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Analysis of ST segment alarms in children admitted to the paediatric and cardiac intensive care units and cardiac progressive care unit: a single-centre retrospective study

Published online by Cambridge University Press:  25 September 2024

Christine Peyton Gallagher Open the ORCID record for Christine Peyton Gallagher [Opens in a new window] ,
Sonja I. Ziniel ,
Jennifer Newman ,
Beth Wathen ,
Paul Marusich ,
Christopher Poppy ,
Todd Carpenter  and
Katja M. Gist
Christine Peyton Gallagher*
Affiliation:
Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA Cardiac ICU, Boston Children’s Hospital, Boston, MA, USA
Sonja I. Ziniel
Affiliation:
Department of Pediatrics, Children’s Hospital Colorado, Aurora, CO, USA
Jennifer Newman
Affiliation:
Children’s Hospital Colorado, Aurora, CO, USA
Beth Wathen
Affiliation:
Children’s Hospital Colorado, Aurora, CO, USA
Paul Marusich
Affiliation:
Children’s Hospital Colorado, Aurora, CO, USA
Christopher Poppy
Affiliation:
Department of Pediatrics, Children’s Hospital Colorado, Aurora, CO, USA
Todd Carpenter
Affiliation:
Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
Katja M. Gist
Affiliation:
Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
*
Corresponding author: C. P. Gallagher; Email: [email protected]
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Abstract

ST segment monitoring in the adult population allows for the early detection of myocardial ischaemia. In children admitted to the paediatric intensive care unit (PICU), cardiac intensive care unit (CICU), and cardiac progressive care unit (CPCU), it is unclear if continuous ST segment alarm monitoring is necessary in all patients. All patients admitted to the PICU, CICU, and CPCU during the study period were included. Children with any ST segment alarms were compared with those without an alarm during their stay. The electrocardiogram confirmed true ST segment alarms were compared with all other ST segment alarms. Demographic and clinical data were extracted from the medical record. Medical interventions and procedures occurring around ST segment alarms were recorded for multivariable analysis assessing for the association of true ST segment. Logistic regression was used to evaluate the associations with ST segment alarms during hospital stays. ST segment alarms occurred in 36% of hospital stays, and only 3.4% were considered true. True alarms were significantly more common among patients with a cardiac-related diagnosis, located in both cardiac units, and having received an intervention with any vasoactive medication. In the multivariable logistic regression, patients 11 years or older, hypotension, supraventricular tachycardia, and initiation/escalation of any vasoactive were independently associated with a true ST segment alarm. True ST segment alarms were infrequent, occurring in 1.2% of stays during the study period. Alarm monitoring may be beneficial in those with an underlying cardiac diagnosis.

Keywords

ST segmentclinical alarmsauditory fatigue
Type
Original Article
Information
Cardiology in the Young , Volume 34 , Issue 9 , September 2024 , pp. 1900 - 1905
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Copyright
© The Author(s), 2024. Published by Cambridge University Press

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