Non-contact physiological monitoring of post-operative patients in the intensive care unit

João Jorge,Oliver Gibson,Mauricio Villarroel,Hamish Tomlinson,John Duncan Young,Julie L Darbyshire,Mirae Harford,Jody Ede,Peter Watkinson,Lionel Tarassenko

doi:10.1038/s41746-021-00543-z

Abstract

Prolonged non-contact camera-based monitoring in critically ill patients presents unique challenges, but may facilitate safe recovery. A study was designed to evaluate the feasibility of introducing a non-contact video camera monitoring system into an acute clinical setting. We assessed the accuracy and robustness of the video camera-derived estimates of the vital signs against the electronically-recorded reference values in both day and night environments. We demonstrated non-contact monitoring of heart rate and respiratory rate for extended periods of time in 15 post-operative patients. Across day and night, heart rate was estimated for up to 53.2% (103.0 h) of the total valid camera data with a mean absolute error (MAE) of 2.5 beats/min in comparison to two reference sensors. We obtained respiratory rate estimates for 63.1% (119.8 h) of the total valid camera data with a MAE of 2.4 breaths/min against the reference value computed from the chest impedance pneumogram. Non-contact estimates detected relevant changes in the vital-sign values between routine clinical observations. Pivotal respiratory events in a post-operative patient could be identified from the analysis of video-derived respiratory information. Continuous vital-sign monitoring supported by non-contact video camera estimates could be used to track early signs of physiological deterioration during post-operative care.

Highlights

Clinical complications following surgery remain a major concern worldwide[1], admission to the intensive care unit (ICU)following major surgery is standard practice in many healthcare systems
Recording data was available for a cohort of 15 patients as 10 patients were not admitted to the ICU for one of the following reasons: patient admitted to an alternative Recovery Unit (4 patients), surgery cancelled or rescheduled (3 patients), or unavailable research staff or equipment (3 patients)
We evaluated the feasibility of a non-contact monitoring system over clinically relevant time periods for critical care patients during post-operative care

Summary

Introduction

Clinical complications following surgery remain a major concern worldwide[1], admission to the intensive care unit (ICU)following major surgery is standard practice in many healthcare systems. Patients discharged from an ICU to the ward following a post-operative ICU admission are at high risk of adverse events[2]. In-hospital adverse events may be prevented with earlier detection of physiological deterioration followed by prompt intervention[3,4,5]. Detection of deterioration in post-ICU ward patients has been shown to reduce the rate of ICU readmission[6], which is associated with worse outcomes[7]. Aim to detect abnormal patterns in the vital signs as often and as soon as they occur so that acute care for deteriorating patients can be escalated[2,17]

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Conclusion