1
|
Tekin K, Karadogan M, Gunaydin S, Kismet K. Everything About Pulse Oximetry-Part 2: Clinical Applications, Portable/Wearable Pulse Oximeters, Remote Patient Monitoring, and Recent Advances. J Intensive Care Med 2023; 38:887-896. [PMID: 37464772 DOI: 10.1177/08850666231189175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
Purpose: Pulse oximetry is widely used in healthcare settings for both screening and continuous monitoring. In this article, it was aimed to review some aspects of pulse oximetry including clinical applications, portable devices, and recent advances in detail. Materials and Methods: The international and national reliable sources were used in the literature review for critical data analysis. A total of 31 articles including 19 prospective comparative clinical studies, 9 reviews, 1 meta-analysis, 1 retrospective study, and 1 experimental study were used for preparation of this part of the review. Results: In this part of the article, clinical applications of pulse oximeters, portable/wearable pulse oximeters, remote patient monitoring, and recent advances were all reviewed in detail. Conclusion: Pulse oximetry is a widely used and reliable noninvasive technique that provides useful information about blood oxygenation in individuals. This technique can guide oxygen therapy, reduce the occurrence of hypoxemia, and decrease the frequency of admissions to the intensive care unit, as well as arterial blood gas sampling. New multiwaveform sensors and advanced signal processing techniques can differentiate between different types of hemoglobin and may be useful for continuous measurement of total hemoglobin, as well as for detecting and providing information on blood loss and cardiac output.
Collapse
Affiliation(s)
- Kemal Tekin
- QMEN Informatics Software Consulting Education Ltd, Ankara, Turkey
| | | | - Secil Gunaydin
- QMEN Informatics Software Consulting Education Ltd, Ankara, Turkey
| | - Kemal Kismet
- QMEN Informatics Software Consulting Education Ltd, Ankara, Turkey
| |
Collapse
|
2
|
Xiao T, Fu Y, Li B, Li Y, Zhang J, Li H, Zhou X, Zhong L, Zhu L, Qin G, Zou X, Zhang X, Zheng M, Zou P, Hu Y, Chen X, Wang Y, Wu N, Gao S, Hu X, Luo X, Ju R. A study protocol for investigating the sonographic characteristics of neonates with critical illness: an observational cohort study. BMJ Paediatr Open 2023; 7:e001975. [PMID: 37369561 PMCID: PMC10410971 DOI: 10.1136/bmjpo-2023-001975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 05/07/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Haemodynamic instability and hypoxaemia are common and serious threats to the survival of neonates. A growing body of literature indicates that critical care ultrasound has become the optimal evaluation tool for sick neonates. However, few studies have described sonographic characteristics of haemodynamics systematically in the neonates with critical illness. This protocol describes a prospective observational cohort study aimed at (1) characterising the sonographic characteristics of the neonates with critical diseases; and (2) assessing the mortality, significant morbidity, utility of vasoactive medications, fluid resuscitation, duration of ventilation, etc. METHODS AND ANALYSIS: This is a single-centre, prospective and observational study conducted in Chengdu Women's and Children's Central Hospital from 1 December 2022 to 31 December 2027. Neonates admitted to the neonatal intensive care unit will be recruited. After inclusion, the neonates will undergo the neonatal critical care ultrasound. The data collected via case report forms include clinical variables and sonographic measures. The primary outcome is to identify the sonographic characteristics of sick neonates with different diseases, and the secondary outcome is to describe the mortality, significant morbidity, utility of vasoactive medications, fluid resuscitation and duration of ventilation. DISCUSSION Our study provided an organised neonatal critical care ultrasound workflow, which can be applied in practice. Accordingly, this study will first set up large data on the sonographic description of the neonates with critical illness, which can help to understand the pathophysiology of the critical illness, potentially titrating the treatment. TRIAL REGISTRATION NUMBER Chinese Clinical Trial Registry (ChiCTR2200065581; https://www.chictr.org.cn/com/25/showproj.aspx?proj=184095).
