신생아 중환자실에서 맥박산소측정기의 감지도 비교: Nellcor N-595® versus Masimo SET®
Comparison of the Clinical Performance between Two Pulse Oximeters in NICU: Nellcor N-595® versus Masimo SET®
0
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
목적: 신생아 집중치료실에서 널리 이용되고 있는 맥박산소측정장치의 과도한 거짓 알람은 참 알람에 대한 반응을 느리게 하였다. 이에 Masimo SET®는 움직임에 의한 거짓 알람을 극복한장치로 소개되었다. 저자들은 안정 시나 일상적인 움직임이 있을 때 두 장치간의 거짓 알람의 빈도를 조사함으로써 Nellcor N-595®와 Masimo SET®의 임상적 수행능력을 비교하고자 하였다. 방법: 연구 당시 체중이 1,000-2,500 g인 미숙아 20명을 대상으로 하였다. 두 장치의 sensor를 동일한 환아의 양쪽 발에 각각 부착한 후 산소포화도가 85% 이하인 경우 알람이 울리도록하였다. 맥박산소포화도 측정장치의 알람이 울린 경우 중에서장치의 맥박수가 심전도의 심박수와 차이가 나는 경우, 파형이일정하게 그려지지 않는 경우, 저산소증의 뚜렸한 증상이 없는경우를 거짓 알람으로 정의하였고 두 장치의 거짓 알람의 빈도를 비교하였다. 결과: 대상 환아의 나이는 출생 후 평균 20.8일이었으며 평균체중은 1,668 g이었다. 두 장치간의 전체 거짓 알람의 빈도는Nellcor N-595®에 비해 Masimo SET®에서 유의하게 적었으나(Nellcor N-595®에서 48회, Masimo SET®에서 27회), 일상적인움직임이 있을 경우 두 장치간의 거짓 알람의 빈도는 통계학적으로 유의한 차이가 없었다(Nellcor N-595®에서 32회, Masimo SET®에서 19회). 결론: Masimo SET®는 Nellcor N-595®에 비해 거짓 알람의빈도가 적고 실제 저산소증 여부를 잘 반영하므로 적절한 산소치료에 유용하고 의료진의 불필요한 처치를 감소시키는데 도움이 될 것으로 생각된다.
Abstract
Purpose: Numerous false alarms by pulse oximetry, which is widely used in neonatal intensive care unit, can delay response to true alarms. Masimo SET® was introduced lately, to overcome false alarms by motion. We compared the clinical performance of two devices (Nellcor N-595® and Masimo SET®) for the evaluation of the false alarm frequency during usual motion artifacts and stable state. Methods: A total of 20 preterm infants weighing 1,000-2,500 g were enrolled in the study. The sensors of two devices were placed on the different feet on the same infants, and both devices were programmed to emit an alarm for episode of hypoxemia (SpO2≤85%). The false alarms were defined as episodes of poor correlation with ECG heart rate, poor waveforms, and the absence of obvious signs of hypoxia. We compared the frequency of false alarms between the two devices. Results: The mean chronological age was 20.8 days and the mean body weight was 1,668 g on the study day. The frequency of total false alarm was significantly fewer for Masimo SET® pulse oximetry (48 in Nellcor N-595®, 27 in Masimo SET®) although the false alarm during usual motion artifacts was not significantly between two devices (32 in Nellcor N-595®, 19 in Masimo SET®). Conclusion: The Masimo SET® pulse oximetry has fewer false alarm rates and identified more true hypoxic events than Nellcor N-595® pulse oximetry. Therefore, it is useful for adequate oxygen therapy and helps to decrease unnecessary handling by clinicians and nurses.
참고문헌 (24)
- Mower WR, "Pulse oximetry as a fifth pediatric vital sign", Pediatrics, 99, pp.681~686 (1997)
- Salyer JW, "Neonatal and pediatric pulse oximetry", Respir Care, 48, pp.386~396 (2003)
- Jubran A, "Pulse oximetry", Crit Care, 3, pp.11~17 (1999)
- Koh SO, "Pulse oximetry", Korean J Anesthesiol, 23, pp.549~552 (1990)
- Kamat V, "Pulse oximetry", Indian J Anaesthesiol, 46, pp.261~268 (2002)
- Park JM, "Pulse oximetry", Korean J Anesthesiol, 25, pp.798~806 (1992)
- Trivedi NS, "Effects of motion, ambient light, and hypoperfusion on pulse oximeter function", J Clin Anesth, 9, pp.179~183 (1997)
- Lawless ST, "Crying wolf: false alarms in a pediatric intensive care unit", Crit Care Med, 22, pp.981~985 (1994)
- Ahlborn V, "False alarms in very low birthweight infants: comparison between three intensive care monitoring systems", Acta Paediatr, 89, pp.571~576 (2000)
- Chambrin MC, "Alarms in the intensive care unit: how can the number of false alarms be reduced?", Crit Care, 5, pp.184~188 (2001)
- Malviya S, "False alarms and sensitivity of conventional pulse oximetry versus the Masimo SET technology in the pediatric postanesthesia care unit", Anesth Analg, 90, pp.1336~1340 (2000)
- Goldman JM, "Masimo signal extraction pulse oximetry", J Clin Monit Comput, 16, pp.475~483 (2000)
- Barker SJ, ""Motion-resistant" pulse oximetry: a comparison of new and old models", Anesth Analg, 95, pp.967~972 (2002)
- Barker SJ, "A comparison of Nellcor N-395, N-595, and Masimo radical pulse oximeters during motion and hypoxemia", Anesth Analg, 97, pp.9~ (2003)
- Barker SJ, "The effects of motion on the performance of pulse oximeters in volunteers (revised publication)", Anesthesiology, 86, pp.101~108 (1997)
- Goldstein MR, "Performance of motion-resistant pulse oximeters in tracking neonatal heart rate variability", Anesth Analg, 94(S1), pp.102~ (2002)
- Sahni R, "Motion resistant pulse oximetry in neonates", Arch Dis Child Fetal Neonatal Ed, 88, pp.505~508 (2003)
- Poets CF, "Pulse oximetry in the neonatal intensive care unit (NICU): detection of hyperoxemia and false alarm rates", Anesth Analg, 94, pp.41~43 (2002)
- Hay WW Jr, "Reliability of conventional and new pulse oximetry in neonatal patients", J Perinatol, 22, pp.360~366 (2002)
- Workie FA, "Clinical use of newgeneration pulse oximeters in the neonatal intensive care unit", Am J Perinatol, 22, pp.357~360 (2005)
- Miyasaka K, "Pulse oximetry in the management of children in the PICU", Anesth Analg, 94, pp.44~46 (2002)
- Chang YS, "Effect of position change on oxygen saturation(SpO2) by pulse oximetry in the newborn infants", Korean J Perinatol, 4, pp.295~304 (1993)
- Min KT, "Clinical evaluation of pulse oximetry in ICU patients", Korean J Anesthesiol, 20, pp.737~744 (1987)
- Park CH, "Reliability of pulse oximetry in severe hypoxemic children with congenital heart disease", Korean J Crit Care Med, 12, pp.65~68 (1997)