Computerised physiological trend monitoring in neonatal intensive care

• Main Author: Cunningham, Steven
• Published: University of Edinburgh 1995
• Subjects: 618.92
• Online Access: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.649014

We have assessed the introduction of a commercially available computerised physiological trend monitoring network into a neonatal intensive care area. The attitudes of staff and parents were on the whole favourable, with the majority feeling that infant care benefited from the introduction of computers. A detailed study of the effects of computerised physiological monitoring on patient outcome in both short and medium term, showed no significant benefits. The computers improved both the quality and accuracy of the stored infant physiological data. Artefact was predominantly predictable; it could be ignored in real time trends and removed from recorded data prior to statistical analysis. Neonatalogy is a relatively new science, and a continuously expanding physiological data source could help to improve patient care through research. Three areas were explored: (a) Reference blood pressures ranges were established for very low birth weight infants, using more detailed information on a larger group of infants than previously possible. (b) Infants with retinopathy of prematurity compared to those without the disease, did not differ significantly in the amount of time they spent with a continuously monitored transcutaneous oxygen greater than 12 kPa. (c) Previously undescribed blood pressure waves were identified. Associated with hypoxia, they may help improve understanding of fetal autonomic development. Although unable to demonstrate an improvement in patient outcome resulting from the introduction of a computerised physiological network (possibly due to poor outcome measurements), we have demonstrated improved staff confidence, better physiological record and the opportunity for improvement in care through research.