of Vital Signs Measurements by a Smartwatch and a Portable Health Device: Validation Study

10.2196/16811 ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. e16811 ◽  
Author(s):  
Christina Hahnen ◽  
Cecilia G Freeman ◽  
Nilanjan Haldar ◽  
Jacquelyn N Hamati ◽  
Dylan M Bard ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Vital Sign ◽  
Vital Signs ◽  
Final Analysis ◽  
University Hospital ◽  
Health Concern ◽  
Absolute Difference ◽  
Mean Absolute Difference ◽  
The Mean ◽  
Performance Monitor

Background New consumer health devices are being developed to easily monitor multiple physiological parameters on a regular basis. Many of these vital sign measurement devices have yet to be formally studied in a clinical setting but have already spread widely throughout the consumer market. Objective The aim of this study was to investigate the accuracy and precision of heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and oxygen saturation (SpO2) measurements of 2 novel all-in-one monitoring devices, the BodiMetrics Performance Monitor and the Everlast smartwatch. Methods We enrolled 127 patients (>18 years) from the Thomas Jefferson University Hospital Preadmission Testing Center. SBP and HR were measured by both investigational devices. In addition, the Everlast watch was utilized to measure DBP, and the BodiMetrics Performance Monitor was utilized to measure SpO2. After 5 min of quiet sitting, four hospital-grade standard and three investigational vital sign measurements were taken, with 60 seconds in between each measurement. The reference vital sign measurements were calculated by determining the average of the two standard measurements that bounded each investigational measurement. Using this method, we determined three comparison pairs for each investigational device in each subject. After excluding data from 42 individuals because of excessive variation in sequential standard measurements per prespecified dropping rules, data from 85 subjects were used for final analysis. Results Of 85 participants, 36 (42%) were women, and the mean age was 53 (SD 21) years. The accuracy guidelines were only met for the HR measurements in both devices. SBP measurements deviated 16.9 (SD 13.5) mm Hg and 5.3 (SD 4.7) mm Hg from the reference values for the Everlast and BodiMetrics devices, respectively. The mean absolute difference in DBP measurements for the Everlast smartwatch was 8.3 (SD 6.1) mm Hg. The mean absolute difference between BodiMetrics and reference SpO2 measurements was 3.02%. Conclusions Both devices we investigated met accuracy guidelines for HR measurements, but they failed to meet the predefined accuracy guidelines for other vital sign measurements. Continued sale of consumer physiological monitors without prior validation and approval procedures is a public health concern.

scholarly journals FRI0618-HPR EFFECTS OF MUSIC THERAPY ON PAIN, ANXIETY, AND VITAL SIGNS IN CHRONIC INFLAMMATORY RHEUMATIC DISEASES PATIENTS DURING BIOLOGICAL DRUGS INFUSION

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 914.2-914
Author(s):  
S. Boussaid ◽  
M. Ben Majdouba ◽  
S. Jriri ◽  
M. Abbes ◽  
S. Jammali ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Music Therapy ◽  
Systolic Blood Pressure ◽  
Respiratory Rate ◽  
Vital Signs ◽  
Biological Therapies ◽  
Biological Drugs ◽  
Pain Anxiety ◽  
The Mean

