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ST waveform analysis for monitoring hypoxic distress in fetal sheep after prolonged umbilical cord occlusion.

Authors :
Andriessen P
Zwanenburg A
van Laar JOEH
Vullings R
Hermans BJM
Niemarkt HJ
Jellema RK
Ophelders DRMG
Wolfs TGAM
Kramer BW
Delhaas T
Source :
PloS one [PLoS One] 2018 Apr 16; Vol. 13 (4), pp. e0195978. Date of Electronic Publication: 2018 Apr 16 (Print Publication: 2018).
Publication Year :
2018

Abstract

Introduction: The inconclusive clinical results for ST-waveform analysis (STAN) in detecting fetal hypoxemia may be caused by the signal processing of the STAN-device itself. We assessed the performance of a clinical STAN device in signal processing and in detecting hypoxemia in a fetal sheep model exposed to prolonged umbilical cord occlusion (UCO).<br />Methods: Eight fetal lambs were exposed to 25 minutes of UCO. ECG recordings were analyzed during a baseline period and during UCO. STAN-event rates and timing of episodic T/QRS rise, baseline T/QRS rise and the occurrence of biphasic ST-waveforms, as well as signal loss, were assessed.<br />Results: During baseline conditions of normoxemia, a median of 40 (IQR, 25-70) STAN-events per minute were detected, compared to 10 (IQR, 2-22) during UCO. During UCO STAN-events were detected in five subjects within 10 minutes and in six subjects after 18 minutes, respectively. Two subjects did not generate any STAN-event during UCO. Biphasic ST event rate was reduced during UCO (median 0, IQR 0-5), compared to baseline (median 32, IQR, 6-55). ST-waveforms could not be assessed in 62% of the recording time during UCO, despite a good quality of the ECG signal.<br />Conclusions: The STAN device showed limitations in detecting hypoxemia in fetal sheep after prolonged UCO. The STAN device produced high false positive event rates during baseline and did not detect T/QRS changes adequately after prolonged fetal hypoxemia. During 14% of baseline and 62% of the UCO period, the STAN-device could not process the ECG signal, despite its good quality. Resolving these issues may improve the clinical performance of the STAN device.

Details

Language :
English
ISSN :
1932-6203
Volume :
13
Issue :
4
Database :
MEDLINE
Journal :
PloS one
Publication Type :
Academic Journal
Accession number :
29659625
Full Text :
https://doi.org/10.1371/journal.pone.0195978