van der Stam Jonna A, Mestrom Eveline H J, Scheerhoorn Jai, Jacobs Fleur E N B, Nienhuijs Simon, Boer Arjen-Kars, van Riel Natal A W, de Morree Helma M, Bonomi Alberto G, Scharnhorst Volkher, Bouwman R Arthur
Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands.
Clinical Laboratory, Catharina Hospital, Eindhoven, Netherlands.
JMIR Perioper Med. 2023 Feb 20;6:e40474. doi: 10.2196/40474.
Postoperative deterioration is often preceded by abnormal vital parameters. Therefore, vital parameters of postoperative patients are routinely measured by nursing staff. Wrist-worn sensors could potentially provide an alternative tool for the measurement of vital parameters in low-acuity settings. These devices would allow more frequent or even continuous measurements of vital parameters without relying on time-consuming manual measurements, provided their accuracy in this clinical population is established.
This study aimed to assess the accuracy of heart rate (HR) and respiratory rate (RR) measures obtained via a wearable photoplethysmography (PPG) wristband in a cohort of postoperative patients.
The accuracy of the wrist-worn PPG sensor was assessed in 62 post-abdominal surgery patients (mean age 55, SD 15 years; median BMI 34, IQR 25-40 kg/m). The wearable obtained HR and RR measurements were compared to those of the reference monitor in the postanesthesia or intensive care unit. Bland-Altman and Clarke error grid analyses were performed to determine agreement and clinical accuracy.
Data were collected for a median of 1.2 hours per patient. With a coverage of 94% for HR and 34% for RR, the device was able to provide accurate measurements for the large majority of the measurements as 98% and 93% of the measurements were within 5 bpm or 3 rpm of the reference signal. Additionally, 100% of the HR and 98% of the RR measurements were clinically acceptable on Clarke error grid analysis.
The wrist-worn PPG device is able to provide measurements of HR and RR that can be seen as sufficiently accurate for clinical applications. Considering the coverage, the device was able to continuously monitor HR and report RR when measurements of sufficient quality were obtained.
ClinicalTrials.gov NCT03923127; https://www.clinicaltrials.gov/ct2/show/NCT03923127.
术后病情恶化通常先于生命体征参数异常。因此，术后患者的生命体征参数由护理人员常规测量。腕戴式传感器有可能为低危环境下生命体征参数的测量提供一种替代工具。如果能确定这些设备在该临床人群中的准确性，那么它们将能够更频繁甚至连续地测量生命体征参数，而无需依赖耗时的手动测量。
本研究旨在评估通过可穿戴式光电容积脉搏波描记法（PPG）腕带在一组术后患者中获得的心率（HR）和呼吸频率（RR）测量值的准确性。
在62例腹部手术后患者（平均年龄55岁，标准差15岁；中位体重指数34，四分位间距25 - 40 kg/m²）中评估腕戴式PPG传感器的准确性。将可穿戴设备获得的HR和RR测量值与麻醉后或重症监护病房中的参考监测仪测量值进行比较。进行Bland - Altman分析和克拉克误差网格分析以确定一致性和临床准确性。
每位患者的数据收集中位数为1.2小时。该设备能够为大多数测量提供准确测量值，HR测量值的覆盖率为94%，RR测量值的覆盖率为34%，因为98%的HR测量值和93%的RR测量值在参考信号的5次/分钟或3次/分钟范围内。此外，根据克拉克误差网格分析，100%的HR测量值和98%的RR测量值在临床上是可接受的。
腕戴式PPG设备能够提供在临床应用中可视为足够准确的HR和RR测量值。考虑到覆盖率，当获得足够质量的测量值时，该设备能够连续监测HR并报告RR。
ClinicalTrials.gov NCT03923127；https://www.clinicaltrials.gov/ct2/show/NCT03923127
