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Postanesthesia care by remote monitoring of vital signs in surgical wards

Boer, Christa; Touw, Hugo R.; Loer, Stephan A.

Current Opinion in Anesthesiology: December 2018 - Volume 31 - Issue 6 - p 716–722
doi: 10.1097/ACO.0000000000000650
TECHNOLOGY, EDUCATION AND SAFETY: Edited by Stephan A. Loer
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Purpose of review This narrative review summarizes recent insights into the role of remote monitoring of vital signs in the postoperative period in surgical wards.

Recent findings Despite recent improvements in the safety of anesthesia and surgical procedures, postoperative complication rates are still unacceptably high. This is partly attributable to the intermittent provision of personal care to patients by nurses and ward physicians. Continuous remote monitoring of vital functions in the early postoperative period may reduce these complication rates. There are several medical-grade remote monitoring platforms available that integrate a biosensor signal with electronic patient records, enabling automated prediction or notification of patient deterioration. Most available platforms have technical limitations with respect to the accuracy of respiratory rate measurements. Of note, although the implementation of automated notifications of patient deterioration is associated with a reduced activation of acute response teams, the involvement of ward physicians in the early diagnosis and treatment of subtle changes in vital functions is increased.

Summary Remote monitoring of vital signs in the surgical ward may contribute to prevention of severe complications and reduction in failure-to-rescue rates, although evidence for this association is still lacking. Anesthesiologists should contribute their knowledge and skills with respect to perioperative abnormalities in vital functions to improve patient safety during the postoperative period.

Department of Anesthesiology, Amsterdam Cardiovascular Sciences, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands

Correspondence to Dr Christa Boer, Professor, Department of Anesthesiology, Amsterdam Cardiovascular Sciences, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands. Tel: +31 204443830; e-mail: c.boer@vumc.nl

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