Clinical evaluation of alarm efficiency in intensive care unit.

Objective: To evaluate the efficiency of haemodynamic and respiratory monit oring system by a clinical analysis of the alarms. Study design: Observational prospective study. Patients: 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 situa tions were defined to statistical descriptive analysis: a) false positive ( FP); b) true positive (TP); c) false negative (FN); and d) true negative (T N). True positive alarm which induced consequences on patients care were al so analysed. Results: 15,013 minutes allowed the recordings of 3,665 alarms, 44% from ar terial pressure, 17% from SpO(2) and 12% from airways maximal pressure. 46% were false positive alarms inducing a noisy pollution. The positive predic tive value PPV = TP/(TP + FP) of these alarms were respectively 51% for art erial pressure, 18% for SpO(2) and 100% for Paw. Only 5% of true positive a larms induced consequences on patients care. Conclusion: This protocol allowed the evaluation of monitoring efficiency. This kind of evaluation may help to improve monitoring capacity with reduci ng noisy pollution from false positive alarms. (C) 2000 Editions scientifiq ues et medicales Elsevier SAS.