Heart Rates in Hospitalized Children by Age and Body Temperature

Daymont, Carrie; Bonafide, Christopher P.; Brady, Patrick

doi:10.1542/peds.2014-3738

Cited by 36 publications

(48 citation statements)

References 20 publications

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“…Several groups have used data from EHR’s to redefine the distribution of vital signs observed in children in the ED ( 8 , 10 ) or hospital wards ( 9 , 33 ). These analyses clearly show that the standard textbook and guideline distributions and thresholds for “abnormal” for vital signs do not reflect empirically observed distributions ( 9 ).…”

Section: Discussionmentioning

confidence: 99%

Pediatric Vital Sign Distribution Derived From a Multi-Centered Emergency Department Database

2018

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BackgroundWe hypothesized that current vital sign thresholds used in pediatric emergency department (ED) screening tools do not reflect observed vital signs in this population. We analyzed a large multi-centered database to develop heart rate (HR) and respiratory rate centile rankings and z-scores that could be incorporated into electronic health record ED screening tools and we compared our derived centiles to previously published centiles and Pediatric Advanced Life Support (PALS) vital sign thresholds.MethodsInitial HR and respiratory rate data entered into the Cerner™ electronic health record at 169 participating hospitals’ ED over 5 years (2009 through 2013) as part of routine care were analyzed. Analysis was restricted to non-admitted children (0 to <18 years). Centile curves and z-scores were developed using generalized additive models for location, scale, and shape. A split-sample validation using two-thirds of the sample was compared with the remaining one-third. Centile values were compared with results from previous studies and guidelines.ResultsHR and RR centiles and z-scores were determined from ~1.2 million records. Empirical 95th centiles for HR and respiratory rate were higher than previously published results and both deviated from PALS guideline recommendations.ConclusionHeart and respiratory rate centiles derived from a large real-world non-hospitalized ED pediatric population can inform the modification of electronic and paper-based screening tools to stratify children by the degree of deviation from normal for age rather than dichotomizing children into groups having “normal” versus “abnormal” vital signs. Furthermore, these centiles also may be useful in paper-based screening tools and bedside alarm limits for children in areas other than the ED and may establish improved alarm limits for bedside monitors.

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Section: Discussionmentioning

confidence: 99%

Pediatric Vital Sign Distribution Derived From a Multi-Centered Emergency Department Database

2018

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“…8 9 Development of the nervous system continues after birth, 10 and heart rate is an age-dependent parameter in children. 11 As the heart rate is higher when compared with adults, and the scientific background on the behaviour of the plethysmographic waveform as a function of age is very limited, evidence from adult populations cannot be directly adapted to children.…”

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confidence: 99%

Surgical pleth index in children younger than 24 months of age: a randomized double-blinded trial

Harju

Kalliomäki

Leppikangas

et al. 2016

British Journal of Anaesthesia

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“…Examination of the systematic inflammatory response syndrome associated with pneumonia is routinely used in clinical practice [11]. Diagnostic criteria are fast breathing, fever, tachypnea, and white blood cell count to detect systematic inflammation in the human body [12][13][14]. Our proposed system measures HR, RR, and T within 10 seconds.…”

Section: Pediatric Pneumonia Screening System Using Hr Rr and Tmentioning

confidence: 99%

Random tree algorithm-based pediatric pneumonia screening using heart rate, respiration rate and temperature

Dagdanpurev¹,

Tsogzolmaa²,

Sun³

et al. 2019

JBRCI

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Despite a reduction in pneumonia-related mortality, pneumonia remains a leading cause of death among children aged 0-5 years. Most of these deaths occur in developing countries. However, more than half of pneumonia-related deaths are preventable with improved facilities and health strategies. Early rapid diagnosis is important to decrease pneumonia mortality. We developed a portable, cost-effective, rapid pneumonia screening system using a random tree algorithm to support early detection of pneumonia in children. We enrolled 105 participants: 57 patients aged 1-13 years (33 boys, 24 girls) diagnosed with pneumonia by chest radiograph and 48 normal volunteers aged 2-14 years (25 boys, 22 girls). We conducted a clinical trial in the Bayangol District Geriatric and Pediatric Hospital, Ulaanbaatar, Mongolia from January 12-19, 2019. Our screening system measured heart rate, respiration rate and skin temperature within 10 seconds and used a random tree algorithm to distinguish patients with pneumonia and normal volunteers. The system uses a photosensor, Doppler radar, and infrared thermophile to determine vital signs and an Arduino Nano microprocessor to perform computations. Paired t-tests were used to compare vital signs between patients with pneumonia and normal volunteers. The random tree algorithm achieved sensitivity of 96.5%, specificity of 81.3%, positive predictive value of 85.9%, and negative predictive value of 95.1%. The paired t-tests showed strong statistically significant differences in all three vital signs between patients with pneumonia and normal volunteers. Our random tree algorithm-based screening system offers an effective, rapid, and convenient tool for early detection of pneumonia in children. Its cost-effectiveness enables application in low-income countries. The system measures multiple vital signs simultaneously within 10 seconds, which may be useful for initial physical examinations in pediatric hospitals.

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Heart Rates in Hospitalized Children by Age and Body Temperature

Cited by 36 publications

References 20 publications

Pediatric Vital Sign Distribution Derived From a Multi-Centered Emergency Department Database

Pediatric Vital Sign Distribution Derived From a Multi-Centered Emergency Department Database

Surgical pleth index in children younger than 24 months of age: a randomized double-blinded trial

Random tree algorithm-based pediatric pneumonia screening using heart rate, respiration rate and temperature

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