Michard Frederic
MiCo Sárl, Denens, Switzerland.
Korean J Anesthesiol. 2017 Oct;70(5):493-499. doi: 10.4097/kjae.2017.70.5.493. Epub 2017 Sep 28.
Smartphones and electronic tablets (e-tablets) have become ubiquitous devices. Their ease of use, smartness, accessibility, mobility and connectivity create unique opportunities to improve quality of surgical care from prehabilitation to rehabilitation. Before surgery, digital applications (Apps), serious games and text messaging may help for a better control of risk factors (hypertension, overweight), for smoking cessation, and for optimizing adherence to preoperative recommendations (e.g., regarding anticoagulation or antihypertensive treatments). During surgery, Apps may help to rationalize fluid management and estimate blood loss. After surgery, smartphones and/or connected sensors (pulse oximeter, adhesive path, electronic tattoo, bioimpedance necklace) can be used to monitor body temperature, heart rate, heart rate variability (detection of cardiac arrhythmia), respiratory rate, arterial oxygen saturation and thoracic fluid content. Therefore, these tools have potential for the early detection of infectious, cardiac and respiratory complications in the wards and from home. When connected to echo probes, smartphones and e-tablets can also be used as ultrasound devices during central venous catheter insertion, for peripheral nerve blocks, and to perform echocardiography in patients developing cardiac complications. Finally, electronic checklists now exist as Apps to enhance communication between patients and healthcare professionals, and to track and record step by step each element of the surgical journey. Studies are now urgently needed to investigate whether this digital revolution can translate into a better outcome, an earlier detection of postoperative complications, a decrease in hospital readmissions and in health care costs.
智能手机和电子平板电脑已成为无处不在的设备。它们的易用性、智能性、可及性、移动性和连接性为改善从术前康复到术后康复的手术护理质量创造了独特的机会。手术前,数字应用程序(应用)、严肃游戏和短信可能有助于更好地控制风险因素(高血压、超重)、戒烟以及优化对术前建议的依从性(例如,关于抗凝或抗高血压治疗)。手术期间,应用程序可能有助于合理进行液体管理和估计失血量。手术后,智能手机和/或连接的传感器(脉搏血氧仪、粘性路径、电子纹身、生物阻抗项链)可用于监测体温、心率、心率变异性(检测心律失常)、呼吸频率、动脉血氧饱和度和胸腔液体含量。因此,这些工具具有在病房和家中早期发现感染、心脏和呼吸并发症的潜力。当与超声探头连接时,智能手机和平板电脑还可在中心静脉导管插入、周围神经阻滞期间用作超声设备,并用于对出现心脏并发症的患者进行超声心动图检查。最后,现在有作为应用程序的电子检查表,以加强患者与医护人员之间的沟通,并逐步跟踪和记录手术过程的每个环节。现在迫切需要进行研究,以调查这场数字革命是否能转化为更好的结果、更早地发现术后并发症、减少医院再入院率和医疗保健成本。