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Poppe JA, Smorenburg RS, Goos TG, Taal HR, Reiss IKM, Simons SHP. Development of a Web-Based Oxygenation Dashboard for Preterm Neonates: A Quality Improvement Initiative. J Med Syst 2024; 48:46. [PMID: 38656727 PMCID: PMC11043117 DOI: 10.1007/s10916-024-02064-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 04/08/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Preterm neonates are extensively monitored to require strict oxygen target attainment for optimal outcomes. In daily practice, detailed oxygenation data are hardly used and crucial patterns may be missed due to the snapshot presentations and subjective observations. This study aimed to develop a web-based dashboard with both detailed and summarized oxygenation data in real-time and to test its feasibility to support clinical decision making. METHODS Data from pulse oximeters and ventilators were synchronized and stored to enable real-time and retrospective trend visualizations in a web-based viewer. The dashboard was designed based on interviews with clinicians. A preliminary version was evaluated during daily clinical rounds. The routine evaluation of the respiratory condition of neonates (gestational age < 32 weeks) with respiratory support at the NICU was compared to an assessment with the assistance of the dashboard. RESULTS The web-based dashboard included data on the oxygen saturation (SpO2), fraction of inspired oxygen (FiO2), SpO2/FiO2 ratio, and area < 80% and > 95% SpO2 curve during time intervals that could be varied. The distribution of SpO2 values was visualized as histograms. In 65% of the patient evaluations (n = 86) the level of hypoxia was assessed differently with the use of the dashboard. In 75% of the patients the dashboard was judged to provide added value for the clinicians in supporting clinical decisions. CONCLUSIONS A web-based customized oxygenation dashboard for preterm neonates at the NICU was developed and found feasible during evaluation. More clear and objective information was found supportive for clinicians during the daily rounds in tailoring treatment strategies.
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Affiliation(s)
- J A Poppe
- Department of Neonatal and Paediatric Intensive Care, Division of Neonatology, Erasmus MC Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands.
| | - R S Smorenburg
- Department of Neonatal and Paediatric Intensive Care, Division of Neonatology, Erasmus MC Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - T G Goos
- Department of Neonatal and Paediatric Intensive Care, Division of Neonatology, Erasmus MC Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Biomechanical Engineering, Delft University of Technology, Delft, The Netherlands
| | - H R Taal
- Department of Neonatal and Paediatric Intensive Care, Division of Neonatology, Erasmus MC Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - I K M Reiss
- Department of Neonatal and Paediatric Intensive Care, Division of Neonatology, Erasmus MC Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - S H P Simons
- Department of Neonatal and Paediatric Intensive Care, Division of Neonatology, Erasmus MC Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands
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Durmuş B, Heppe DHM, Taal HR, Manniesing R, Raat H, Hofman A, Steegers EAP, Gaillard R, Jaddoe VWV. Parental smoking during pregnancy and total and abdominal fat distribution in school-age children: the Generation R Study. Int J Obes (Lond) 2014; 38:966-72. [PMID: 24448598 DOI: 10.1038/ijo.2014.9] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2013] [Revised: 12/29/2013] [Accepted: 01/14/2014] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Fetal smoke exposure may influence growth and body composition later in life. We examined the associations of maternal and paternal smoking during pregnancy with total and abdominal fat distribution in school-age children. METHODS We performed a population-based prospective cohort study among 5243 children followed from early pregnancy onward in the Netherlands. Information about parental smoking was obtained by questionnaires during pregnancy. At the median age of 6.0 years (90% range: 5.7-7.4), we measured anthropometrics, total fat and android/gynoid fat ratio by dual-energy X-ray absorptiometry, and preperitoneal and subcutaneous abdominal fat were measured by ultrasound. RESULTS The associations of maternal smoking during pregnancy were only present among girls (P-value for sex interaction<0.05). Compared with girls from mothers who did not smoke during pregnancy, those from mothers who smoked during the first trimester only had a higher android/gynoid fat ratio (difference 0.23 (95% confidence interval (CI): 0.09-0.37) s.d. scores (SDS). Girls from mothers who continued smoking throughout pregnancy had a higher body mass index (difference: 0.24 (95% CI: 0.14-0.35) SDS), total fat mass (difference: 0.23 (95% CI: 0.14-0.33) SDS), android/gynoid fat ratio (difference: 0.34 (95% CI: 0.22-0.46) SDS), subcutaneous abdominal fat (difference: 0.22 (95% CI: 0.11-0.33) SDS) and preperitoneal abdominal fat (difference: 0.20 (95% CI: 0.08-0.31) SDS). Similar associations with body fat distribution outcomes were observed for paternal smoking during pregnancy. Both continued maternal and paternal smoking during pregnancy may be associated with an increased risk of childhood overweight. The corresponding odds ratios were 1.19 (95% CI: 0.98-1.46) and 1.32 (1.10-1.58), respectively. CONCLUSIONS Maternal and paternal smoking during pregnancy are associated with an adverse body and abdominal fat distribution and increased risk of overweight in children. Similar effects of maternal and paternal smoking suggest that direct intrauterine mechanisms and common family-based lifestyle-related factors explain the associations.