Background:Music therapy is based on ancient cross-cultural beliefs that music can have a “healing” effect on mind and body. Research determined that listening to music can increase comfort and relaxation, relieve pain, lower distress, reduce anxiety, improve positive emotions and mood, and decrease psychological symptoms. Music therapy has been used greatly in various medical procedures to reduce associated anxiety and pain. Patients have a high level of anxiety when they are in the hospital, this is the case of patients with rheumatic diseases who consult regularly to have intravenous infusion of biological therapies.Objectives:The purpose of this study was to examine the effectiveness of music therapy on pain, anxiety, and vital signs among patients with chronic inflammatory rheumatic diseases during intravenous infusion of biological drugs.Methods:Fifty patients were divided into two groups: The experimental group G1 (n=25) received drug infusion while lestening to soft music (30 minutes); and the control group G2 (n=25) received only drug infusion. Measures include pain, anxiety, vital signs (blood pressure, heart rate and respiratory rate). The pain was measured using visual analogic scale (VAS). The state-trait anxiety inventory (STAI) was used for measuring anxiety, low anxiety ranges from 20 to 39, the moderate anxiety ranges from 40 to 59, and high anxiety ranges from 60 to 80. Vital signs (systolic blood pressure [SBP], diastolic blood pressure [DBP], heart rate [HR], and respiratory rate [RR]) were measured before, during and immediately after the infusion.Statistical package for social sciences (SPSS) was used for analysis.Results:The mean age in G1 was 44.45 years (26-72) with a sex ratio (M/F) of 0.8. Including the 25 patients, 12 had rheumatoid arthritis, 10 had ankylosing spondylitis and 3 had psoriatic arthritis. The mean disease duration was 8 years. In G2, the mean age was 46 years (25-70) with a sex ratio (M/F) of 0.75, 12 had rheumatoid arthritis, 11 had ankylosing spondylitis and 2 had psoriatic arthritis. The mean disease duration was 7.5 years. The biological drugs used were: Infliximab in 30 cases, Tocilizumab in 12 cases and Rituximab in 8 cases.Before the infusion, the patients of experimental group had a mean VAS of 5/10±3, a mean STAI of 50.62±6.01, a mean SBP of 13.6 cmHg±1.4, a mean DBP of 8.6 cmHg±1, a mean HR of 85±10 and a mean RR of 18±3. While in control group the mean VAS was 5.5±2, the mean STAI was 50.89±5.5, the mean SBP was 13.4±1.2, the mean DBP was 8.8±1.1, the mean HR was 82±8 and the mean RR was 19±2.During the infusion and after music intervention in G1, the mean STAI became 38.35±5 in G1 versus 46.7±5.2 in G2 (p value=0.022), the mean SBP became 12.1±0.5 in G1 versus 13±1 in G2 (p=0.035), the mean DBP became 8.1±0.8 in G1 versus 8.4±0.9 in G2 (p=0.4), the mean HR became 76±9 in G1 versus 78±7 in G2 (p=0.04) and the mean RR became 17.3±2.1 in G1 versus 18.2±1.7 in G2 (p=0.39).This study found a statistically significant decrease in anxiety, systolic blood pressure and heart rate in patients receiving music interventions during biological therapies infusion, but no significant difference were identified in diastolic blood pressure and respiratory rate.Conclusion:The findings provide further evidence to support the use of music therapy to reduce anxiety, and lower systolic blood pressure and heart rate in patients with rheumatic disease during biological therapies infusion.References:[1] Lin, C., Hwang, S., Jiang, P., & Hsiung, N. (2019).Effect of Music Therapy on Pain After Orthopedic Surgery -A Systematic review and Meta-Analysis. Pain Practice.Disclosure of Interests:None declared

Abstract 16967: Increased Blood Pressure Variability is Associated With Worse Outcome in Acute Ischemic Stroke

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Adam de Havenon ◽  
Haimei Wang ◽  
Greg Stoddard ◽  
Lee Chung ◽  
Jennifer Majersik
Keyword(s):  
Blood Pressure ◽  
Logistic Regression ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Blood Pressure Variability ◽  
Harmful Effect ◽  
Final Analysis ◽  
Ordinal Logistic Regression ◽  
Stroke Severity ◽  
The Mean

