scholarly journals How well are heart rates measured by pulse oximeters and electronic sphygmomanometers? Practice-based evidence from an observational study of acutely ill medical patients during hospital admission

2019 ◽  
Vol 18 (3) ◽  
pp. 144-147
Author(s):  
Mary Rimbi ◽  
◽  
Immaculate Nakitende ◽  
Teopista Namujwiga ◽  
John Kellett ◽  
...  
Keyword(s):  
Heart Rate ◽  
Observational Study ◽  
Hospital Admission ◽  
Pulse Oximeter ◽  
Medical Patients ◽  
Limits Of Agreement ◽  
Heart Rates ◽  
Electrocardiogram Ecg ◽  
Pulse Oximeters

Background: heart rates generated by pulse oximeters and electronic sphygmomanometers in acutely ill patients may not be the same as those recorded by ECG Methods: heart rates recorded by an oximeter and an electronic sphygmomanometer were compared with electrocardiogram (ECG) heart rates measured on acutely ill medical patients. Results: 1010 ECGs were performed on 217 patients while they were in the hospital. The bias between the oximeter and the ECG measured heart rate was -1.37 beats per minute (limits of agreement -22.6 to 19.9 beats per minute), and the bias between the sphygmomanometer and the ECG measured heart rate was -0.14 beats per minute (limits of agreement -22.2 to 21.9 beats per minute). Both devices failed to identify more than half the ECG recordings that awarded 3 NEWS points for heart rate. Conclusion: Heart rates of acutely ill patients are not reliably measured by pulse oximeter or electronic sphygmomanometers.

scholarly journals Wristbands in Home-Based Rehabilitation—Validation of Heart Rate Measurement

Sensors ◽  
2021 ◽  
Vol 22 (1) ◽  
pp. 60
Author(s):  
Magdalena Jachymek ◽  
Michał T. Jachymek ◽  
Radosław M. Kiedrowicz ◽  
Jarosław Kaźmierczak ◽  
Edyta Płońska-Gościniak ◽  
...  
Keyword(s):  
Heart Rate ◽  
Stress Test ◽  
Absolute Error ◽  
Concordance Correlation ◽  
Heart Rates ◽  
Home Based ◽  
Accuracy And Precision ◽  
Validation Criteria ◽  
Precision And Accuracy ◽  
Electrocardiogram Ecg

The possibility of using a smartwatch as a rehabilitation tool to monitor patients’ heart rates during exercise has gained the attention of many researchers. This study aimed to evaluate the accuracy and precision of the HR measurement performed by two wrist monitors: the Fitbit Charge 4 and the Xiaomi Mi Band 5. Thirty-one healthy volunteers were asked to perform a stress test on a treadmill. Their heart rates were recorded simultaneously by the wristbands and an electrocardiogram (ECG) at 1 min intervals. The mean absolute error percentage (MAPE), Lin’s concordance correlation coefficient (LCCC), and Bland–Altman analysis were calculated to compare the precision and accuracy of heart rate measurements. The estimated validation criteria were MAPE < 10% and LCCC < 0.8. The overall MAPE and LCCC of the Fitbit were 10.19% (±11.79%) and 0.753 (95% CI: 0.717–0.785), respectively. The MAPE and LCCC of the Xiaomi were 6.89% (±9.75) and 0.903 (0.886–0.917), respectively. The precision and accuracy of both devices decreased with the increased exercise intensity. The accuracy of wearable wrist-worn heart rate monitors varies and depends on the intensity of training. Therefore, the decision to use such a device as a heart rate monitor during in-home rehabilitation should be made with caution.

scholarly journals The Effect of a Disposable Probe Cover on Pulse Oximetry

2002 ◽  
Vol 30 (2) ◽  
pp. 211-214 ◽  
Author(s):  
P. Cheung ◽  
J. G. Hardman ◽  
R. Whiteside
Keyword(s):  
Standard Deviation ◽  
Prospective Study ◽  
Pulse Oximetry ◽  
Clinical Significance ◽  
Pulse Oximeter ◽  
Small Error ◽  
Mean Difference ◽  
The Other ◽  
Limits Of Agreement ◽  
Pulse Oximeters

