Secondary Logo

Journal Logo

Another Stone to the Edifice of Wireless Anesthesia

Ariès, Philippe MD; Reynet, Olivier Asst; Clément, Benoît PhD; Nguyen, Ba Vinh MD

doi: 10.1213/ANE.0000000000001458
Letters to the Editor: Letter to the Editor
Free

Military Teaching Hospital “Clermont Tonnerre”, Brest, France, French Military Health Service Academy, Ecole du Val-de-Grâce, Paris, France, phil.ar@hotmail.fr

ENSTA Bretagne, IT Department/Ocean and Sensing and Mapping Team

ENSTA Bretagne, IT Department/Ocean and Sensing and Mapping Team Lab-STICC UMR CNRS 6285

Military Teaching Hospital “Clermont Tonnerre”, Brest, France, French Military Health Service Academy, Ecole du Val-de-Grâce, Paris, France

We read with great interest the study by Simpao et al1 describing the use of wireless technology to connect bedside monitors to a portable anesthesia information management system (AIMS) in a neonatal intensive care unit. Authors wanted to show both benefits and security of bluetooth technology in case of logistical problems. Among 30 bedside procedures using wireless AIMS, only 3 cases of data loss had been observed; causes could not be identified among 2 of them. The authors concluded that wireless technology was not reliable in such an environment, leading to a preference for wired connections.

However, their results must not exclude wireless research and development in anesthesia. Initial development of new technology always implies some failures and leads to search solutions. Understanding errors and finding solutions can be facilitated progressively by fast technology improvement. Understanding mechanisms of data gaps that occurred in the study is crucial. The 2 main causes of bluetooth perturbations are electromagnetic interferences (EMIs) and obstacles between wireless transmitters. Studies have shown that that the electromagnetic environment in hospitals, including the operating room (OR), is complex.2 Identification of all possible sources of EMI (not only electrosurgical units), that is, all electronic devices used in the OR, is a key point. Authors should have listed them. Because authors rejected the hypothesis of electrocautery as the source of interferences, an accurate scene analysis should have been performed when data loss occurred. Data could have been lost because of another electronic device used concomitantly or an obstacle that interrupted bluetooth transmission between transmitters.

To our knowledge, few studies have been performed in the OR to evaluate reliability of monitoring wireless technology. Evaluating new monitoring reliability is a critical point because patient safety relies on it. Therefore, new tools must be evaluated by comparing them with preexistent technology before using them in clinical practice.

We are conducting a pilot study to compare a bluetooth electrocardiography (ECG) monitoring with the wired ECG signal. The aim of our study is to show that bluetooth ECG monitoring can be a reliable and safe data transmission system in the OR. The prototype has been developed from a common work between anesthesiologists of the Military Teaching Hospital of Brest and engineers of the Civilian-Military French National Graduate Engineering Institute (ENSTA Bretagne) since September 2015. Continuous exchanges have allowed engineers to find step solutions to physicians’ challenges, such as resistance to EIM or autonomy. First results are encouraging, and bluetooth ECG monitoring seems to be accurate and reliable. For example, bradycardia and tachycardia are detected by bluetooth ECG monitoring as quickly as the wired one. Our ongoing study answers to Hofer and Cannesson’s editorial,3 which asks for more research into wireless monitoring in anesthesiology.

Philippe Ariès, MD

Military Teaching Hospital “Clermont Tonnerre”

Brest, France

French Military Health Service Academy

Ecole du Val-de-Grâce

Paris, France

phil.ar@hotmail.fr

Olivier Reynet, Asst

ENSTA Bretagne

IT Department/Ocean and Sensing and Mapping Team

Benoît Clément, PhD

ENSTA Bretagne

IT Department/Ocean and Sensing and Mapping Team

Lab-STICC UMR CNRS 6285

Ba Vinh Nguyen, MD

Military Teaching Hospital “Clermont Tonnerre”

Brest, France

French Military Health Service Academy

Ecole du Val-de-Grâce

Paris, France

Back to Top | Article Outline

REFERENCES

1. Simpao AF, Gálvez JA, England WR, et al. A technical evaluation of wireless connectivity from patient monitors to an anesthesia information management system during intensive care unit surgery. Anesth Analg. 2016;122:425–429.
2. Riederer M, Lauer O, Fahrni P, Vahldieck R, Fröhlich J. Characterization of the electromagnetic environment in a hospital: measurement procedures and results. IEEE EMC Soc Newsl. 2010;224:50–56.
3. Hofer I, Cannesson M. Is wireless the future of monitoring? Anesth Analg. 2016;122:305–306.
© 2016 International Anesthesia Research Society