ST analysis of the fetal electrocardiogram - Comments on recent experimental data.

Autor: Kjellmer I; Department of Pediatrics, Institute of Clinical Sciences, Sahlgren´s Academy, University of Gothenburg, Gothenburg, Sweden., Lindecrantz K; School of Technology and Health, Royal Institute of Technology, Stockholm and Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden., Rosén KG; Department of Physiology, Sahlgren´s Academy, University of Gothenburg, Gothenburg, Sweden.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2019 Aug 22; Vol. 14 (8), pp. e0221210. Date of Electronic Publication: 2019 Aug 22 (Print Publication: 2019).
DOI: 10.1371/journal.pone.0221210
Abstrakt: In their paper, Andriessen at al present a validation of fetal ECG analysis and the clinical STAN device in midgestation fetal lambs exposed to 25 minutes of umbilical cord occlusion. The study presents results that contrast remarkably from previously published experimental data which raises a number of questions and comments. The most striking finding of Andriessen et al is the recording of an extremely high number of alarms from the STAN equipment during control conditions when no alarms at all are expected. These patterns have never been seen, neither in the clinical situation nor in our own fetal sheep studies. The reason for this becomes apparent when their way of recording the FECG is scrutinized. In their assessment of STAN, Andriessen at al use an assumed negative aVF lead with the assumption that it will reflect the FECG in the same way as the unipolar scalp lead used clinically. The signal used for disqualification of STAN is itself not qualified to properly represent the fetal scalp lead signal that STAN is designed for. To question a proven technology is fully accepted but those attempting would be asked to argue along fully validated data and related analysis including questioning of their own data.
Competing Interests: STAN is a medical device for fetal surveillance during labor developed over >40 years and since 1997 produced and marketed by the company Neoventa Medical AB (NM), located in Moelndal, Sweden. Of the authors, KGR and KL were involved in the start of NM as they formed the physiological and technical base for the STAN concept. KGR was the Medical director until 2007 when he left the company. KL has never been employed by NM but both hold a small number of shares. IK participated in the early development of the STAN concept but declares no conflict of interest.
Databáze: MEDLINE
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