Geneva, Switzerland, 26-27 April 2012 PIERS on the Move – Phone Oximetry for Pre-Eclampsia Beth...
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Transcript of Geneva, Switzerland, 26-27 April 2012 PIERS on the Move – Phone Oximetry for Pre-Eclampsia Beth...
![Page 1: Geneva, Switzerland, 26-27 April 2012 PIERS on the Move – Phone Oximetry for Pre-Eclampsia Beth Payne Guy Dumont PhD Candidate Professor bpayne@cw.bc.caguyd@ece.ubc.ca.](https://reader035.fdocuments.in/reader035/viewer/2022070412/56649e665503460f94b61a47/html5/thumbnails/1.jpg)
Geneva, Switzerland, 26-27 April 2012
PIERS on the Move – Phone Oximetry for Pre-Eclampsia
Beth Payne Guy DumontPhD Candidate Professor [email protected] [email protected]
University of British ColumbiaVancouver, BC, Canada
Joint ITU-WHO Workshop on e-Health Standards and Interoperability
(Geneva, Switzerland, 26-27 April 2012)
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Pre-eclampsia
Hypertensive disorder of pregnancy with only cure being delivery of the placenta63,000 – 76,000 maternal deaths annually500,000 perinatal deaths annually>99% of these deaths in LMICsDeaths a result of delays in triage, transport and treatment
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The PIERS models
Multivariate prognostic models for prediction of adverse maternal outcomes within 48hr – 7 days of diagnosis with pre-eclampsia
RationaleIdentify individual women at greatest (and least) risk in order to guide care (triage, transport, treatment)
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von Dadelszen et al. Lancet 2011
The fullPIERS model
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The miniPIERS model
• Simplified version of the PIERS model for use in low-resourced settings
• Allows task-shifting of care to reduce delays
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von Dadelszen et al. Lancet 2011
Predictors of adverse maternal outcome
– GA– Chest pain/ dyspnoea
– SpO2
– Platelet count– Creatinine– AST
Prognosis: The PIERS Model
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Millman et al. J Obstet Gynaecol Can 2011
Predictors of adverse maternal outcome
– GA– Chest pain/ dyspnoea
– SpOSpO22
– Platelet count– Creatinine– AST
The PIERS Model
AUC ROC of SpO2 as a predictor of any adverse maternal outcome within 48hrs of eligibility. (AUC ROC 0.71 [95% CI 0.65, 0.77])
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What is pulse oximetry?
Equipmentexplained.comEquipmentexplained.com
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What is pulse oximetery?
Equipmentexplained.comEquipmentexplained.com
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The Phone Oximeter
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12
Validation
• BC Childrens Hospital, Vancouver• High Satisfaction (83%)
• Mulago Hospital, Uganda• High Satisfaction (78%)
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Triage Transportation Treatment
PIERS on the MovePIERS on the Move
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The Problem…
?
$$$$ $
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Capillary refill time
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Respiratory Interaction
Thoracic Pressure Cardiac Output
HR
(Sinus Arrhythmia)
Pulse Strength
During Spontaneous Inspiration…
Respiratory Induced Intensity Variation (V)
Heart
Rate (Hz)
Amplitude
Time (s)
Frequency
(RIIV) (HR)
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Summary
The goal of the PIERS project is to develop and validate simple outcome prediction tools for use in women with pre-eclampsiaPrediction modelling allows creation of complex decision support tools that have the potential to improve care of women and babies
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Thank You!
Pediatric Anesthesia Research Team
http://part.cfri.ca
Electrical and Computer Engineering in Medicine
http://ecem.ece.ubc.ca
The Phone Oximeter
http://www.phoneoximeter.org