Abstract

Recognition of early signs of deterioration in postoperative course could be improved by continuous monitoring of vital parameters. Wearable sensors could enable this by wireless transmission of vital signs. A novel accelerometer-based device, called Healthdot, has been designed to be worn on the skin to measure the two key vital parameters respiration rate (RespR) and heart rate (HeartR). The goal of this study is to assess the reliability of heart rate and respiration rate measured by the Healthdot in comparison to the gold standard, the bedside patient monitor, during the postoperative period in bariatric patients. Data were collected in a consecutive group of 30 patients who agreed to wear the device after their primary bariatric procedure. Directly after surgery, a Healthdot was attached on the patients' left lower rib. Vital signs measured by the accelerometer based Healthdot were compared to vital signs collected with the gold standard patient monitor for the period that the patient stayed at the post-anesthesia care unit. Over all patients, a total of 22 hours of vital signs obtained by the Healthdot were recorded simultaneously with the bedside patient monitor data. 87.5% of the data met the pre-defined bias of 5 beats per minute for HeartR and 92.3% of the data met the pre-defined bias of 5 respirations per minute for RespR. The Healthdot can be used to accurately derive heart rate and respiration rate in postbariatric patients. Wireless continuous monitoring of key vital signs has the potential to contribute to earlier recognition of complications in postoperative patients. Future studies should focus on the ability to detect patient deterioration in low-care environments and at home after discharge from the hospital.

Highlights

  • In hospitalized patients, vital signs are routinely measured by spot checks to identify clinical deterioration in the postoperative period [1]

  • The objective of this study is to determine the accuracy of the Healthdot for continuously monitoring respiration rate (RespR) and heart rate (HeartR) in bariatric patients during their stay in a post-anesthesia care unit, by comparing these measurements with the standard electrocardiagram ECG and capnography measurements collected from a patient monitor

  • The results of this study suggest that the Healthdot can provide quantitative assessment of HeartR and RespR of bariatric patients and is able to measure in an automatic, wireless and continuous way

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Summary

Introduction

Vital signs are routinely measured by spot checks to identify clinical deterioration in the postoperative period [1]. These assessments are usually based on manual measurements and represent a considerable workload for healthcare personnel, are prone-to-error and are not continuous [2, 3]. It may be challenging to reach the required accuracy and precision using accelerometry in bariatric patients, due to their large Body-Mass-Index (BMI) and thicker layer of subcutaneous fat around the chest, which could compromise the measurements. It is interesting to evaluate the accuracy of an accelerometry-based vital signs monitor in this patient group

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