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Affiliation(s)
- B Durmuş
- 1] The Generation R Study Group, Erasmus Medical Centre, Rotterdam, The Netherlands [2] Department of Pediatrics, Erasmus Medical Centre, Rotterdam, The Netherlands [3] Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - D H M Heppe
- 1] The Generation R Study Group, Erasmus Medical Centre, Rotterdam, The Netherlands [2] Department of Pediatrics, Erasmus Medical Centre, Rotterdam, The Netherlands [3] Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - H R Taal
- 1] The Generation R Study Group, Erasmus Medical Centre, Rotterdam, The Netherlands [2] Department of Pediatrics, Erasmus Medical Centre, Rotterdam, The Netherlands [3] Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - R Manniesing
- Department of Radiology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - H Raat
- Department of Public Health, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - A Hofman
- Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - E A P Steegers
- Department of Obstetrics and Gynecology, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - R Gaillard
- 1] The Generation R Study Group, Erasmus Medical Centre, Rotterdam, The Netherlands [2] Department of Pediatrics, Erasmus Medical Centre, Rotterdam, The Netherlands [3] Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - V W V Jaddoe
- 1] The Generation R Study Group, Erasmus Medical Centre, Rotterdam, The Netherlands [2] Department of Pediatrics, Erasmus Medical Centre, Rotterdam, The Netherlands [3] Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands
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Heppe DHM, Taal HR, Ernst GDS, Van Den Akker ELT, Lequin MMH, Hokken-Koelega ACS, Geelhoed JJM, Jaddoe VWV. Bone age assessment by dual-energy X-ray absorptiometry in children: an alternative for X-ray? Br J Radiol 2011; 85:114-20. [PMID: 21586503 DOI: 10.1259/bjr/23858213] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE The aim of the study was to validate dual-energy X-ray absorptiometry (DXA) as a method to assess bone age in children. METHODS Paired dual-energy X-ray absorptiometry (DXA) scans and X-rays of the left hand were performed in 95 children who attended the paediatric endocrinology outpatient clinic of University Hospital Rotterdam, the Netherlands. We compared bone age assessments by DXA scan with those performed by X-ray. Bone age assessment was performed by two blinded observers according to the reference method of Greulich and Pyle. Intra-observer and interobserver reproducibility were investigated using the intraclass correlation coefficient (ICC), and agreement was tested using Bland and Altman plots. RESULTS The intra-observer ICCs for both observers were 0.997 and 0.991 for X-ray and 0.993 and 0.987 for DXA assessments. The interobserver ICC was 0.993 and 0.991 for X-ray and DXA assessments, respectively. The mean difference between bone age assessed by X-ray and DXA was 0.11 years. The limits of agreement ranged from -0.82 to 1.05 years, which means that 95% of all differences between the methods were covered by this range. CONCLUSIONS Results of bone age assessment by DXA scan are similar to those obtained by X-ray. The DXA method seems to be an alternative for assessing bone age in a paediatric hospital-based population.
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Affiliation(s)
- D H M Heppe
- The Generation R Study Group, Erasmus Medical Center, 3000 CA Rotterdam, The Netherlands
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