Background: Increased blood pressure variability (BPV) is detrimental in the weeks to months after ischemic stroke, but it has not been adequately studied in the acute phase. We hypothesized that increased BPV in acute ischemic stroke (AIS) patients would be associated with worse outcome. Methods: We retrospectively reviewed inpatients at our hospital between 2010-2014 with an ICD-9 code of AIS; 213 were confirmed to have AIS by a vascular neurologist. A modified Rankin Score (mRS) after discharge was available in 148/213, at a mean of 86 ± 60 days. In 45/213 the discharge mRS was either 0 or 6, in which case they were included in the final analysis. BPV was measured as the standard deviation (SD) of each patient’s systolic blood pressure readings during the first 24 hours and 5 days of hospitalization (9,844 total readings), or until discharge if discharged in <5 days (Figure 1). The SBP SD was further divided in quartiles. A multivariate ordinal logistic regression with the outcome of mRS, the primary predictor of quartiles of SBP SD, and baseline NIH stroke scale (NIHSS) to control for initial stroke severity. Results: Mean±SD age was 64.2 ± 16.3 years, NIHSS was 12.6 ± 7.9, and mRS was 2.7 ± 2.1. The mean SBP SDs for the first 24 hours and 5 days were 12.1 ± 6.2 mm Hg and 14.1 ± 4.9 mm Hg. In the ordinal logistic regression model, the quartiles of SBP SD for the first 24 hours and 5 days were positively associated with higher mRS (OR = 1.37, 95% CI 1.01 - 1.74, p = 0.009; OR = 1.30, 95% CI 1.03 - 1.63, p = 0.028). This effect became even more pronounced in patients with the highest quartile of variability (OR = 2.76, 95% CI 1.29 - 5.88, p = 0.009; OR = 2.10, 95% CI 1.01 - 4.36, p = 0.046). Conclusion: In our cohort of 193 patients with AIS, there was a significant association between increased systolic BPV and worse functional outcome, after controlling for initial stroke severity. This data suggests that increased BPV may have a harmful effect for AIS patients, which warrants a prospective observational study.

Prototyping Sensor Network System for Automatic Vital Signs Collection

2013 ◽  
Vol 52 (03) ◽  
pp. 239-249 ◽  
Author(s):  
H. Noma ◽  
C. Naito ◽  
M. Tada ◽  
H. Yamanaka ◽  
T. Takemura ◽  
...  
Keyword(s):  
Sensor Network ◽  
Vital Sign ◽  
Paired Comparison ◽  
Estimation Error ◽  
Vital Signs ◽  
Position Estimation ◽  
University Hospital ◽  
Network System ◽  
Sensing System ◽  
Proximity Sensing

SummaryObjective: Development of a clinical sensor network system that automatically collects vital sign and its supplemental data, and evaluation the effect of automatic vital sensor value assignment to patients based on locations of sensors.Methods: The sensor network estimates the data-source, a target patient, from the position of a vital sign sensor obtained from a newly developed proximity sensing system. The proximity sensing system estimates the positions of the devices using a Bluetooth inquiry process. Using Bluetooth access points and the positioning system newly developed in this project, the sensor network collects vital sign and its 4W (who, where, what, and when) supplemental data from any Blue-tooth ready vital sign sensors such as Continua-ready devices. The prototype was evaluated in a pseudo clinical setting at Kyoto University Hospital using a cyclic paired comparison and statistical analysis.Results: The result of the cyclic paired analysis shows the subjects evaluated the proposed system is more effective and safer than POCS as well as paper-based operation. It halves the times for vital signs input and eliminates input errors. On the other hand, the prototype failed in its position estimation for 12.6% of all attempts, and the nurses overlooked half of the errors. A detailed investigation clears that an advanced interface to show the system’s “confidence”, i.e. the probability of estimation error, must be effective to reduce the oversights.Conclusions: This paper proposed a clinical sensor network system that relieves nurses from vital signs input tasks. The result clearly shows that the proposed system increases the efficiency and safety of the nursing process both subjectively and objectively. It is a step toward new generation of point of nursing care systems where sensors take over the tasks of data input from the nurses.

Advance Monitoring of Blood Pressure and Respiratory Rate Using De-Noising Auto Encoder

2021 ◽  
Author(s):  
Seung-Ho Park ◽  
Kyoung-Su Park
Keyword(s):  
Blood Pressure ◽  
Respiratory Rate ◽  
Vital Sign ◽  
Superficial Temporal Artery ◽  
Vital Signs ◽  
Pulse Signal ◽  
Temporal Artery ◽  
Sinus Arrhythmia ◽  
Vital Signs Monitoring ◽  
Vital Sign Measurement