Collapse
Affiliation(s)
- Tiantian Xiao
- Department of Neonatology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Yiyong Fu
- Department of Neonatology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Biao Li
- Department of Neonatology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Yan Li
- Department of Neonatology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Jingyi Zhang
- Department of Neonatology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Huaying Li
- Department of Neonatology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Xiaofeng Zhou
- Department of Neonatology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Linping Zhong
- Department of Neonatology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Lin Zhu
- Department of Neonatology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Gaoyang Qin
- Department of Neonatology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Xin Zou
- Department of Neonatology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Xiaolong Zhang
- Department of Neonatology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Minsheng Zheng
- Department of Neonatology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Pinli Zou
- Department of Neonatology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Youning Hu
- Department of Neonatology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Xia Chen
- Department of Neonatology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Yuan Wang
- Department of Neonatology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Nana Wu
- Department of Neonatology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Shuqiang Gao
- Department of Neonatology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Xuhong Hu
- Department of Neonatology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Xiaohong Luo
- Department of Neonatology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Rong Ju
- Department of Neonatology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| |
Collapse
|
3
|
Ginsburg AS, Nia SZ, Chomba D, Parsimei M, Dunsmuir D, Waiyego M, Coleman J, Ochieng R, Zhou G, Macharia WM, Ansermino JM. Clinical feasibility of an advanced neonatal epidermal multiparameter continuous monitoring technology in a large public maternity hospital in Nairobi, Kenya. Sci Rep 2022; 12:11722. [PMID: 35810244 PMCID: PMC9271033 DOI: 10.1038/s41598-022-16051-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 07/04/2022] [Indexed: 11/09/2022] Open
Abstract
Clinically feasible multiparameter continuous physiological monitoring technologies are needed for use in resource-constrained African healthcare facilities to allow for early detection of critical events and timely intervention for major morbidities in high-risk neonates. We conducted a prospective clinical feasibility study of a novel multiparameter continuous physiological monitoring technology in neonates at Pumwani Maternity Hospital in Nairobi, Kenya. To assess feasibility, we compared the performance of Sibel's Advanced Neonatal Epidermal (ANNE) technology to reference technologies, including Masimo's Rad-97 pulse CO-oximeter with capnography technology for heart rate (HR), respiratory rate (RR), and oxygen saturation (SpO2) measurements and Spengler's Tempo Easy non-contact infrared thermometer for temperature measurements. We evaluated key performance criteria such as up-time, clinical event detection performance, and the agreement of measurements compared to those from the reference technologies in an uncontrolled, real-world setting. Between September 15 and December 15, 2020, we collected and analyzed 503 h of ANNE data from 109 enrolled neonates. ANNE's up-time was 42 (11%) h more for HR, 77 (25%) h more for RR, and 6 (2%) h less for SpO2 compared to the Rad-97. However, ANNE's ratio of up-time to total attached time was less than Rad-97's for HR (0.79 vs 0.86), RR (0.68 vs. 0.79), and SpO2 (0.69 vs 0.86). ANNE demonstrated adequate performance in identifying high and low HR and RR and high temperature events; however, showed relatively poor performance for low SpO2 events. The normalized spread of limits of agreement were 8.4% for HR and 52.2% for RR and the normalized root-mean-square deviation was 4.4% for SpO2. Temperature agreement showed a spread of limits of agreement of 2.8 °C. The a priori-identified optimal limits were met for HR and temperature but not for RR or SpO2. ANNE was clinically feasible for HR and temperature but not RR and SpO2 as demonstrated by the technology's up-time, clinical event detection performance, and the agreement of measurements compared to those from the reference technologies.
Collapse
Affiliation(s)
- Amy Sarah Ginsburg
- Clinical Trials Center, University of Washington, Seattle, Building 29, Suite 250, 6200 NE 74th Street, Seattle, WA, 98115, USA.