The re-use of pulse oximeter probes presents the possibility of between-patient contamination. Use of a disposable polyethylene cover may reduce this risk. In a controlled, prospective study we examined the effect of such a cover on the accuracy of pulse oximetry. Each of ten volunteer subjects was monitored simultaneously by two identical Nellcor pulse oximeters, one with a plastic cover and the other, without a cover, used as a control. The pulse oximetry (SpO 2 ) reading for each probe was recorded while subjects breathed 21% O 2 and again while they breathed 10% O 2. The probe cover was then swapped onto the other probe and the recordings were repeated. Ninety-five per cent limits of agreement in SpO 2 (mean difference in SpO 2 (1.95 x standard deviation of difference) between covered and non-covered probes were -0.6% to 0.6% while breathing 21% oxygen and -2.0% to 2.9% while breathing 10% oxygen. We conclude that a protective plastic sheath may induce a small error in pulse oximetry reading that is most marked during hypoxaemia. This error is unlikely to be of clinical significance.

scholarly journals Respiratory rates observed over 15 and 30 s compared with rates measured over 60 s: practice-based evidence from an observational study of acutely ill adult medical patients during hospital admission

QJM ◽  
2019 ◽  
Vol 112 (7) ◽  
pp. 513-517 ◽  
Author(s):  
M Rimbi ◽  
D Dunsmuir ◽  
J M Ansermino ◽  
I Nakitende ◽  
T Namujwiga ◽  
...  
Keyword(s):  
Observational Study ◽  
Respiratory Rate ◽  
Sub Saharan Africa ◽  
Early Warning Score ◽  
Medical Patients ◽  
Rate Measurement ◽  
Limits Of Agreement ◽  
Resource Poor ◽  
Sub Saharan ◽  
Single Center Observational Study

AbstractBackgroundRespiratory rate is often measured over a period shorter than 1 min and then multiplied to produce a rate per minute. There are few reports of the performance of such estimates compared with rates measured over a full minute.AimCompare performance of respiratory rates calculated from 15 and 30 s of observations with measurements over 1 min.DesignA prospective single center observational studyMethodsThe respiratory rates calculated from observations for 15 and 30 s were compared with simultaneous respiratory rates measured for a full minute on acutely ill medical patients during their admission to a resource poor hospital in sub-Saharan Africa using a novel respiratory rate tap counting software app.ResultsThere were 770 respiratory rates recorded on 321 patients while they were in the hospital. The bias (limits of agreement) between the rate derived from 15 s of observations and the full minute was −1.22 breaths per minute (bpm) (−7.16 to 4.72 bpm), and between the rate derived from 30 s and the full minute was −0.46 bpm (–3.89 to 2.97 bpm). Rates observed over 1 min that scored 3 National Early Warning Score points were not identified by half the rates derived from 15 s and a quarter of the rates derived from 30 s.ConclusionPractice-based evidence shows that abnormal respiratory rates are more reliably detected with measurements made over a full minute, and respiratory rate measurement ‘short-cuts’ often fail to identify sick patients.

Method for measurement of heart rate in awake, noninstrumented small mammals

1984 ◽  
Vol 247 (6) ◽  
pp. H1010-H1012
Author(s):  
F. Vetterlein ◽  
J. Sammler ◽  
H. dal Ri ◽  
G. Schmidt
Keyword(s):  
Heart Rate ◽  
Small Mammals ◽  
Small Animals ◽  
Heart Rates ◽  
Metal Plates ◽  
Electrocardiogram Ecg

A method is described that enables the researcher to determine the heart rate in awake, noninstrumented small animals by recording the electrocardiogram (ECG) via the paws. Single animals are placed in a cage that has metal plates built into its floor. Through switches any two plates can be connected with an ECG recorder whenever contact with at least one front and one hind paw is made. The heart rate is then determined by measuring the number of R waves per unit of time. In rats of 140 and 300 g body wt mean resting heart rates of 384 +/- 10 and 320 +/- 4 beats/min, respectively, have been measured with this method.

scholarly journals AN OBSERVATIONAL STUDY ON THE ACCURACY OF HEART RATE READINGS BETWEEN SMART WATCHES AND A HAND HELD VITAL SIGN MONITOR IN STATIC AND DYNAMIC MOTIONS ON A HEALTHY YOUNG ADULT POPULATION

2021 ◽  
Vol 10 (6) ◽  
pp. 3848-3852
Author(s):  
Lynn Fernandes
Keyword(s):  
Heart Rate ◽  
Clinical Practice ◽  
Observational Study ◽  
Adult Population ◽  
Smart Phone ◽  
Medical Sciences ◽  
Healthy Young Adult ◽  
Exclusion Criteria ◽  
Heart Rates ◽  
Young Adult Population

