Intellivue

The study was performed in the ICU-setting. The monitoring system (Phillips Intellivue, Eindhoven, The Netherlands) was used to register the following predefined physiological parameters. The end-tidal CO₂ concentrations, and peak and airway occlusion pressure were monitored continuously. Breathing rate, tidal volume and airway pressures were registered using a clinical respirator (Evita 4, Draeger, Lübeck, Germany).

The HBO₂ treatment was performed in a hyperbaric multichamber (Drass Galeazzi SpA, Type HPO4000, HPE50.2.A) that had been modified to deliver intensive care treatment during pressurization, including mechanical ventilation (Servo-I-30 HBO Editor, Maquet), cardiovascular monitoring (Intellivue, Phillips, MP30), and multiple intravascular infusions (Perfusor Space, Braun). All participants who underwent HBO₂ treatment were treated according a standardized treatment protocol, which aimed at a minimum of 3 HBO₂ treatments, with the first treatment administered as soon as possible after hospital admission. The treatment duration of each session was 90 minutes at a pressure of 284 kPa without air breaks and a compression and decompression rate of 15 minutes.
Concomitant care was also protocolized and aimed at 3 surgical revisions during the first 24 hours after diagnosis, with repeated revisions thereafter as necessary. Antibiotic treatment with meropenem, ciprofloxacin, and clindamycin and intensive care treatment were adapted to individual needs [6 (link)].

In this cross-sectional study, we analyzed 25 751 visits to continuously monitored beds of the Stanford Health Care Emergency Department between August 1, 2020, and December 31, 2021. For each visit, we observed patient age, sex, triage acuity by ESI, and charted vital signs from ED triage to ED departure, including HR, RR, Spo₂, and systolic blood pressure (SBP) and diastolic blood pressure (DBP) summarized as mean arterial pressure (MAP = [1/3]SBP + [2/3]DBP). We obtained corresponding vital sign measurements (HR, RR, Spo₂, and MAP) from IntelliVue bedside monitors (Koninklijke Philips). To reduce the effect of localized variation and noise, we used the 1-minute mean of each measurement. Where measurements of a given modality were missing in the record, we carried the last observation forward. Because MAP was obtained through intermittent sphygmomanometry, intervals between measurements were set to the last recorded measurement. This study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) reporting guideline. The study was approved by the institutional review board of Stanford University, with a waiver of consent for retrospective research on anonymized data.

During the experiment, heart rate, oxygen saturation (SpO2), and respiratory rate were continuously monitored. All signals were acquired using a Philips Intellivue system (Philips Medical systems, Boeblingen, Germany) that ported data to a CNS Data Collector (Moberg ICU Solutions, Ambler, Philadelphia, PA, USA). We collected and exported the data from the CNS Data Collector from each bed using our proprietary IT system, ICU Cockpit. Signals were sampled at 1.024 Hz.

This study was conducted between February and July 2020 and surveyed ICU staff from two surgical ICUs of a large German academic hospital. The primary patient monitoring system used at the time of the study was the Philips IntelliVue (Koninklijke Philips NV; MX800 software version M.00.03; MMS X2 software version H.15.41-M.00.04).