RT Journal Article
SR Electronic
T1 Impact of electronic data monitoring on the incidence of hyperoxia in premature neonates
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P4130
VO 40
IS Suppl 56
A1 Christopher Collura
A1 Marc Ellsworth
A1 Malinda Harris
A1 Grant Wilson
A1 William Carey
A1 Christopher Colby
YR 2012
UL http://erj.ersjournals.com/content/40/Suppl_56/P4130.abstract
AB Background: Episodes of hyperoxia, a known risk factor for bronchopulmonary dysplasia in premature neonates, most often are identified manually by care providers.Objective: We sought to determine whether an automated electronic data surveillance tool (DST) would reduce the rate of hyperoxic episodes in premature neonates.Methods: We studied all neonates born at <29 weeks gestation who were admitted to our NICU between August 2008 - June 2010. Because a standardized respiratory treatment protocol (RTP) for this same population had been introduced in early 2009, the study period was divided into three epochs (E) of equal duration as follows: E1 - no RTP, no DS; E2 - with RTP, no DS; E3 - with RTP, with DS.Because our standard clinical data systems collect data at 15 minute intervals, we prospectively defined a hyperoxic episode as three consecutive measurements (at 0, 15 and 30 minutes) of O2 sat >92%, the upper limit of the RTP.During E1 and E2, O2 sats >92% were detected manually by the bedside nurses. During E3, the DST analyzed clinical data and automatically notified the charge nurse of a patient's hyperoxic episode.We retrospectively compared the rate of hyperoxic episodes of each epoch, using the Chi-squared test to determine statistical significance.Results: Neonates treated during E3 experienced fewer hyperoxic episodes than those treated during E2 (17 v. 24 episodes per 1000 O2 sat measurements; p < 0.0001). These rates both were lower than that of E1 (41 episodes per 1000 O2 sat measurements; p < 0.0001).Conclusion: Use of a DST was associated with less frequent episodes of hyperoxia among premature neonates and seemed to enhance the efficacy of a respiratory treatment protocol.