| | - Sahar Zandi Nia
- Department of Anesthesiology, The University of British Columbia, Vancouver, BC, Canada
| | - Dorothy Chomba
- Department of Pediatrics, Aga Khan University, Nairobi, Kenya
| | | | - Dustin Dunsmuir
- Department of Anesthesiology, The University of British Columbia, Vancouver, BC, Canada
| | | | - Jesse Coleman
- Evaluation of Technologies for Neonates in Africa, Seattle, USA
| | | | - Guohai Zhou
- Center for Clinical Investigation, Brigham and Women's Hospital, Boston, MA, USA
| | | | - J Mark Ansermino
- Department of Anesthesiology, The University of British Columbia, Vancouver, BC, Canada
| |
Collapse
|
4
|
Ginsburg AS, Zandi Nia S, Chomba D, Dunsmuir D, Waiyego M, Coleman J, Ochieng R, Liu S, Zhou G, Ansermino JM, Macharia WM. Clinical feasibility of a contactless multiparameter continuous monitoring technology for neonates in a large public maternity hospital in Nairobi, Kenya. Sci Rep 2022; 12:3097. [PMID: 35197529 PMCID: PMC8866488 DOI: 10.1038/s41598-022-07189-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 02/09/2022] [Indexed: 11/16/2022] Open
Abstract
Multiparameter continuous physiological monitoring (MCPM) technologies are critical in the clinical management of high-risk neonates; yet, these technologies are frequently unavailable in many African healthcare facilities. We conducted a prospective clinical feasibility study of EarlySense’s novel under-mattress MCPM technology in neonates at Pumwani Maternity Hospital in Nairobi, Kenya. To assess feasibility, we compared the performance of EarlySense’s technology to Masimo’s Rad-97 pulse CO-oximeter with capnography technology for heart rate (HR) and respiratory rate (RR) measurements using up-time, clinical event detection performance, and accuracy. Between September 15 and December 15, 2020, we collected and analyzed 470 hours of EarlySense data from 109 enrolled neonates. EarlySense’s technology’s up-time per neonate was 2.9 (range 0.8, 5.3) hours for HR and 2.1 (range 0.9, 4.0) hours for RR. The difference compared to the reference was a median of 0.6 (range 0.1, 3.1) hours for HR and 0.8 (range 0.1, 2.9) hours for RR. EarlySense’s technology identified high HR and RR events with high sensitivity (HR 81%; RR 83%) and specificity (HR 99%; RR 83%), but was less sensitive for low HR and RR (HR 0%; RR 14%) although maintained specificity (HR 100%; RR 95%). There was a greater number of false negative and false positive RR events than false negative and false positive HR events. The normalized spread of limits of agreement was 9.6% for HR and 28.6% for RR, which met the a priori-identified limit of 30%. EarlySense’s MCPM technology was clinically feasible as demonstrated by high percentage of up-time, strong clinical event detection performance, and agreement of HR and RR measurements compared to the reference technology. Studies in critically ill neonates, assessing barriers and facilitators to adoption, and costing analyses will be key to the technology’s development and potential uptake and scale-up.
Collapse
Affiliation(s)
- Amy Sarah Ginsburg
- Clinical Trials Center, University of Washington, Building 29, Suite 250, 6200 NE 74th Street, Seattle, WA, 98115, USA.
| | - Sahar Zandi Nia
- Department of Anesthesiology, The University of British Columbia, Vancouver, BC, Canada
| | - Dorothy Chomba
- Department of Pediatrics, Aga Khan University, Nairobi, Kenya
| | - Dustin Dunsmuir
- Department of Anesthesiology, The University of British Columbia, Vancouver, BC, Canada
| | | | - Jesse Coleman
- Evaluation of Technologies for Neonates in Africa, Seattle, WA, USA
| | | | - Sichen Liu
- Department of Anesthesiology, The University of British Columbia, Vancouver, BC, Canada
| | - Guohai Zhou
- Center for Clinical Investigation, Brigham and Women's Hospital, Boston, MA, USA
| | - J Mark Ansermino
- Department of Anesthesiology, The University of British Columbia, Vancouver, BC, Canada
| | | |
Collapse
|
5
|
Vesoulis Z, Tims A, Lodhi H, Lalos N, Whitehead H. Racial discrepancy in pulse oximeter accuracy in preterm infants. J Perinatol 2022; 42:79-85. [PMID: 34642469 PMCID: PMC8508473 DOI: 10.1038/s41372-021-01230-3] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 09/10/2021] [Accepted: 10/01/2021] [Indexed: 01/31/2023]
Abstract
OBJECTIVE Pulse oximetry is commonly used in Neonatology, however recent adult data suggest racial disparity in accuracy, with overestimation of oxygen saturation for Black patients. STUDY DESIGN Black and White infants <32 weeks gestation underwent simultaneous arterial blood gas and pulse oximetry measurement. Error by race was examined using mean bias, Arms, Bland-Altman, and linear/non-linear analysis. RESULTS A total of 294 infants (124 Black, 170 White) were identified with mean GA of 25.8 ± 2.1 weeks and mean BW of 845 ± 265 grams, yielding 4387 SaO2-SpO2 datapoints. SpO2 overestimation, measured by mean bias, was 2.4-fold greater for Black infants and resulted in greater occult hypoxemia (SpO2 > 90% when SaO2 < 85%; 9.2% vs. 7.7% of samples). Sensitivity and specificity for detection of true hypoxemia were similar between groups (39 vs. 38%; 81 vs. 78%). CONCLUSION There is a modest but consistent difference in SpO2 error between Black and White infants, with increased incidence of occult hypoxemia in Black infants.
