Wireless wearables for postoperative surveillance on surgical wards: a survey of 1158 anaesthesiologists in Western Europe and the USA

Frederic Michard; Robert H Thiele; Bernd Saugel; Alexandre Joosten; Moritz Flick; Ashish K Khanna; Collaborators; Collaborators in Europe; Collaborators in the USA

doi:10.1016/j.bjao.2022.100002

Wireless wearables for postoperative surveillance on surgical wards: a survey of 1158 anaesthesiologists in Western Europe and the USA

BJA Open. 2022 Feb 23:1:100002. doi: 10.1016/j.bjao.2022.100002. eCollection 2022 Mar.

Authors

Frederic Michard¹, Robert H Thiele², Bernd Saugel^{3

4}, Alexandre Joosten⁵, Moritz Flick³, Ashish K Khanna^{4

6}; Collaborators; Collaborators in Europe; Collaborators in the USA

Collaborators

Matthieu Biais⁷, Vincent Bonhomme⁸, Wolfgang Buhre⁹, Bernard Cholley¹⁰, Jean-Michel Constantin¹¹, Emmanuel Futier¹², Samir Jaber¹³, Marc Leone¹⁴, Benedikt Preckel¹⁵, Daniel Reuter¹⁶, Patrick Schoettker¹⁷, Thomas Scheeren¹⁸, Michael Sander¹⁹, Luzius A Steiner²⁰, Sascha Treskatsch²¹, Kai Zacharowski²², Anoushka Afonso²³, Lovkesh Arora²⁴, Michael L Ault²⁵, Karsten Bartels²⁶, Charles Brown²⁷, Daniel Brown²⁸, Douglas Colquhoun²⁹, Ryan Fink³⁰, Tong J Gan³¹, Neil Hanson³², Omar Hyder³³, Timothy Miller³⁴, Matt McEvoy³⁵, Ronald Pearl³⁶, Romain Pirracchio³⁷, Marc Popovich³⁸, Sree Satyapriya³⁹, B Scott Segal⁴⁰, George Williams⁴¹

Affiliations

¹ MiCo, Denens, Switzerland.
² Department of Anesthesiology, University of Virginia, Charlottesville, VA, USA.
³ Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
⁴ Outcomes Research Consortium, Cleveland, OH, USA.
⁵ Department of Anesthesiology, University Paris Saclay, Paul Brousse Hospital, Villejuif, France.
⁶ Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, NC, USA.
⁷ Université de Bordeaux, Hôpital Tripode, Bordeaux, France.
⁸ Centre Hospitalier Universitaire, Liège, Belgium.
⁹ University Medical Center, Maastricht, the Netherlands.
¹⁰ Université de Paris, INSERM, IthEM, Hopital Européen Georges Pompidou, AP-HP, Paris, France.
¹¹ University Paris-Sorbonne, Hopital Pitié-Salpétrière, Paris, France.
¹² Université Clermont Auvergne, Hopital d'Estaing, Clermont-Ferrand, France.
¹³ Université de Montpellier, Saint Eloi Hospital, Montpellier, France.
¹⁴ Université Aix-Marseille, Hopital Nord, Marseille, France.
¹⁵ Amsterdam University Medical Centers Location AMC, the Netherlands.
¹⁶ Rostock University Medical Center, Rostock, Germany.
¹⁷ Université de Lausanne, CHUV, Lausanne, Switzerland.
¹⁸ University Medical Center, Groningen, the Netherlands.
¹⁹ University Medical Center, Giessen, Germany.
²⁰ Anesthesiology, University Hospital Basel and Department of Clinical Research, University of Basel, Switzerland.
²¹ Charité University Medical Center, Berlin, Germany.
²² University Medical Center, Frankfurt, Germany.
²³ Memorial Sloan Kettering Cancer Center, New York City, NY, USA.
²⁴ University of Iowa Health Care, Iowa City, IA, USA.
²⁵ Northwestern Memorial Hospital, Chicago, IL, USA.
²⁶ University of Nebraska Medical Center, Omaha, NE, USA.
²⁷ Johns Hopkins University Hospital, Baltimore, MD, USA.
²⁸ Mayo Clinic, Rochester, MN, USA.
²⁹ University of Michigan Health, Ann Arbor, MI, USA.
³⁰ Oregon Health Services University, Portland, OR, USA.
³¹ StonyBrook University Medical Center, StonyBrook, NY, USA.
³² University of Minnesota Medical Center, Minneapolis, MN, USA.
³³ Massachussets General Hospital, Harvard Medical School, Boston, MA, USA.
³⁴ Duke University Hospital, Durham, NC, USA.
³⁵ Vanderbilt University Medical Center, Nashville, TN, USA.
³⁶ Stanford University School of Medicine, Stanford, CA, USA.
³⁷ University of California San Francisco, CA, USA.
³⁸ University Hospitals Cleveland Medical Center, Cleveland, OH, USA.
³⁹ Ohio State University, Columbus, OH, USA.
⁴⁰ Wake Forest University Medical Center, Winston-Salem, NC, USA.
⁴¹ University of Texas Medical Center, Houston, TX, USA.

Abstract

Background: Several continuous monitoring solutions, including wireless wearable sensors, are available or being developed to improve patient surveillance on surgical wards. We designed a survey to understand the current perception and expectations of anaesthesiologists who, as perioperative physicians, are increasingly involved in postoperative care.

Methods: The survey was shared in 40 university hospitals from Western Europe and the USA.

Results: From 5744 anaesthesiologists who received the survey link, there were 1158 valid questionnaires available for analysis. Current postoperative surveillance was mainly based on intermittent spot-checks of vital signs every 4-6 h in the USA (72%) and every 8-12 h in Europe (53%). A majority of respondents (91%) considered that continuous monitoring of vital signs should be available on surgical wards and that wireless sensors are preferable to tethered systems (86%). Most respondents indicated that oxygen saturation (93%), heart rate (80%), and blood pressure (71%) should be continuously monitored with wrist devices (71%) or skin adhesive patches (54%). They believed it may help detect clinical deterioration earlier (90%), decrease rescue interventions (59%), and decrease hospital mortality (54%). Opinions diverged regarding the impact on nurse workload (increase 46%, decrease 39%), and most respondents considered that the biggest implementation challenges are economic (79%) and connectivity issues (64%).

Conclusion: Continuous monitoring of vital signs with wireless sensors is wanted by most anaesthesiologists from university hospitals in Western Europe and in the USA. They believe it may improve patient safety and outcome, but may also be challenging to implement because of cost and connectivity issues.

Keywords: anaesthesiology; failure to rescue; monitoring; patient safety; postoperative complications; surgery; wearables.