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Clinical impact of vital sign abnormalities in patients admitted with acute exacerbation of chronic obstructive pulmonary disease: an observational study using continuous wireless monitoring

Internal and Emergency Medicine

Early detection of abnormal vital signs is critical for timely management of acute hospitalised patients and continuous monitoring
may improve this. We aimed to assess the association between preceding vital sign abnormalities and serious adverse
events (SAE) in patients hospitalised with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).

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Continuously monitored vital signs for detection of myocardial injury in high-risk patients - An observational study

Loft FC et al - Acta Anaesthesiol Scand . 2022 Mar 5. doi: 10.1111/aas.14056.

This study aimed to assess the association between continuous monitored vital sign deviations and subsequent myocardial injury following major abdominal cancer surgery and during acute exacerbation of chronic obstructive pulmonary disease.


Wireless Single-Lead ECG Monitoring to Detect New-Onset Postoperative Atrial Fibrillation in Patients After Major Noncardiac Surgery: A Prospective Observational Study

Jokinen JDV et al - Anesth Analg . 2022 Feb 25. doi: 10.1213/ANE.0000000000005960

In patients undergoing major gastrointestinal cancer surgery, we aimed to describe the frequency of POAF as automatically estimated and detected via wireless repeated sampling monitoring and secondarily to describe the association between preceding vital sign deviations and POAF.


Continuous monitoring of vital sign abnormalities; association to clinical complications in 500 postoperative patients

Haahr-Raunkjaer C et al - Acta Anaesthesiol Scand . 2022 Feb 16. doi: 10.1111/aas.14048

We aimed to assess the association between abnormal vital signs inspired by Early Warning Score thresholds and subsequent SAEs in patients undergoing major abdominal surgery.


Semi-Supervised Analysis of the Electrocardiogram Using Deep Generative Models

Rasmussen S M et al. - 2021 43rd Annual International Conference of the IEEE Engineering in Medicine & Biology Society (EMBC) - DOI: 10.1109/EMBC46164.2021.9629915

Deep learning has gained increased impact on medical classification problems in recent years, with models being trained to high performance. However neural networks require large amounts of labeled data, which on medical data can be expensive and cumbersome to obtain. We propose a semi-supervised setup using an unsupervised variational autoencoder combined with a supervised classifier to distinguish between atrial fibrillation and non-atrial fibrillation using ECG records from the MIT-BIH Atrial Fibrillation Database.

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Prediction of severe adverse event from vital signs for post-operative patients

Gu Y et al. - 2021 43rd Annual International Conference of the IEEE Engineering in Medicine & Biology Society (EMBC) - DOI: 10.1109/EMBC46164.2021.9630918

Monitoring post-operative patients is important for preventing severe adverse events (SAE), which increases morbidity and mortality. Conventional bedside monitoring system has demonstrated the difficulty in long term monitoring of those patients because majority of them are ambulatory. With development of wearable system and advanced data analytics, those patients would benefit greatly from continuous and predictive monitoring. In this study, we aim to predict SAE based on monitoring of vital signs.

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Continuous Glucose Monitoring Reveals Perioperative Hypoglycemia in Most Patients With Diabetes Undergoing Major Surgery

Carlsson C et al. - Annals of Surgery, 2021 October 08. 2021 May 13. doi: 10.1097/SLA.0000000000005246

Inadequate glycemic control in the perioperative period is associated with serious adverse events, but monitoring currently relies on point blood glucose measurements, which may underreport glucose excursions.
We aimed to investigate the frequency and duration of hypo- and hyperglycemia, assessed by continuous glucose monitoring (CGM) during and after major surgery, in departments with implemented diabetes care protocols.

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Agreement Between Transcutaneous Monitoring and Arterial Blood Gases During COPD Exacerbation

Sørensen KM et al. - Respir Care. 2021 October. doi: 10.4187/respcare.08510.

Transcutaneous measurements of CO2 and O2 ([Formula: see text], [Formula: see text]) are noninvasive and allow for continuous monitoring in adults with exacerbation of COPD, but substantial accuracy issues may exist. We investigated agreement between results of arterial blood gas analysis and transcutaneous measurements of CO2 and O2 in patients with COPD.


Agreement between wireless and standard measurements of vital signs in acute exacerbation of chronic obstructive pulmonary disease: a clinical validation study

Elvekjær M et al. - Physiol Meas . 2021 May 13. doi: 10.1088/1361-6579/ac010c.

Wireless sensors for continuous monitoring of vital signs have potential to improve patient care by earlier detection of deterioration in general ward patients. We aimed to assess agreement between wireless and standard (wired) monitoring devices in patients hospitalized with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).


Continuous peripheral perfusion index in patients admitted to hospital wards - an observational study

Rasmussen PS et al. - Acta Anaesthesiol Scand . 2020 Sep 21. doi: 10.1111/aas.13711

Patients admitted due to either acute exacerbation of chronic obstructive pulmonary disease (AECOPD) or after major abdominal cancer surgery were included in this study. Patients were monitored continuously up to 96 hours with a pulse oximeter. Comparisons between median PPI each day, time of day and admission type were described with mean difference (MD) and analysed using Wilcoxon rank sum test and related to morbidity and mortality.


Physiological Abnormalities in Patients Admitted With Acute Exacerbation of COPD: An Observational Study With Continuous Monitoring

Elvekjaer M et al. - J Clin Monit Comput. 2019;10.1007/s10877-019-00415-8

We aimed to assess if continuous monitoring of vital signs in patients admitted with AECOPD detects micro events more often than routine ward rounds. In this observational pilot study (NCT03467815), 30 adult patients admitted with AECOPD were included. Patients were continuously monitored with peripheral oxygen saturation (SpO2), heart rate, and respiratory rate during the first 4 days after admission.

Towards an Automated Multimodal Clinical Decision Support System at the Post Anesthesia Care Unit
Olsen RM et al. - Comput Biol Med. 2018;101:15-21

The aim of this study was to develop a predictive algorithm detecting early signs of deterioration (ESODs) in the post anesthesia care unit (PACU), thus being able to intervene earlier in the future to avoid serious adverse events. The algorithm must utilize continuously collected cardiopulmonary vital signs and may serve as an alternative to current practice, in which an alarm is activated by single parameters.


Continuous Vital Sign Monitoring After Major Abdominal surgery-Quantification of Micro Events

Duus CL et al. - Acta Anaesthesiol Scand. 2018;62(9):1200-1208

Millions of patients undergo major abdominal surgery worldwide each year, and the post-operative phase carries a high risk of respiratory and circulatory complications. Standard ward observation of patients includes vital sign registration at regular intervals. Patients may deteriorate between measurements, and this may be detected by continuous monitoring. The aim of this study was to compare the number of micro events detected by continuous monitoring to those documented by the widely used standardized Early Warning Score (EWS).


Technological Aided Assessment of the Acutely Ill Patient - The Case of Postoperative Complications

Haahr-Raunkjær C et al. - Eur J Intern Med. 2017;45:41-45

This narrative review will describe current monitoring possibilities for postoperative patients and how it may prevent complications. Several wireless systems are being developed for monitoring vital parameters, but many of these are not yet validated for critically ill patients. The ultimate goal with patient monitoring and detect of events is to prevent postoperative complications, death and costs in the health care system.