Intensive care unit alarms--how many do we need?
OBJECTIVE: To validate cardiovascular alarms in critically ill patients in an experimental setting by generating a database of physiologic data and clinical alarm annotations, and report the current rate of alarms and their clinical validity. Currently, monitoring of physiologic parameters in critic...
| Publicado en: | Critical Care Medicine Vol. 38; no. 2; pp. 451 - 457 |
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| Autores principales: | , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Lippincott Williams & Wilkins
Feb2010
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105290159&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 105290159 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00903493 04O jtl: Critical Care Medicine issn: 00903493 maglogo: N pubinfo: dt: Feb2010 vid: 38 iid: 2 pid: 433 pub: Lippincott Williams & Wilkins place: Baltimore, Maryland artinfo: ui: 105290159 105290159 2010534070 10.1097/CCM.0b013e3181cb0888 NLM20016379 105290159 ppf: 451 ppct: 6 formats: tig: atl: Intensive care unit alarms--how many do we need? aug: au: Siebig S Kuhls S Imhoff M Gather U Schölmerich J Wrede CE affil: Department of Internal Medicine I, Hospital of the University of Regensburg, Regensburg, Germany. Sylvia.siebig@klinik.uni-r.de sug: subj: Laboratory Equipment and Supplies Standards Intensive Care Units Equipment Failure False Positive Results Female Human Male Middle Age Monitoring, Physiologic Equipment and Supplies Prospective Studies Videorecording Middle Aged: 45-64 years Female Male ab: OBJECTIVE: To validate cardiovascular alarms in critically ill patients in an experimental setting by generating a database of physiologic data and clinical alarm annotations, and report the current rate of alarms and their clinical validity. Currently, monitoring of physiologic parameters in critically ill patients is performed by alarm systems with high sensitivity, but low specificity. As a consequence, a multitude of alarms with potentially negative impact on the quality of care is generated. DESIGN: Prospective, observational, clinical study. SETTING: Medical intensive care unit of a university hospital. DATA SOURCE: Data from different medical intensive care unit patients were collected between January 2006 and May 2007. MEASUREMENTS AND MAIN RESULTS: Physiologic data at 1-sec intervals, monitor alarms, and alarm settings were extracted from the surveillance network. Video recordings were annotated with respect to alarm relevance and technical validity by an experienced physician. During 982 hrs of observation, 5934 alarms were annotated, corresponding to six alarms per hour. About 40% of all alarms did not correctly describe the patient condition and were classified as technically false; 68% of those were caused by manipulation. Only 885 (15%) of all alarms were considered clinically relevant. Most of the generated alarms were threshold alarms (70%) and were related to arterial blood pressure (45%). CONCLUSION: This study used a new approach of off-line, video-based physician annotations, showing that even with modern monitoring systems most alarms are not clinically relevant. As the majority of alarms are simple threshold alarms, statistical methods may be suitable to help reduce the number of false-positive alarms. Our study is also intended to develop a reference database of annotated monitoring alarms for further application to alarm algorithm research. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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