Abstract As the importance of continuous vital signs monitoring increases, the need for wearable devices to measure vital sign is increasing. In this study, the device is designed to measure blood pressure (BP), respiratory rate (RR), and heartrate (HR) with one sensor. The device is in earphone format and is manufactured as wireless type using Arduino-based bluetooth module. The device measures pulse signal in the Superficial temporal artery using Photoplethysmograghy (PPG) sensor. The device uses the Auto Encoder to remove noise caused by movement, etc., contained in the pulse signal. Extract the feature from the pulse signal and use them for the vital sign measurement. The device is measured using Slope transit time (STT) method for BP and Respiratory sinus arrhythmia (RSA) method for RR. Finally, the accuracy is determined by comparing the vital signs measured through the device with the reference vital signs measured simultaneously.

scholarly journals Reliability of a wearable wireless patch for continuous remote monitoring of vital signs in patients recovering from major surgery: a clinical validation study from the TRaCINg trial

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e031150 ◽  
Author(s):  
Candice Downey ◽  
Shu Ng ◽  
David Jayne ◽  
David Wong
Keyword(s):  
Monitoring System ◽  
Vital Sign ◽  
Vital Signs ◽  
University Hospital ◽  
Secondary Outcome ◽  
Major Surgery ◽  
Limits Of Agreement ◽  
Temperature Bias ◽  
Vital Signs Monitoring ◽  
Recorded Data

ObjectiveTo validate whether a wearable remote vital signs monitor could accurately measure heart rate (HR), respiratory rate (RR) and temperature in a postsurgical patient population at high risk of complications.DesignManually recorded vital signs data were paired with vital signs data derived from the remote monitor set in patients participating in the Trial of Remote versus Continuous INtermittent monitoring (TRaCINg) study: a trial of continuous remote vital signs monitoring.SettingSt James’s University Hospital, UK.Participants51 patients who had undergone major elective general surgery.InterventionsThe intervention was the SensiumVitals monitoring system. This is a wireless patch worn on the patient’s chest that measures HR, RR and temperature continuously. The reference standard was nurse-measured manually recorded vital signs.Primary and secondary outcome measuresThe primary outcomes were the 95% limits of agreement between manually recorded and wearable patch vital sign recordings of HR, RR and temperature. The secondary outcomes were the percentage completeness of vital sign patch data for each vital sign.Results1135 nurse observations were available for analysis. There was no clinically meaningful bias in HR (1.85 bpm), but precision was poor (95% limits of agreement −23.92 to 20.22 bpm). Agreement was poor for RR (bias 2.93 breaths per minute, 95% limits of agreement −8.19 to 14.05 breaths per minute) and temperature (bias 0.82°C, 95% limits of agreement −1.13°C to 2.78°C). Vital sign patch data completeness was 72.8% for temperature, 59.2% for HR and 34.1% for RR. Distributions of RR in manually recorded measurements were clinically implausible.ConclusionsThe continuous monitoring system did not reliably provide HR consistent with nurse measurements. The accuracy of RR and temperature was outside of acceptable limits. Limitations of the system could potentially be overcome through better signal processing. While acknowledging the time pressures placed on nursing staff, inaccuracies in the manually recorded data present an opportunity to increase awareness about the importance of manual observations, particularly with regard to methods of manual HR and RR measurements.

Association of Glasgow Coma Scale with Total Homocysteine Levels in Patients with Hemorrhagic Stroke

2019 ◽  
Vol 75 (1) ◽  
pp. 9-15 ◽  
Author(s):  
Dapeng Dai ◽  
Yong Sun ◽  
Chengzhang Liu ◽  
Houxun Xing ◽  
Binyan Wang ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Glasgow Coma Scale ◽  
Hemorrhagic Stroke ◽  
Final Analysis ◽  
Inverse Association ◽  
Severe Damage ◽  
Coma Scale ◽  
Total Homocysteine ◽  
The Mean ◽  
Stratified Analysis

