Details

Autor(en) / Beteiligte

• Bawua, Linda K.
• Miaskowski, Christine
• Suba, Sukardi
• Badilini, Fabio
• Mortara, David
• Hu, Xiao
• Rodway, George W.
• Hoffmann, Thomas J.
• Pelter, Michele M.

Titel

Agreement between respiratory rate measurement using a combined electrocardiographic derived method versus impedance from pneumography

Ist Teil von

• Journal of electrocardiology, 2022-03, Vol.71, p.16-24

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2022

Quelle

MEDLINE

Beschreibungen/Notizen

• Background: Impedance pneumography (IP) is the current device-driven method used to measure respiratory rate (RR) in hospitalized patients. However, RR alarms are common and contribute to alarm fatigue. While RR derived from electrocardiographic (ECG) waveforms hold promise, they have not been compared to the IP method. Purpose: Study examined the agreement between the IP and combined-ECG derived (EDR) for normal RR (≥12 or ≤20 breaths/minute [bpm]); low RR (≤5 bpm); and high RR (≥30 bpm). Methodology: One-hundred intensive care unit patients were included by RR group: (1) normal RR (n = 50; 25 low RR and 25 high RR); (2) low RR (n = 50); and (3) high RR (n = 50). Bland-Altman analysis was used to evaluate agreement. Results: For normal RR, a significant bias difference of −1.00 + 2.11 (95% CI −1.60 to −0.40) and 95% limit of agreement (LOA) of −5.13 to 3.13 was found. For low RR, a significant bias difference of −16.54 + 6.02 (95% CI: −18.25 to −14.83) and a 95% LOA of −28.33 to - 4.75 was found. For high RR, a significant bias difference of 17.94 + 12.01 (95% CI: 14.53 to 21.35) and 95% LOA of −5.60 to 41.48 was found. Conclusion: Combined-EDR method had good agreement with the IP method for normal RR. However, for the low RR, combined-EDR was consistently higher than the IP method and almost always lower for the high RR, which could reduce the number of RR alarms. However, replication in a larger sample including confirmation with visual assessment is warranted. •No study has examined respiratory rate (RR) agreement between impedance pneumography (IP) and an ECG derived (EDR) method.•The EDR method had good agreement with the IP method for normal RR (>12 <20 breaths/minute [bpm]). However, for low RR (<5 bpm) the EDR was consistently higher than IP and almost always lower for high RR (>30 bpm).•Nearly 70% of our 100 ICU patients had RRs that exceeded the upper normal limit (<20 bpm), suggesting tachypnea is common.