Collapse
Affiliation(s)
- Zachary Vesoulis
- Department of Pediatrics, Division of Newborn Medicine, Washington University, St. Louis, MO, USA.
| | - Anna Tims
- Department of Pediatrics, Washington University, St. Louis, MO, USA
| | - Hafsa Lodhi
- Department of Pediatrics, Washington University, St. Louis, MO, USA
| | - Natasha Lalos
- Department of Pediatrics, Washington University, St. Louis, MO, USA
| | - Halana Whitehead
- Department of Pediatrics, Division of Newborn Medicine, Washington University, St. Louis, MO, USA
| |
Collapse
|
6
|
Siefkes HM, Lakshminrusimha S. Management of systemic hypotension in term infants with persistent pulmonary hypertension of the newborn: an illustrated review. Arch Dis Child Fetal Neonatal Ed 2021; 106:446-455. [PMID: 33478959 PMCID: PMC8217132 DOI: 10.1136/archdischild-2020-319705] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 12/22/2020] [Accepted: 12/29/2020] [Indexed: 01/03/2023]
Abstract
In persistent pulmonary hypertension of the newborn (PPHN), the ratio of pulmonary vascular resistance to systemic vascular resistance is increased. Extrapulmonary shunts (patent ductus arteriosus and patent foramen value) allow for right-to-left shunting and hypoxaemia. Systemic hypotension can occur in newborns with PPHN due to variety of reasons, such as enhanced peripheral vasodilation, impaired left ventricular function and decreased preload. Systemic hypotension can lead to end organ injury from poor perfusion and hypoxaemia in the newborn with PPHN. Thus, it must be managed swiftly. However, not all newborns with PPHN and systemic hypotension can be managed the same way. Individualised approach based on physiology and echocardiographic findings are necessary to improve perfusion to essential organs. Here we present a review of the physiology and mechanisms of systemic hypotension in PPHN, which can then guide treatment.
Collapse
|
7
|
Salverda HH, Cramer SJE, Witlox RSGM, Dargaville PA, Te Pas AB. Automated oxygen control in preterm infants, how does it work and what to expect: a narrative review. Arch Dis Child Fetal Neonatal Ed 2021; 106:215-221. [PMID: 32732378 DOI: 10.1136/archdischild-2020-318918] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 06/10/2020] [Accepted: 06/11/2020] [Indexed: 11/03/2022]
Abstract
BACKGROUND Automated oxygen control systems are finding their way into contemporary ventilators for preterm infants, each with its own algorithm, strategy and effect. OBJECTIVE To provide guidance to clinicians seeking to comprehend automated oxygen control and possibly introduce this technology in their practice. METHOD A narrative review of the commercially available devices using different algorithms incorporating rule-based, proportional-integral-derivative and adaptive concepts are described and explained. An overview of how they work and, if available, the clinical effect is given. RESULTS All algorithms have shown a beneficial effect on the proportion of time that oxygen saturation is within target range, and a decrease in hyperoxia and severe hypoxia. Automated oxygen control may also reduce the workload for bedside staff. There is concern that such devices could mask clinical deterioration, however this has not been reported to date. CONCLUSIONS So far, trials involving different algorithms are heterogenous in design and no head-to-head comparisons have been made, making it difficult to differentiate which algorithm is most effective and what clinicians can expect from algorithms under certain conditions.