Objectives: We aimed to evaluate the association between Glasgow Coma Scale (GCS) and total homocysteine (tHcy) levels and examine the possible effect modifiers in patients with hemorrhagic stroke. Methods: A total of 1,516 participants with hemorrhagic stroke and having the complete data on baseline GCS and tHcy measurements were included in the final analysis. Results: The mean (SD) of age, tHcy, and GCS levels were 61.5 (11.3) years, 17.0 (10.3) μmol/L, and 13.9 (2.2), respectively. Compared with participants with severe damage (GCS <9), those with mild damage (GCS ≥13) had significantly lower transformed tHcy levels (β = –2.46; 95% CI –4.80 to –0.12). Consistently, a significantly lower transformed tHcy levels were found in participants with mild damage (GCS ≥13; β = –1.37; 95% CI –2.66 to –0.08) compared with those with moderate to severe damage (GCS <13). In the stratified analysis, a stronger inverse association between GCS categories (≥13 vs. <13) and tHcy concentrations was observed in ever smokers (vs. never; p for interaction = 0.045), and in participants with systolic blood pressure (SBP) ≥160 mm Hg (vs. <160 mm Hg; p for interaction = 0.031), or total cholesterol (TC) ≥5.2 mmol/L (vs. <5.2 mmol/L; p for interaction = 0.025). Conclusion: There was an inverse association between GCS level and tHcy concentration among patients with hemorrhagic stroke, especially in ever smokers or in participants with higher SBP or TC levels.

scholarly journals Vital-SCOPE: Design and Evaluation of a Smart Vital Sign Monitor for Simultaneous Measurement of Pulse Rate, Respiratory Rate, and Body Temperature for Patient Monitoring

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Guanghao Sun ◽  
Takemi Matsui ◽  
Yasuyuki Watai ◽  
Seokjin Kim ◽  
Tetsuo Kirimoto ◽  
...  
Keyword(s):  
Body Temperature ◽  
Respiratory Rate ◽  
Correlation Coefficient ◽  
Pulse Rate ◽  
Simultaneous Measurement ◽  
Vital Sign ◽  
Vital Signs ◽  
Pearson’S Correlation ◽  
Pearson's Correlation ◽  
The Mean

Consistent vital sign monitoring is critically important for early detection of clinical deterioration of patients in hospital settings. Mostly, nurses routinely measure and document the primary vital signs of all patients 2‐3 times daily to assess their condition. To reduce nurse workload and thereby improve quality of patient care, a smart vital sign monitor named “Vital‐SCOPE” for simultaneous measurement of vital signs was developed. Vital-SCOPE consists of multiple sensors, including a reflective photo sensor, thermopile, and medical radar, to be used in simultaneous pulse rate, respiratory rate, and body temperature monitoring within 10 s. It was tested in laboratory and hospital settings. Bland-Altman and Pearson’s correlation analyses were used to compare the Vital-SCOPE results to those of reference measurements. The mean difference of the respiratory rate between respiratory effort belt and Vital-SCOPE was 0.47 breaths per minute with the 95% limit of agreement ranging from −7.4 to 6.5 breaths per minute. The Pearson’s correlation coefficient was 0.63 (P<0.05). Moreover, the mean difference of the pulse rate between electrocardiogram and Vital-SCOPE was 3.4 beats per minute with the 95% limit of agreement ranging from −13 to 5.8 beats per minute; the Pearson’s correlation coefficient was 0.91 (P<0.01), indicating strong linear relationship.

scholarly journals Modifying the sternopleural hair pattern in Drosophila by selection

1961 ◽  
Vol 2 (1) ◽  
pp. 158-160 ◽  
Author(s):  
E. C. R. Reeve
Keyword(s):  
Drosophila Melanogaster ◽  
Inbred Lines ◽  
The Other ◽  
Absolute Difference ◽  
Mean Absolute Difference ◽  
Quantitative Characters ◽  
Genetic Behaviour ◽  
The Mean ◽  
Left Right Asymmetry ◽  
Two Sides

Two apparently very similar quantitative characters, the numbers of hairs on the sternopleural region and on the abdominal sternites of Drosophila melanogaster, show unexpected differences in their genetic behaviour. In particular, the amount of left-right asymmetry of the sternopleurals (i.e. the mean absolute difference in numbers of hairs on the two sides of the fly) tends to decline when inbred lines are intercrossed, and can be both increased and decreased by straightforward selection; the corresponding index for the sternite hairs—the uncorrelated variance between two sternites, or the mean absolute difference between the numbers of hairs on each—appears, on the other hand, to be susceptible neither to selection nor to change when inbred lines are crossed (Mather, 1953; Reeve & Robertson, 1954; Reeve, 1959).

