J Clin Monit Comput - An evaluation of the Integrated Pulmonary Index (IPI) for the detection of respiratory events in sedated patients undergoing colonoscopy.

Tópicos

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Resumo

The Integrated Pulmonary Index (IPI?) is a new decision making tool calculated from measured end tidal carbon dioxide (etCO(2)), respiratory rate (RR), oxygen saturation (SpO(2)) and pulse rate (PR) using a fuzzy logic model. The aim of this study was to compare prospectively IPI to respiratory adverse events in patients undergoing moderate sedation for colonoscopy. Following ethics committee approval and personal informed consent 51 adult patients undergoing elective colonoscopy were enrolled. Patients received routine care by the endoscopy staff that were blinded to IPI, etCO(2), and RR; whilst a trained senior anesthesiologist observer, not involved in the procedure, collected this data. 'Requires attention' respiratory adverse events (at least 1 min of SpO(2) = 92 % and/or RR = 8 and or 20 % decrease in etCO(2)) and 'requires intervention' respiratory adverse events (at least 1 min of SpO(2) = 85 % and/or RR = 0) were documented by the observer. There were no differences in etCO(2), RR, SpO(2) and PR between 5778 IPI readings ranging from 1 to 10. Low (1-3), medium (4-6) and high (7-10) IPI groups did not differ in RR, SpO(2) and PR, but etCO(2) was higher in the high IPI group (p = 0.0185). Among requires attention events (n = 113) the IPI was high (7-10) in 53.1 %, intermediate (4-6) in 32.7 %, or low (1-3) in 14.2 %. The presented data demonstrate limited agreement between respiratory physiological parameters and the IPI. Further IPI evaluation and validation is indicated mainly for events requiring immediate intervention and in different patient populations including obese patients.

Resumo Limpo

integr pulmonari index ipi new decis make tool calcul measur end tidal carbon dioxid etco respiratori rate rr oxygen satur spo puls rate pr use fuzzi logic model aim studi compar prospect ipi respiratori advers event patient undergo moder sedat colonoscopi follow ethic committe approv person inform consent adult patient undergo elect colonoscopi enrol patient receiv routin care endoscopi staff blind ipi etco rr whilst train senior anesthesiologist observ involv procedur collect data requir attent respiratori advers event least min spo andor rr decreas etco requir intervent respiratori advers event least min spo andor rr document observ differ etco rr spo pr ipi read rang low medium high ipi group differ rr spo pr etco higher high ipi group p among requir attent event n ipi high intermedi low present data demonstr limit agreement respiratori physiolog paramet ipi ipi evalu valid indic main event requir immedi intervent differ patient popul includ obes patient

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