Collapse
Affiliation(s)
- Hylke H Salverda
- Neonatology, Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands
| | - Sophie J E Cramer
- Neonatology, Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands
| | - Ruben S G M Witlox
- Neonatology, Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands
| | - Peter A Dargaville
- Department of Pediatrics, Royal Hobart Hospital, Hobart, Tasmania, Australia.,Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Arjan B Te Pas
- Neonatology, Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands
| |
Collapse
|
8
|
Ginsburg AS, Macharia W, Ansermino JM. Evaluating neonatal medical devices in Africa. LANCET DIGITAL HEALTH 2021; 3:e211-e212. [PMID: 33640307 DOI: 10.1016/s2589-7500(21)00025-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 01/26/2021] [Accepted: 02/04/2021] [Indexed: 11/19/2022]
Affiliation(s)
- Amy Sarah Ginsburg
- Department of Biostatistics, University of Washington, Seattle, WA 98115, USA.
| | - William Macharia
- Department of Pediatrics, The Aga Khan University, Nairobi, Kenya
| | - J Mark Ansermino
- Department of Anesthesiology, The University of British Columbia, Vancouver, BC, Canada
| |
Collapse
|
9
|
Lenahan JL, Nkwopara E, Phiri M, Mvalo T, Couasnon MT, Turner K, Ndamala C, McCollum ED, May S, Ginsburg AS. Repeat assessment of examination signs among children in Malawi with fast-breathing pneumonia. ERJ Open Res 2020; 6:00275-2019. [PMID: 32494572 PMCID: PMC7248340 DOI: 10.1183/23120541.00275-2019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 03/04/2020] [Indexed: 01/04/2023] Open
Abstract
Background As part of a randomised controlled trial of treatment with placebo versus 3 days of amoxicillin for nonsevere fast-breathing pneumonia among Malawian children aged 2–59 months, a subset of children was hospitalised for observation. We sought to characterise the progression of fast-breathing pneumonia among children undergoing repeat assessments to better understand which children do and do not deteriorate. Methods Vital signs and physical examination findings, including respiratory rate, arterial oxygen saturation measured by pulse oximetry (SpO2), chest indrawing and temperature were assessed every 3 h for the duration of hospitalisation. Children were assessed for treatment failure during study visits on days 1, 2, 3 and 4. Results Hospital monitoring data from 436 children were included. While no children had SpO2 90–93% at baseline, 7.4% (16 of 215) of children receiving amoxicillin and 9.5% (21 of 221) receiving placebo developed SpO2 90–93% during monitoring. Similarly, no children had chest indrawing at enrolment, but 6.6% (14 of 215) in the amoxicillin group and 7.2% (16 of 221) in the placebo group went on to develop chest indrawing during hospitalisation. Conclusion Repeat monitoring of children with fast-breathing pneumonia identified vital and physical examination signs not present at baseline, including SpO2 90–93% and chest indrawing. This information may support providers and policymakers in developing guidance for care of children with nonsevere pneumonia. This study characterised the progression of fast-breathing pneumonia among children in Malawi. Repeat monitoring of children identified vital and physical exam signs not present at baseline, including oxygen saturation of 90–93% and chest indrawing.http://bit.ly/2vUlckS
Collapse
Affiliation(s)
- Jennifer L Lenahan
- International Programs, Save the Children Federation Inc., Westport, CT, USA
| | - Evangelyn Nkwopara
- International Programs, Save the Children Federation Inc., Westport, CT, USA
| | - Melda Phiri
- Dept of Pediatrics, University of North Carolina Project, Lilongwe Medical Relief Fund Trust, Lilongwe, Malawi
| | - Tisungane Mvalo
- Dept of Pediatrics, University of North Carolina Project, Lilongwe Medical Relief Fund Trust, Lilongwe, Malawi
| | - Mari T Couasnon
- International Programs, Save the Children Federation Inc., Westport, CT, USA
| | - Kali Turner
- International Programs, Save the Children Federation Inc., Westport, CT, USA
| | - Chifundo Ndamala
- Dept of Pediatrics, University of North Carolina Project, Lilongwe Medical Relief Fund Trust, Lilongwe, Malawi
| | - Eric D McCollum
- Dept of Pediatrics, Eudowood Division of Pediatric Respiratory Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Susanne May
- Dept of Biostatistics, University of Washington, Seattle, WA, USA
| | - Amy Sarah Ginsburg
- International Programs, Save the Children Federation Inc., Westport, CT, USA
| |
Collapse
|
10
|