Physical training and heart rate and blood pressure variability: a 5-yr randomized trial

2004 ◽  
Vol 286 (5) ◽  
pp. H1821-H1826 ◽  
Author(s):  
Arja L. T. Uusitalo ◽  
Tomi Laitinen ◽  
Sari B. Väisänen ◽  
Esko Länsimies ◽  
Rainer Rauramaa
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Oxygen Consumption ◽  
Blood Pressure Variability ◽  
Maximal Oxygen Consumption ◽  
Final Analysis ◽  
Peak Performance ◽  
Autonomic Modulation ◽  
The Mean ◽  
Time Point

We studied the effect of regular physical activity on cardiac and vascular autonomic modulation during a 5-yr controlled randomized training intervention in a representative sample of older Finnish men. Heart rate variability (HRV) and blood pressure variability (BPV) are markers of cardiac and vascular health, reflecting cardiac and vascular autonomic modulation. One hundred and forty randomly selected 53- to 63-yr-old men were randomized into two identical groups: an intervention (EX) group and a reference (CO) group, of which 89 men remained until the final analysis (EX: n = 47; CO: n = 42). The EX group trained for 30–60 min three to five times a week with an intensity of 40–60% of maximal oxygen consumption. The mean weekly energy expenditure of the training program for the 5-yr training period was 3.80 MJ, and 71% of the EX group exceeded the mean. The EX group had a significantly ( P < 0.01) higher oxygen consumption at ventilatory aerobic threshold (V̇o2VT) than the CO group at the 5-yr time point. V̇o2VT had a tendency to increase in the EX group and decrease in the CO group (interaction P < 0.001) from the baseline to the 5-yr time point. Peak performance did not change. Low-frequency power of R-R interval variability decreased in the EX group ( P < 0.01, by 6%) from the baseline to the 5-yr time point. BPV did not change. In conclusion, low-intensity regular exercise training did not prevent HRV from decreasing or change BPV in 5 yr in older Finnish men.

scholarly journals Trauminiai penetruojantys širdies sužalojimai: 25 metų duomenų analizė

2010 ◽  
Vol 8 (2) ◽  
pp. 0-0
Author(s):  
Žymantas Jagelavičius ◽  
Vytautas Jovaišas ◽  
Arūnas Žilinskas ◽  
Algis Kybartas ◽  
Gintaras Kiškis ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiac Injury ◽  
University Hospital ◽  
Cardiac Trauma ◽  
Chest Injuries ◽  
Injured Part ◽  
The Mean ◽  
Vilnius University ◽  
Surgery Department ◽  
Mean Time

