Clinical evaluation of a wearable sensor for mobile monitoring of respiratory rate on hospital wards

Kristiina Järvelä,Panu Takala,Frederic Michard,Leena Vikatmaa

doi:10.1007/s10877-021-00753-6

Kristiina Järvelä, Panu Takala + Show 2 more

Open Access

https://doi.org/10.1007/s10877-021-00753-6

Copy DOI

Abstract

A wireless and wearable system was recently developed for mobile monitoring of respiratory rate (RR). The present study was designed to compare RR mobile measurements with reference capnographic measurements on a medical-surgical ward. The wearable sensor measures impedance variations of the chest from two thoracic and one abdominal electrode. Simultaneous measurements of RR from the wearable sensor and from the capnographic sensor (1 measure/minute) were compared in 36 ward patients. Patients were monitored for a period of 182 ± 56 min (range 68–331). Artifact-free RR measurements were available 81% of the monitoring time for capnography and 92% for the wearable monitoring system (p < 0.001). A total of 4836 pairs of simultaneous measurements were available for analysis. The average reference RR was 19 ± 5 breaths/min (range 6–36). The average difference between the wearable and capnography RR measurements was − 0.6 ± 2.5 breaths/min. Error grid analysis showed that the proportions of RR measurements done with the wearable system were 89.7% in zone A (no risk), 9.6% in zone B (low risk) and < 1% in zones C, D and E (moderate, significant and dangerous risk). The wearable method detected RR values > 20 (tachypnea) with a sensitivity of 81% and a specificity of 93%. In ward patients, the wearable sensor enabled accurate and precise measurements of RR within a relatively broad range (6–36 b/min) and the detection of tachypnea with high sensitivity and specificity.

Highlights

Unexpected deaths on hospital wards remain all too common [1,2,3]
In the large (> 46,000 patients) EUSOS study done in 28 European countries, most surgical patients (73%) who died before hospital discharge were not admitted to critical care at any stage after surgery [5]
Forty consecutive adult ward patients were enrolled in the study

Summary

Introduction

In a UK national audit study, among 23,554 adult in-hospital cardiac arrests, more than half (57%) occurred on the wards and only 5% in the intensive care unit (ICU) [4]. In the large (> 46,000 patients) EUSOS study done in 28 European countries, most surgical patients (73%) who died before hospital discharge were not admitted to critical care at any stage after surgery [5]. Healthcare workers may only suddenly notice this is happening because spotchecks are usually done on a 4–8 h interval. Finding patients before they rapidly deteriorate and suffer a serious adverse event might be the major opportunity to improve patient safety [1,2,3, 7]

Methods

Results

Conclusion