自动获取注射器实时增量给药数据的两种新型非接触式原型研究
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Investigation of Two Prototypes of Novel Noncontact Technologies for Automated Real-Time Capture of Incremental Drug Administration Data From Syringes.
背景与目的
一个理想的电子麻醉记录系统不仅可以记录生理数据，还可以记录给予的可注射药物剂量，包括从一个注射器递增给出的药物剂量，而不需要手动输入数据。我们比较了2种原型设备，其通过2种不同的光学非接触方式无线识别单个注射器和测量其柱塞位置的变化，并允许计算给予的增量药物剂量。
方 法
两个设备都包含射频识别读取器，可无线读取来自注射器药物标签内的射频识别标签的唯一代码。定制设计的支架可以在任何位置插入1 mL至20 mL注射器并定位在可重复的位置。 “激光”装置具有由注射器柱塞的端部打断的移动激光束。红外（IR）装置测量从发射器到注射器柱塞并返回到接收器的IR光的行进时间。因此，当使用任何注射器时，两个装置因此可以确定自前一次施用的药物和体积。对于每个尺寸为1,2,5,10和20mL的注射器，在其全范围内进行121次柱塞长度测量，其中每台机器使用随机de Bruijn序列进行灌水和称重的参考方法。
结 果
对于每个注射器尺寸，与参考方法相比，激光装置显示出比IR装置更高的精度和精度，更低的偏差和更窄的一致性（95％置信区间=偏差±1.96SD）。对于所有注射器尺寸，激光器的偏差范围为-0.05至0.32 mL，IR为-2.42至1.38 mL。 IR与参考方法的相关系数值范围为0.6259至0.9255，柱塞行程距离最短的注射器（2和5 mL）中观察到的系数最低，而在激光与参考比较中，这些系数相似（ 0.9641-0.9981）。
结 论
两个装置测量了注射器体积变化，显示了测量增量药物剂量的潜力，记录这些以及每次测量的时间。 IR装置没有移动部件，这在临床情况下是有利的。然而，目前的装置不够准确难以用于临床，可以通过改进硬件和软件设计来补救。激光设备在所有注射器尺寸和包含的体积上显示出高精度和精确度，并且被认为具有足够的准确性，且经适当改进后适合临床使用。
原始文献摘要
Eagle B, Williams D J, Dingley J. Investigation of Two Prototypes of Novel Noncontact Technologies for Automated Real-Time Capture of Incremental Drug Administration Data From Syringes[J]. Anesthesia & Analgesia, 2017, 125(2):458-466.
PURPOSE:
An ideal electronic anesthesia recording system would be capable of not only recording physiological data but also injectable drug doses given, including those given incrementally from one syringe, without recourse to manual data entry. We compared 2 prototype devices which wirelessly recognized individual syringes and measured changes in their plunger positions via 2 different optical noncontact means, allowing calculation of incremental drug doses given.
METHODS: Both devices incorporated a radio-frequency identification reader, which wirelessly read a unique code from a radio-frequency identification tag within syringe drug labels. A custom-designed cradle oriented any inserted 1-mL to 20-mL syringe in a repeatable position. The "laser" device had a moving laser beam broken by the end of the syringe plunger. The infrared (IR) device measured time of travel of IR light from a sender to a syringe plunger and back to a receiver. Both devices could therefore determine the drug and volume administered since the previous occasion when any syringe had been used. For each syringe size of 1, 2, 5, 10, and 20 mL, 121 plunger-length measurements were made over their full range, with each machine against a reference method of water filling and weighing using a randomized de Bruijn sequence.
RESULTS:
For every syringe size, the laser device showed greater accuracy and precision, lower bias, and narrower limits of agreement (95% confidence intervals = bias ± 1.96 SD) than the IR device when compared to the reference method. For all syringe sizes, the range of bias was -0.05 to 0.32 mL for the laser and -2.42 to 1.38 mL for the IR. Lin concordance correlation coefficient values for the IR versus reference methods ranged from 0.6259 to 0.9255, with the lowest coefficients seen in syringes with the shortest distance of plunger travel (2 and 5 mL), while in laser versus reference comparisons, these coefficients were similar (0.9641-0.9981) over all syringe lengths.
CONCLUSION:
Both devices measured syringe volume changes, demonstrating potential for measuring incremental drug doses, recording these, and also the time of each measurement. The IR device had no moving parts, which would be advantageous in a clinical situation. However, the current embodiment was not deemed accurate enough for clinical use, potentially remediable through improvements in hardware and software design. The laser device showed high accuracy and precision over all syringe sizes and contained volumes, and was considered potentially accurate enough for clinical use with suitable development.
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