Žymantas Jagelavičius, Vytautas Jovaišas, Arūnas Žilinskas, Algis Kybartas, Gintaras Kiškis, Vygantas Gruslys, Irena Liubertienė, Ričardas JanilionisVilniaus universiteto Krūtinės ligų, alergologijos ir radiologijos klinika, Krūtinės chirurgijos centras; Vilniaus universiteto ligoninės „Santariškių klinikų“ centro filialas, Krūtinės chirurgijos skyrius,Žygimantų g. 3, LT-01102 VilniusEl paštas: [email protected] Įvadas / tikslasŠirdies sužalojimai yra viena letališkiausių traumų, ją patiria jaunesnio amžiaus žmonės. Dauguma sužeistųjų į širdį miršta nepasiekę ligoninės. Pateikiame Vilniaus universiteto ligoninės Santariškių klinikų Centro filialo Krūtinės chirurgijos skyriaus patirtį gydant širdies traumą patyrusius asmenis. Ligoniai ir metodaiRetrospektyviai išanalizavome 170 ligonių, gydytų dėl įtariamo širdies sužalojimo ir operuotų per pirmas 24 valandas po traumos, 1983–2007 metų duomenis. Įvertinome veiksnius, turėjusius įtakos išgyvenamumui. RezultataiVidutinis ligonių amžius – 36 metai. Vyrų buvo 88,2 %. Dauguma atvežti Vilniaus miesto greitosios medicinos pagalbos – 126 (74,1 %). Vidutinė trukmė nuo traumos iki patekimo į priėmimo skyrių Vilniuje būdavo 104 min., o rajone ar siunčiant iš kitų šalies gydymo įstaigų – 310 min. Dauguma krūtinės sužalojimų buvo durtiniai pjautiniai – 161 (94,7 %), šautiniai – 9 (5,3 %). Operacijos metu dažniausiai būdavo nustatomas hemoperikardas ar tamponada – 130 (76,5 %) ligonių. Dažniausiai sužalojama širdies vieta buvo dešinysis skilvelis – 68 (40,0 %) ligoniams. Papildomų sužalojimų patyrė 92 (54,1 %) ligoniai. Iš 170 gydytų ligonių išgyveno 151, bendras išgyvenamumas siekė 88,8 %. Palyginti su mirusiais ligoniais, išgyvenusieji atvykdami turėjo aukštesnį sistolinį kraujospūdį (87,9 mmHg ir 56,3 mmHg, p=0,001), dažniau visus penkis gyvybės požymius (80,8 % ir 47,4 %, p=0,003), o tiems, kurie neišgyveno, dažniau pasitaikydavo širdies tamponada (52,6 % ir 29,8 %, p=0,045), sunkesnis (IV–VI laipsnio) širdies sužalojimas (89,5 % ir 29,8 %, p<0,001) ir širdies veiklos sustojimas per operaciją (84,2 % ir 7,9 %, p<0,001). IšvadosBlogesnę sužalotųjų į širdį prognozę lemia žemesnis kraujospūdis, išnykę gyvybės požymiai atvykus, operuojant nustatoma širdies tamponada, kiaurinis širdies sužalojimas ir širdies veiklos sustojimas. Greičiau suteikus tinkamą pagalbą didesnė dalis sužeistųjų turėtų šansą išgyventi. Reikšminiai žodžiai: širdies sužalojimai, širdies trauma, širdies žaizda, penetruojantys krūtinės sužalojimai Penetrating cardiac injuries: evaluation of a 25-year experience Žymantas Jagelavičius, Vytautas Jovaišas, Arūnas Žilinskas, Algis Kybartas, Gintaras Kiškis, Vygantas Gruslys, Irena Liubertienė, Ričardas JanilionisVilnius University Hospital „Santariškių Clinics“, Central Branch, Thoracic Surgery Department, Žygimantų str. 3,LT-01102 Vilnius, LithuaniaE-mail: [email protected] Background /objectiveCardiac injuries are one of the most lethal traumas, and they are usually sustained by young people. Most of the injured die before reaching hospital. We present our experience in treating penetrating cardiac injuries in Vilnius University Hospital “Santariskiu Clinics” Centre Affiliation. Patients and MethodsWe have retrospectively analyzed data on 170 patients who were treated and operated on for suspicion of cardiac injury within the first 24 hours after trauma in our department during a 25-year period. We evaluated the effect of various factors on survival. ResultsThe mean age was 36 years. 88.2% were male. The mean time from trauma till reception room in Vilnius was 104 min and beyond Vilnius 310 min. Most of the injuries were stab wounds (161, 94.7%). During operation the general finding was haemopericardium or tamponade – 130 (76.5%). Right ventricle was the most frequently injured part of the heart (68, 40.0%). 92 (54.1%) patients had associated injuries. 151 of 170 patients survived, the survival rate until discharge was 88.8%. Compared to nonsurvivors, survivors had a higher systolic blood pressure (87.9 mm Hg vs. 56.3 mm Hg, p = 0.001) and more often had all signs of life (80.8% vs. 47.4%, p = 0.003), but in nonsurvivors more frequent were tamponade (52.6% vs. 29.8%, p = 0.045), higher grade (IV–VI) of injury (89.5% vs. 29.8%, p < 0.001) and stopping of heart action (84.2% vs. 7.9%, p < 0.001). ConclusionsLower blood pressure, missing one or more signs of life on arrival determine the worse outcome as well as tamponade, higher grade cardiac injury and stopping of the heart action during the operation. The proper care given more rapidly to the victims injured to the heart could help to save more lives. Keywords: cardiac injuries, cardiac trauma, heart wound, penetrating chest injuries

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