Ginsburg AS, Nkwopara E, Macharia W, Ochieng R, Waiyego M, Zhou G, Karasik R, Xu S, Ansermino JM. Evaluation of non-invasive continuous physiological monitoring devices for neonates in Nairobi, Kenya: a research protocol. BMJ Open 2020; 10:e035184. [PMID: 32284391 PMCID: PMC7200030 DOI: 10.1136/bmjopen-2019-035184] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Continuous physiological monitoring devices are often not available for monitoring high-risk neonates in low-resource settings. Easy-to-use, non-invasive, multiparameter, continuous physiological monitoring devices could be instrumental in providing appropriate care and improving outcomes for high-risk neonates in these low-resource settings. METHODS AND ANALYSIS The purpose of this prospective, observational, facility-based evaluation is to provide evidence to establish whether two existing non-invasive, multiparameter, continuous physiological monitoring devices developed by device developers, EarlySense and Sibel, can accurately and reliably measure vital signs in neonates (when compared with verified reference devices). We will also assess the feasibility, usability and acceptability of these devices for use in neonates in low-resource settings in Africa. Up to 500 neonates are enrolled in two phases: (1) a verification and accuracy evaluation phase at Aga Khan University-Nairobi and (2) a clinical feasibility evaluation phase at Pumwani Maternity Hospital in Nairobi, Kenya. Both quantitative and qualitative data are collected and analysed. Agreement between the investigational and reference devices is determined using a priori-defined accuracy thresholds. ETHICS AND DISSEMINATION This trial was approved by the Aga Khan University Nairobi Research Ethics Committee and the Western Institutional Review Board. We plan to disseminate research results in peer-reviewed journals and international conferences. TRIAL REGISTRATION NUMBER NCT03920761.
Collapse
Affiliation(s)
- Amy Sarah Ginsburg
- Clinical Trial Center, University of Washington, Seattle, Washington, United States
| | | | | | | | - Mary Waiyego
- Pediatrics, Pumwani Maternity Hospital, Nairobi, Kenya
| | - Guohai Zhou
- Biostatistics, Brigham and Women's Hospital, Boston, Massachusetts, United States
| | | | - Shuai Xu
- Sibel Inc, Evanston, Illinois, United States
- Dermatology, Northwestern University, Evanston, Illinois, USA
| | - J Mark Ansermino
- Anesthesiology, The University of British Columbia, Vancouver, British Columbia, Canada
| |
Collapse
|
11
|
Lee DT, Park CJ, Peterec S, Morotti R, Cowles RA. Outcomes of neonates with listeriosis supported with extracorporeal membrane oxygenation from 1991 to 2017. J Perinatol 2020; 40:105-111. [PMID: 31636340 DOI: 10.1038/s41372-019-0534-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 09/18/2019] [Accepted: 09/30/2019] [Indexed: 11/09/2022]
Abstract
BACKGROUND Listeriosis may cause severe disease in fetuses and neonates. The outcomes of critically ill neonates with early-onset listeriosis requiring extracorporeal membrane oxygenation (ECMO) from 1975 to 1991 have been reported. OBJECTIVE To update the characteristics and outcomes of neonates with listeriosis supported by ECMO. STUDY DESIGN Retrospective study of neonates with culture-proven listeriosis reported to the Extracorporeal Life Support Organization Registry between 1991 and 2017. Comparisons were made between this cohort and the case series from 1975-1991. RESULTS Twenty-two neonates had culture-proven Listeria monocytogenes infection and required ECMO support. Eight-six percent survived to discharge, compared with 67% in the previous cohort (p = 0.2). The median ECMO duration was 131 h, compared with 209 h in the previous cohort (p = 0.1). Nonsurvivors had a significantly lower pre-ECMO pH (6.91 vs 7.31, p = 0.0006). CONCLUSION The survival of neonates with listeriosis supported with ECMO is high, supporting the use of ECMO as rescue therapy for this condition.
Collapse
Affiliation(s)
- Dianne T Lee
- Department of Pediatrics, Section of Neonatal-Perinatal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Christine J Park
- Department of Surgery, Division of Pediatric Surgery, Yale School of Medicine, New Haven, CT, USA
| | - Steven Peterec
- Department of Pediatrics, Section of Neonatal-Perinatal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Raffaella Morotti
- Department of Pathology, Yale School of Medicine, New Haven, CT, USA
| | - Robert A Cowles
- Department of Surgery, Division of Pediatric Surgery, Yale School of Medicine, New Haven, CT, USA.
| |
Collapse
|