Brown Morgan, Moreci Rebecca, Megison Hannah, Long Elizabeth, Maurer Michael, Bienvenue Benjamin, Danos Denise M, Wood James H
Louisiana State University Health Sciences Center, Department of Surgery, 2021 Perdido St, New Orleans, LA, 70112, USA; Our Lady of the Lake Children's Health, Division of Pediatric Surgery, 8300 Constantin Blvd, Baton Rouge, LA, 70809, USA.
Louisiana State University Health Sciences Center, Department of Surgery, 2021 Perdido St, New Orleans, LA, 70112, USA; Our Lady of the Lake Children's Health, Division of Pediatric Surgery, 8300 Constantin Blvd, Baton Rouge, LA, 70809, USA.
J Pediatr Surg. 2025 Apr;60(4):162201. doi: 10.1016/j.jpedsurg.2025.162201. Epub 2025 Jan 28.
Hospitalized patients are subject to overnight vital sign (OVS) monitoring which leads to subsequent sleep disturbance and contributes to adverse outcomes and negative hospital experiences. Studies in pediatric populations have shown that routine OVS checks infrequently detect significant events. We hypothesized that OVS monitoring in pediatric surgery patients rarely detects abnormalities resulting in meaningful interventions.
We performed a retrospective chart review of patients ≥ 5 years old admitted to the pediatric surgery service at a stand-alone Children's Hospital from 2019 to 2021. ICU patients were excluded from analysis. Overnight vital signs were defined as those recorded every 4 h between 10:00 PM and 6:00 AM. Abnormal OVS and subsequent interventions were recorded.
Analysis included 354 patients aged 5-19 years old. At least one OVS was abnormal in 62% of patients. Abnormal blood pressure was the most commonly flagged OVS (80%). The rate of intervention for flagged OVS was 58%. Medication administration was the most common intervention (54%). Unplanned operative intervention and transfer to the ICU were uncommon but did occur in this cohort (0.9% and 1.4%, respectively).
The majority of pediatric surgery patients had at least one flagged OVS and, while rare, some serious complications were detected. While minimizing sleep disturbance and maximizing patient satisfaction is valuable, these results support prioritizing patient safety with routine vital sign assessments until we can determine if there are sub-populations that can be safely managed without sleep disruptions.
Level 4.
Retrospective chart review.
住院患者需要进行夜间生命体征（OVS）监测，这会导致随后的睡眠障碍，并导致不良后果和负面的住院体验。儿科人群的研究表明，常规的OVS检查很少能检测到重大事件。我们假设儿科手术患者的OVS监测很少能检测到导致有意义干预的异常情况。
我们对2019年至2021年在一家独立儿童医院接受儿科手术治疗的5岁及以上患者进行了回顾性病历审查。ICU患者被排除在分析之外。夜间生命体征定义为晚上10点至早上6点每4小时记录一次的生命体征。记录异常的OVS及随后的干预措施。
分析包括354名年龄在5至19岁之间的患者。62%的患者至少有一次OVS异常。血压异常是最常被标记的OVS（80%）。标记的OVS的干预率为58%。药物治疗是最常见的干预措施（54%）。计划外手术干预和转入ICU并不常见，但在该队列中确实发生了（分别为0.9%和1.4%）。
大多数儿科手术患者至少有一次被标记的OVS，虽然很少见，但检测到了一些严重并发症。虽然将睡眠干扰降至最低并最大限度提高患者满意度很有价值，但这些结果支持在我们能够确定是否有可以在不干扰睡眠的情况下安全管理的亚人群之前，通过常规生命体征评估将患者安全放在首位。
4级。
回顾性病历审查。