There are various devices and applications available in the market that can be used to measure heart rates. These are becoming increasingly popular. Amongst these include the Apple watch, the Xiaomi MI Band and using the Thermal Application (T.A.P.) software (used through a Smartphone). In clinical practice and research, usually the E.C.G. Is used to measure the heart rates, (apart from manually counting the beats by palpation). The study will determine the accuracy of using the available devices in the market (previously mentioned), and also determine if they can be used on patients or subjects while sitting and walking, in clinical practice and researches. Method: It will be a comparative observational study. 50 students, selected as per the inclusion and exclusion criteria from Datta Meghe Institute of Medical Sciences will be the subjects of this study. Their heart rates will be monitored with the three devices, and compared with the readings from an E.C.G. It will be done as per Bruce protocol during walking, and in static sitting. The accuracy of the devices will be determined by analyzing the results acquired. The devices are: Apple watch, Xiaomi MI band, and a smart Phone with Thermal Application (T.A.P.) software installed. The successful completion of the study will determine which of the devices show the most accurate heart rate readings, in what positions of a patient (sitting or walking) it would be acceptable to use these devices (in terms of accuracy) in the case where an E.C.G. is not available, or at a time of urgency. The study will also show if it would be appropriate to use these devices in clinical practice and research studies.

scholarly journals Respiratory rates observed over 15 seconds compared with rates measured using the RRate app. Practice-based evidence from an observational study of acutely ill adult medical patients during their hospital admission

2020 ◽  
Vol 19 (1) ◽  
pp. 15-20
Author(s):  
Immaculate Nakitende ◽  
◽  
Teopista Namujwiga ◽  
Dustin Dunsmuir ◽  
J. Mark Ansermino ◽  
...  
Keyword(s):  
Observational Study ◽  
Hospital Admission ◽  
Early Warning ◽  
Clinical Setting ◽  
Computer Algorithm ◽  
Early Warning Score ◽  
Medical Patients ◽  
National Early Warning Score ◽  
Busy Clinical Setting ◽  
Background Counting

Background: counting respiratory rate over 60 seconds can be impractical in a busy clinical setting. Methods: 870 respiratory rates of 272 acutely ill medical patients estimated from observations over 15 seconds and those calculated by a computer algorithm were compared. Results: The bias of 15 seconds of observations was 1.85 breaths per minute and 0.11 breaths per minute for the algorithm derived rate, which took 16.2 SD 8.1 seconds. The algorithm assigned 88% of respiratory rates their correct National Early Warning Score points, compared with 80% for rates from 15 seconds of observation. Conclusion: The respiratory rates of acutely ill patients are measured nearly as quickly and more reliably by a computer algorithm than by observations over 15 seconds.

scholarly journals Fitbit data show poor correlation with measures of activity and sleep among hospitalized general medicine patients

2020 ◽  
Author(s):  
Robert Clark Wu ◽  
Vikas Patel ◽  
Sabreena Moosa ◽  
Laura Langer ◽  
Thomas E. MacMillan ◽  
...  
Keyword(s):  
Heart Rate ◽  
Sleep Duration ◽  
Pearson Correlation ◽  
Hospital Setting ◽  
Poor Correlation ◽  
Poor Sleep ◽  
Medical Patients ◽  
Activity Data ◽  
Heart Rates ◽  
Patient Reported

Abstract Background: Wearable devices such as Fitbits may provide important insights about hospitalized patients that include data on low activity and poor sleep. Monitoring this information could spur interventions to improve mobility and sleep which may reduce the adverse effects associated with hospitalization. However, there is a lack of studies assessing the accuracy of wearables in hospitalized medical patients. The purpose of our study was to determine the accuracy of Fitbit heart rate, sleep and physical activity in hospitalized medical patients.Methods: We conducted a prospective cohort feasibility study enrolling 50 medical inpatients at two hospitals providing them with a wrist-worn Fitbit Charge. Our main measures were Fitbit heart rate, sleep and activity data as well as nurse recorded heart rates, patient reported sleep, and nurse assessments of activity.Results: Of the 50 patients who consented to the study, 47 patients wore the devices. Comparing pairs of heart rate data from Fitbit and nurse recorded vital signs for the same minute, there were 261 pairs available for comparison. The mean difference was 0.45 bpm (SD: 13.0, Pearson correlation: 0.68 P<0.001) and the 95% limits of agreement were -25 to 26 bpm. The association between the patient-reported sleep score and Fitbit total sleep duration was 0.19 (P=0.24) and between the self-reported hours of sleep and Fitbit total sleep duration was 0.21 (P=0.21). The correlation between nurse-recorded activity and Fitbit daily steps was 0.06 (P=0.52). Conclusions: Fitbit heart rates correlated well with nurse-recorded heart rate but did not correlate well with nurse assessments of activity nor with patient self-assessment of sleep. This study highlights limitations of the accuracy of current wearable wrist-worn device algorithms in activity and sleep detection in patients in hospital. The findings call into question the validity of Fitbits for assessment of patient activity and sleep in the hospital setting and suggest that they should not be routinely used without further validation.Trial Registration: ClinicalTrials.gov NCT03646435

