Continuous vital signs monitoring using wireless wearable devices in patients after video-assisted thoracoscopic surgery for lung cancer: A prospective self-control study_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

MEI Xiaoli ¹ , HUANG Yuchen ² , ZHOU Jian ¹ , SONG Yuanyuan ¹ , LUO Ailin ² , YANG Mei ¹ , ZHENG E ¹ , QIU Yang ¹ , WANG Beinuo ¹ , DONG Zhenghao ¹ ,  LIAO Hu ¹

1. Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China;
2. West China School of Medicine, Sichuan University, Chengdu, 610041, P. R. China;

Corresponding author：

LIAO Hu, Email: liaotiger_198653@163.com

Keywords：

Wireless wearable device; video-assisted thoracoscopic surgery; vital signs; monitoring; safety

DOI：

10.7507/1007-4848.202310009

Video：

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Objective To explore the reliability and safety of continuous monitoring of vital signs in patients using wireless wearable monitoring devices after video-assisted thoracoscopic surgery (VATS) for lung cancer. Methods The patients undergoing VATS for lung cancer in West China Hospital, Sichuan University from May to August 2023 were prospectively enrolled. Both wireless wearable and traditional wired devices were used to monitor the vital signs of patients after surgery. Spearman correlation analysis, paired sample t test and ratio Bland-Altman method were used to test the correlation, difference and consistency of monitoring data measured by the two devices. The effective monitoring rate of the wireless wearable device within 12 hours was calculated to test the reliability of its continuous monitoring. Results A total of 20 patients were enrolled, including 15 females and 5 males with an average age of 46.20±11.52 years. Data collected by the two monitoring devices were significantly correlated (P<0.001). Respiratory rate and blood oxygen saturation data collected by the two devices showed no statistical difference (P>0.05), while heart rate measured by wireless wearable device was slightly lower (=−0.307±1.073, P<0.001), and the blood pressure (=1.259±5.354, P<0.001) and body temperature(=0.115±0.231, P<0.001) were slightly higher. The mean ratios of heart rate, respiratory rate, blood oxygen saturation, blood pressure and body temperature collected by the two devices were 0.996, 1.004, 1.000, 1.014, and 1.003, respectively. The 95% limits of agreement (LoA) and 95% confidence interval of 95%LoA of each indicator were within the clinically acceptable limit. The effective monitoring rate of each vital signs within 12 hours was above 98%. Conclusion The wireless wearable device has a high accuracy and reliability for continuous monitoring vital signs of patients after VATS for lung cancer, which provides a security guarantee for subsequent large-scale clinical application and further research.

Citation： MEI Xiaoli, HUANG Yuchen, ZHOU Jian, SONG Yuanyuan, LUO Ailin, YANG Mei, ZHENG E, QIU Yang, WANG Beinuo, DONG Zhenghao, LIAO Hu. Continuous vital signs monitoring using wireless wearable devices in patients after video-assisted thoracoscopic surgery for lung cancer: A prospective self-control study. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2024, 31(2): 229-235. doi: 10.7507/1007-4848.202310009 Copy

1.	Sessler DI, Saugel B. Beyond 'failure to rescue': The time has come for continuous ward monitoring. Br J Anaesth, 2019, 122(3): 304-306.
2.	Sun L, Joshi M, Khan SN, et al. Clinical impact of multi-parameter continuous non-invasive monitoring in hospital wards: A systematic review and meta-analysis. J R Soc Med, 2020, 113(6): 217-224.
3.	Weller RS, Foard KL, Harwood TN. Evaluation of a wireless, portable, wearable multi-parameter vital signs monitor in hospitalized neurological and neurosurgical patients. J Clin Monit Comput, 2018, 32(5): 945-951.
4.	Verrillo SC, Cvach M, Hudson KW, et al. Using continuous vital sign monitoring to detect early deterioration in adult postoperative inpatients. J Nurs Care Qual, 2019, 34(2): 107-113.
5.	陆梦洁, 刘玉秀, 缪华章, 等. Bland-Altman一致性评价的样本含量估计. 中国卫生统计, 2015, 32(3): 537-539.
6.	Hernandez-Silveira M, Ahmed K, Ang SS, et al. Assessment of the feasibility of an ultra-low power, wireless digital patch for the continuous ambulatory monitoring of vital signs. BMJ Open, 2015, 5(5): e006606.
7.	Kant N, Peters GM, Voorthuis BJ, et al. Continuous vital sign monitoring using a wearable patch sensor in obese patients: A validation study in a clinical setting. J Clin Monit Comput, 2022, 36(5): 1449-1459.
8.	Wang L, Zhou B, Zhao Z, et al. Body-mass index and obesity in urban and rural China: Findings from consecutive nationally representative surveys during 2004-18. Lancet, 2021, 398(10294): 53-63.
9.	Cheng SM, Chan JJI, Tan CW, et al. Use of wireless respiratory rate sensor monitoring during opioid patient-controlled analgesia after gynaecological surgery: A prospective cohort study. Indian J Anaesth, 2021, 65(2): 146-152.
10.	Sun Z, Sessler DI, Dalton JE, et al. Postoperative hypoxemia is common and persistent: A prospective blinded observational study. Anesth Analg, 2015, 121(3): 709-715.
11.	Posthuma LM, Downey C, Visscher MJ, et al. Remote wireless vital signs monitoring on the ward for early detection of deteriorating patients: A case series. Int J Nurs Stud, 2020, 104: 103515.
12.	Batchelor TJP, Rasburn NJ, Abdelnour-Berchtold E, et al. Guidelines for enhanced recovery after lung surgery: Recommendations of the Enhanced Recovery After Surgery (ERAS®) Society and the European Society of Thoracic Surgeons (ESTS). Eur J Cardiothorac Surg, 2019, 55(1): 91-115.
13.	Thijs I, Fresiello L, Oosterlinck W, et al. Assessment of physical activity by wearable technology during rehabilitation after cardiac surgery: Explorative prospective monocentric observational cohort study. JMIR Mhealth Uhealth, 2019, 7(1): e9865.
14.	Wang J, Zang Y, Wu Q, et al. Predicting adverse events during six-minute walk test using continuous physiological signals. Front Physiol, 2022, 13: 887954.
15.	麻玉梅, 马黎娜, 郭海云, 等. 智能可穿戴设备在加速康复外科中的应用综述. 医疗卫生装备, 2023, 44(5): 102-108.
16.	Wells CI, Xu W, Penfold JA, et al. Wearable devices to monitor recovery after abdominal surgery: Scoping review. BJS Open, 2022, 6(2): zrac031.
17.	Leenen JPL, Leerentveld C, van Dijk JD, et al. Current evidence for continuous vital signs monitoring by wearable wireless devices in hospitalized adults: Systematic review. J Med Internet Res, 2020, 22(6): e18636.
18.	Areia C, Biggs C, Santos M, et al. The impact of wearable continuous vital sign monitoring on deterioration detection and clinical outcomes in hospitalised patients: A systematic review and meta-analysis. Crit Care, 2021, 25(1): 351.

