TY - JOUR

T1 - Continuous monitoring is superior to manual measurements in detecting vital sign deviations in patients with COVID-19

AU - Grønbæk, Katja Kjær

AU - Rasmussen, Søren Møller

AU - Langer, Natasha Hemicke

AU - Vincentz, Mette

AU - Oxbøll, Anne Britt

AU - Søgaard, Marlene

AU - Awada, Hussein Nasser

AU - Jensen, Tomas O.

AU - Jensen, Magnus Thorsten

AU - Sørensen, Helge B.D.

AU - Aasvang, Eske Kvanner

AU - Meyhoff, Christian Sylvest

N1 - Funding Information: This study received financial and administrative support from the Innovation Fund Denmark (8056‐00055B), Novo Nordisk Foundation (NNF20SA0062833) and The Danish Regions. No sponsor had any role in study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the article for publication. Funding Information: The WARD‐project (Wireless Assessment of Respiratory and Circulatory Distress) has received grants from the Innovation Fund Denmark, the Novo Nordic Foundation, the Danish Cancer Society, Steno Diabetes Center Denmark, The Danish Regions, The Agency for Digitization, Copenhagen Center for Health Technology, Isansys Ltd., Radiometer, A.P. Møller Foundation as well as internal institutional funding. The WARD founders (CSM, EKA, and HBDS) have created a start‐up company, WARD247 ApS, with the aim of pursuing the regulatory and commercial activities of the WARD‐project. WARD247 ApS has obtained license agreement for any WARD‐project software and patents. One patent has been filed: “Wireless Assessment of Respiratory and circulatory Distress (WARD)—Clinical Support System (CSS)—an automated clinical support system to improve patient safety and outcomes.” CSM also reports lecture fees from Radiometer. EKA reports institutional research funding from Norpharma A/S as well as lecture fees from Radiometer, and advisory roles for Concentric analgesics and GenEdit without relation to the present work. Publisher Copyright: © 2023 The Authors. Acta Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation.

PY - 2023

Y1 - 2023

N2 - Background: Patients admitted to the emergency care setting with COVID-19-infection can suffer from sudden clinical deterioration, but the extent of deviating vital signs in this group is still unclear. Wireless technology monitors patient vital signs continuously and might detect deviations earlier than intermittent measurements. The aim of this study was to determine frequency and duration of vital sign deviations using continuous monitoring compared to manual measurements. A secondary analysis was to compare deviations in patients admitted to ICU or having fatal outcome vs. those that were not. Methods: Two wireless sensors continuously monitored (CM) respiratory rate (RR), heart rate (HR), and peripheral arterial oxygen saturation (SpO2). Frequency and duration of vital sign deviations were compared with point measurements performed by clinical staff according to regional guidelines, the National Early Warning Score (NEWS). Results: SpO2 < 92% for more than 60 min was detected in 92% of the patients with CM vs. 40% with NEWS (p <.00001). RR > 24 breaths per minute for more than 5 min were detected in 70% with CM vs. 33% using NEWS (p =.0001). HR ≥ 111 for more than 60 min was seen in 51% with CM and 22% with NEWS (p =.0002). Patients admitted to ICU or having fatal outcome had longer durations of RR > 24 brpm (p =.01), RR > 21 brpm (p =.01), SpO2 < 80% (p =.01), and SpO2 < 85% (p =.02) compared to patients that were not. Conclusion: Episodes of desaturation and tachypnea in hospitalized patients with COVID-19 infection are common and often not detected by routine measurements.

AB - Background: Patients admitted to the emergency care setting with COVID-19-infection can suffer from sudden clinical deterioration, but the extent of deviating vital signs in this group is still unclear. Wireless technology monitors patient vital signs continuously and might detect deviations earlier than intermittent measurements. The aim of this study was to determine frequency and duration of vital sign deviations using continuous monitoring compared to manual measurements. A secondary analysis was to compare deviations in patients admitted to ICU or having fatal outcome vs. those that were not. Methods: Two wireless sensors continuously monitored (CM) respiratory rate (RR), heart rate (HR), and peripheral arterial oxygen saturation (SpO2). Frequency and duration of vital sign deviations were compared with point measurements performed by clinical staff according to regional guidelines, the National Early Warning Score (NEWS). Results: SpO2 < 92% for more than 60 min was detected in 92% of the patients with CM vs. 40% with NEWS (p <.00001). RR > 24 breaths per minute for more than 5 min were detected in 70% with CM vs. 33% using NEWS (p =.0001). HR ≥ 111 for more than 60 min was seen in 51% with CM and 22% with NEWS (p =.0002). Patients admitted to ICU or having fatal outcome had longer durations of RR > 24 brpm (p =.01), RR > 21 brpm (p =.01), SpO2 < 80% (p =.01), and SpO2 < 85% (p =.02) compared to patients that were not. Conclusion: Episodes of desaturation and tachypnea in hospitalized patients with COVID-19 infection are common and often not detected by routine measurements.

KW - continuous monitoring

KW - COVID-19

KW - deterioration

KW - early warning score

KW - hospital admission

KW - patient safety

U2 - 10.1111/aas.14221

DO - 10.1111/aas.14221

M3 - Journal article

C2 - 36852515

AN - SCOPUS:85150631547

VL - 67

SP - 640

EP - 648

JO - Acta Anaesthesiologica Scandinavica

JF - Acta Anaesthesiologica Scandinavica

SN - 0001-5172

IS - 5

ER -