Adverse effects associated with arginine α-ketoglutarate containing supplements

2009 ◽  
Vol 28 (5) ◽  
pp. 259-262 ◽  
Author(s):  
JM Prosser ◽  
N. Majlesi ◽  
GM Chan ◽  
D. Olsen ◽  
RS Hoffman ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Emergency Department ◽  
Heart Rate ◽  
Adverse Effects ◽  
Hospital Admission ◽  
Active Ingredient ◽  
Athletic Performance ◽  
No Production ◽  
Laboratory Values ◽  
Electrocardiogram Ecg

The athletic performance supplement industry is a multibillion-dollar business and one popular category claims to increase nitric oxide (NO) production. We report three patients presenting to the emergency department with adverse effects. A 33-year-old man presented with palpitations, dizziness, vomiting, and syncope, after the use of NO2 platinum. His examination and electrocardiogram (ECG) were normal. The dizziness persisted, requiring admission overnight. A 21-year-old man with palpitations and near syncope had used a "nitric oxide" supplement. He was tachycardic to 115 bpm with otherwise normal examination. Laboratory values including methemoglobin, and ECG were unremarkable. He was treated with 1 L of saline with no change in heart rate. He was admitted for observation. A 24-year-old man presented after taking NO-Xplode with palpitations and a headache. His examination, laboratory values, and ECG were normal. He was discharged. The purported active ingredient in these products is arginine α-ketoglutarate (AAKG), which is claimed to increase NO production by supplying the precursor L-arginine. The symptoms could be due to vasodilation from increased levels of NO, though other etiologies cannot be excluded. AAKG containing supplements may be associated with adverse effects requiring hospital admission.

scholarly journals Fitbit data show poor correlation with measures of activity and sleep among hospitalized general medicine patients

2020 ◽  
Author(s):  
Robert Clark Wu ◽  
Vikas Patel ◽  
Sabreena Moosa ◽  
Laura Langer ◽  
Thomas E. MacMillan ◽  
...  
Keyword(s):  
Heart Rate ◽  
Sleep Duration ◽  
Pearson Correlation ◽  
Hospital Setting ◽  
Poor Correlation ◽  
Poor Sleep ◽  
Medical Patients ◽  
Activity Data ◽  
Heart Rates ◽  
Patient Reported

Abstract BackgroundWearable devices such as Fitbits may provide important insights about hospitalized patients that include data on low activity and poor sleep. Monitoring this information could spur interventions to improve mobility and sleep which may reduce the adverse effects associated with hospitalization. However, there is a lack of studies assessing the accuracy of wearables in hospitalized medical patients. The purpose of our study was to determine the accuracy of Fitbit heart rate, sleep and physical activity in hospitalized medical patients.MethodsWe conducted a prospective cohort feasibility study enrolling 50 medical inpatients at two hospitals providing them with a Fitbit Charge. Our main measures were Fitbit heart rate, sleep and activity data as well as nurse recorded heart rates, patient reported sleep, and nurse assessments of activity.ResultsOf the 50 patients who consented to the study, 47 patients wore the devices. Comparing pairs of heart rate data from Fitbit and nurse recorded vital signs for the same minute, there were 261 pairs available for comparison. The mean difference was 0.45 bpm (SD: 13.0, Pearson correlation: 0.68 P<0.001) and the 95% limits of agreement were -25 to 26 bpm. The association between the patient-reported sleep score and Fitbit total sleep duration was 0.19 (P=0.24) and between the self-reported hours of sleep and Fitbit total sleep duration was 0.21 (P=0.21). The correlation between nurse-recorded activity and Fitbit daily steps was 0.06 (P=0.52). ConclusionsFitbit heart rates correlated well with nurse-recorded heart rate but did not correlate well with nurse assessments of activity nor with patient self-assessment of sleep. This study highlights limitations of the accuracy of current wearable wrist-worn device algorithms in activity and sleep detection in patients in hospital. The findings call into question the validity of Fitbits for assessment of patient activity and sleep in the hospital setting and suggest that they should not be routinely used without further validation.Trial RegistrationClinicalTrials.gov NCT03646435

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