Insights into postoperative respiration by using continuous wireless monitoring of respiratory rate on the postoperative
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ORIGINAL RESEARCH
Insights into postoperative respiration by using continuous wireless monitoring of respiratory rate on the postoperative ward: a cohort study Linda M. Posthuma1 · Maarten J. Visscher1 · Philipp B. Lirk2 · Els J. M. Nieveen van Dijkum3 · Markus W. Hollmann1 · Benedikt Preckel1 Received: 6 June 2019 / Accepted: 3 November 2019 © The Author(s) 2019
Abstract Change of respiratory rate (RespR) is the most powerful predictor of clinical deterioration. Brady- (RespR ≤ 8) and tachypnea (RespR ≥ 31) are associated with serious adverse events. Simultaneously, RespR is the least accurately measured vital parameter. We investigated the feasibility of continuously measuring RespR on the ward using wireless monitoring equipment, without impeding mobilization. Continuous monitoring of vital parameters using a wireless SensiumVitals® patch was installed and RespR was measured every 2 mins. We defined feasibility of adequate RespR monitoring if the system reports valid RespR measurements in at least 50% of time-points in more than 80% of patients during day- and night-time, respectively. Data from 119 patients were analysed. The patch detected in 171,151 of 227,587 measurements valid data for RespR (75.2%). During postoperative day and night four, the system still registered 68% and 78% valid measurements, respectively. 88% of the patients had more than 67% of valid RespR measurements. The RespR’s most frequently measured were 13–15; median RespR was 15 (mean 16, 25th- and 75th percentile 13 and 19). No serious complications or side effects were observed. We successfully measured electronically RespR on a surgical ward in postoperative patients continuously for up to 4 days post-operatively using a wireless monitoring system. While previous studies mentioned a digit preference of 18–22 for RespR, the most frequently measured RespR were 13–16. However, in the present study we did not validate the measurements against a reference method. Rather, we attempted to demonstrate the feasibility of achieving continuous wireless measurement in patients on surgical postoperative wards. As the technology used is based on impedance pneumography, obstructive apnoea might have been missed, namely in those patients receiving opioids post-operatively. Keywords Monitoring · Patient safety · Respiratory rate · Vital parameter · Wireless monitoring
1 Introduction Previous presentations: part of the data has been presented as a poster on the congress of the European Society of Anesthesiologists 2018 in Copenhagen, Denmark. * Benedikt Preckel [email protected] 1
Department of Anesthesiology, Amsterdam UMC, University of Amsterdam Academic Medical Centre AMC, Meibergdreef 9, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands
2
Department of Anesthesiology, Brigham and Women’s Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA
3
Department of Surgery, Amsterdam UMC, University of Amsterdam Academic Medical Centre AMC, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands
Monitoring of vita
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