Abstract
Background: Postoperative hypotension associated with postoperative morbidity and early mortality has been studied previously. Hypertension and other hemodynamic, respiratory, and temperature abnormalities have comparatively understudied during the first postoperative days. Methods: This bi-centre observational cohort study will include 114 adult patients undergoing non-cardiac surgery hospitalized on an unmonitored general care floor and wearing a multi-signal wearable sensor, allowing remote monitoring (Biobeat Technologies Ltd, Petah Tikva, Israel). The study will cover the first 72 hours after discharge of the patient from the post-anaesthesia care unit. Several thresholds will be used for each variable (arterial pressure, heart rate, respiratory rate, oxygen saturation, and skin temperature). Data obtained using the sensor will be compared to data obtained during the routine nurse follow-up. The primary outcome is hemodynamic abnormality. The secondary outcomes are postoperative respiratory and temperature abnormalities, artefacts and blank/null outputs from the wearable device, postoperative complications, and finally, the ease of use of the device. We hypothesize that remote monitoring will detect abnormalities in vital signs more often or more quickly than the detection by nurses’ routine surveillance. Discussion: A demonstration of the ability of wireless sensors to outperform standard monitoring techniques paves the way for the creation of a loop which includes this monitoring mode, the automated creation of alerts, and the sending of these alerts to caregivers. Trial registration: ClinicalTrials.gov, NCT04585178. Registered on October 14, 2020
Highlights
Postoperative mortality remains a current controversial issue, as shown in 2016 by the International Surgical Outcomes Study.[1]
Remote monitoring could be the solution in case of lack of monitored beds
Leenen et al recently published a systematic review of the literature reporting the feasibility of the use of 13 devices and their validation for in-hospital continuous vital signs monitoring.[18]
Summary
2. Zhuo Sun, Augusta University, Augusta, USA Any reports and responses or comments on the article can be found at the end of the article. Creation of a loop which includes this monitoring mode, the automated creation of alerts, and the sending of these alerts to caregivers. We have made changes to the title and the text to clarified the main outcome of the study which is the occurrence of one or more episodes with a mean arterial pressure below the threshold of 60 mmHg during the first 72 postoperative hours. We have added a limitation since there is probably some difference between our population and our nursing monitoring modalities and the corresponding elements of the publication that we used to calculate the number of subjects to be included in our study. Any further responses from the reviewers can be found at the end of the article
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