Lockhorst Elize W, van Noordenne Milicia, Klouwens Linda, Govaert Klaas M, de Bruijn Eva, Verhoef Cornelis, Gobardhan Paul D, Schreinemakers Jennifer M J
Department of Surgery, Amphia Hospital Breda, Breda, The Netherlands.
Department of Surgical Oncology and Gastrointestinal Surgery, Erasmus MC University Cancer Institute, Rotterdam, The Netherlands.
World J Surg. 2024 Aug;48(8):1902-1911. doi: 10.1002/wjs.12248. Epub 2024 Jun 18.
Patients undergoing major oncological abdominal surgery are prone to postoperative complications, making early recognition crucial. Clinical deterioration is often preceded by changes in vital signs, which are typically measured thrice a day by a nurse. However, intermittent measurements may delay recognizing clinical deterioration. Continuous vital parameter monitoring may lead to earlier recognition and management of complications and reduce nursing workload.
To compare vital parameter measurements between ward nurses and a wireless continuous monitoring system (Sensium® wireless patch) and assess whether this patch can detect clinical deterioration earlier in patients with complications in the first postoperative week.
Vital parameters (heart rate, respiratory rate, and temperature) were collected in patients undergoing an oncological resection of the liver, colorectal, or pancreas. Sensium® patch measurements were compared to nurses' measurements to assess the percentages of discordant measurements. In patients with complications in the first postoperative week, time discrepancies between nurses and Sensium® patch measurements were identified in cases of clinical deterioration (respiratory rate ≥15/min, heart rate ≥100/min, and temperature ≥38°C).
Among 227 patients, 22% of the patients experienced complications. Nurse and Sensium® measurements were discrepant in 586/2272 measurements (26%). In 506/586 discrepancies (86%), this was due to the respiratory rate (difference ≥4/min). Compared to nurses, the Sensium® patch detected an elevated respiratory rate 14 h earlier and heart rate 2 h earlier within complications in the first postoperative week. For temperature, no difference was observed.
Continuous monitoring with the Sensium® wireless patch holds promise for earlier recognition of complications in patients who underwent major oncological abdominal surgery.
接受大型肿瘤腹部手术的患者术后容易出现并发症，因此早期识别至关重要。临床恶化通常先于生命体征的变化，而生命体征通常由护士每天测量三次。然而，间歇性测量可能会延迟对临床恶化的识别。持续的生命参数监测可能会导致更早地识别和处理并发症，并减少护理工作量。
比较病房护士与无线连续监测系统（Sensium®无线贴片）对生命参数的测量，并评估该贴片是否能在术后第一周更早地检测出有并发症患者的临床恶化情况。
收集接受肝脏、结肠或胰腺肿瘤切除术患者的生命参数（心率、呼吸频率和体温）。将Sensium®贴片的测量结果与护士的测量结果进行比较，以评估不一致测量的百分比。在术后第一周出现并发症的患者中，在临床恶化（呼吸频率≥15次/分钟、心率≥100次/分钟和体温≥38°C）的情况下，确定护士与Sensium®贴片测量结果之间的时间差异。
227例患者中，22%的患者出现并发症。在2272次测量中，护士与Sensium®的测量结果有586次不一致（26%）。在586次不一致中，有506次（86%）是由于呼吸频率（差异≥4次/分钟）。与护士相比，Sensium®贴片在术后第一周并发症患者中，检测到呼吸频率升高提前14小时，心率升高提前2小时。对于体温，未观察到差异。
使用Sensium®无线贴片进行持续监测有望更早地识别接受大型肿瘤腹部手术患者的并发症。