1. Sessler DI, Saugel B. Beyond 'failure to rescue': The time has come for continuous ward monitoring. Br J Anaesth, 2019, 122(3): 304-306.
2. Sun L, Joshi M, Khan SN, et al. Clinical impact of multi-parameter continuous non-invasive monitoring in hospital wards: A systematic review and meta-analysis. J R Soc Med, 2020, 113(6): 217-224.
3. Weller RS, Foard KL, Harwood TN. Evaluation of a wireless, portable, wearable multi-parameter vital signs monitor in hospitalized neurological and neurosurgical patients. J Clin Monit Comput, 2018, 32(5): 945-951.
4. Verrillo SC, Cvach M, Hudson KW, et al. Using continuous vital sign monitoring to detect early deterioration in adult postoperative inpatients. J Nurs Care Qual, 2019, 34(2): 107-113.
5. 陆梦洁, 刘玉秀, 缪华章, 等. Bland-Altman一致性评价的样本含量估计. 中国卫生统计, 2015, 32(3): 537-539.
6. Hernandez-Silveira M, Ahmed K, Ang SS, et al. Assessment of the feasibility of an ultra-low power, wireless digital patch for the continuous ambulatory monitoring of vital signs. BMJ Open, 2015, 5(5): e006606.
7. Kant N, Peters GM, Voorthuis BJ, et al. Continuous vital sign monitoring using a wearable patch sensor in obese patients: A validation study in a clinical setting. J Clin Monit Comput, 2022, 36(5): 1449-1459.
8. Wang L, Zhou B, Zhao Z, et al. Body-mass index and obesity in urban and rural China: Findings from consecutive nationally representative surveys during 2004-18. Lancet, 2021, 398(10294): 53-63.
9. Cheng SM, Chan JJI, Tan CW, et al. Use of wireless respiratory rate sensor monitoring during opioid patient-controlled analgesia after gynaecological surgery: A prospective cohort study. Indian J Anaesth, 2021, 65(2): 146-152.
10. Sun Z, Sessler DI, Dalton JE, et al. Postoperative hypoxemia is common and persistent: A prospective blinded observational study. Anesth Analg, 2015, 121(3): 709-715.
11. Posthuma LM, Downey C, Visscher MJ, et al. Remote wireless vital signs monitoring on the ward for early detection of deteriorating patients: A case series. Int J Nurs Stud, 2020, 104: 103515.
12. Batchelor TJP, Rasburn NJ, Abdelnour-Berchtold E, et al. Guidelines for enhanced recovery after lung surgery: Recommendations of the Enhanced Recovery After Surgery (ERAS®) Society and the European Society of Thoracic Surgeons (ESTS). Eur J Cardiothorac Surg, 2019, 55(1): 91-115.
13. Thijs I, Fresiello L, Oosterlinck W, et al. Assessment of physical activity by wearable technology during rehabilitation after cardiac surgery: Explorative prospective monocentric observational cohort study. JMIR Mhealth Uhealth, 2019, 7(1): e9865.
14. Wang J, Zang Y, Wu Q, et al. Predicting adverse events during six-minute walk test using continuous physiological signals. Front Physiol, 2022, 13: 887954.
15. 麻玉梅, 马黎娜, 郭海云, 等. 智能可穿戴设备在加速康复外科中的应用综述. 医疗卫生装备, 2023, 44(5): 102-108.
16. Wells CI, Xu W, Penfold JA, et al. Wearable devices to monitor recovery after abdominal surgery: Scoping review. BJS Open, 2022, 6(2): zrac031.
17. Leenen JPL, Leerentveld C, van Dijk JD, et al. Current evidence for continuous vital signs monitoring by wearable wireless devices in hospitalized adults: Systematic review. J Med Internet Res, 2020, 22(6): e18636.
18. Areia C, Biggs C, Santos M, et al. The impact of wearable continuous vital sign monitoring on deterioration detection and clinical outcomes in hospitalised patients: A systematic review and meta-analysis. Crit Care, 2021, 25(1): 351.

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