[Clinical evaluation of alarm efficieny in intensive care].
OBJECTIVE
To evaluate the efficiency of haemodynamic and respiratory monitoring system by a clinical analysis of the alarms.


METHODS
Observational prospective study.


METHODS
25 patients who presented acute respiratory distress syndrome and who were monitored with haemodynamic and respiratory monitoring.


METHODS
Each minute, a bedside clinical observer analysed alarms from the monitoring according to detection or absence to clinical events. Four situations were defined to statistical descriptive analysis: a) false positive (FP); b) true positive (TP); c) false negative (FN); and d) true negative (TN). True positive alarm which induced consequences on patients care were also analysed.


RESULTS
15,013 minutes allowed the recordings of 3,665 alarms, 44% from arterial pressure, 17% from SpO2 and 12% from airways maximal pressure. 46% were false positive alarms inducing a noisy pollution. The positive predictive value PPV = TP/(TP + FP) of these alarms were respectively 51% for arterial pressure, 18% for SpO2 and 100% for Paw. Only 5% of true positive alarms induced consequences on patients care.


CONCLUSIONS
This protocol allowed the evaluation of monitoring efficiency. This kind of evaluation may help to improve monitoring capacity with reducing noisy pollution from false positive alarms.
Biot
L
L
Département d'anesthésie-réanimation, centre hospitalier Lyon Sud, Pierre-Bénite, France.
Carry
P Y
PY
Perdrix
J P
JP
Eberhard
A
A
Baconnier
P
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003422:Critical Care; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000295:instrumentation*; D011446:Prospective Studies; D015656:Respiratory Mechanics / Q000502:physiology