Continuous Monitoring of Vital Parameters for Early Detection of Clinical Deterioration in Hospitalized Patients

University Hospital Bispebjerg and Frederiksberg

Overview

For patients admitted to the medical ward, it is often difficult to predict if their clinical condition will deteriorate, however subtle changes in vital signs are usually present 8 to 24 hours before a life-threatening event such as respiratory failure leading to ICU admission, or unanticipated cardiac arrest. Such adverse trends in clinical observations can be missed, misinterpreted or not appreciated as urgent. New continuous and wearable 24/7 clinical vital parameter monitoring systems offer a unique possibility to identify clinical deterioration before patients condition progress beyond the point-of-no-return, where adverse events are inevitable. The WARD project aims to determine the correlation between cardiopulmonary micro events and clinical adverse events during the first four days after hospital admission.

Study Type

OBSERVATIONAL

Conditions

Continuous Wireless Vital Parameter Monitoring

Interventions

Wireless continuous vital parameter monitoringDEVICE

The patients included in this study will have continuous, wireless monitoring of vital parameters during the first four days of acute admission

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Adults \>18 years * Acute hospitalization or discharge from Intensive Care Unit (ICU) after an admission of at least 24 hours. * Early Warning Score (EWS) ≥4 at least once from admission and until inclusion * One of the following tentative diagnoses as the primary reason for admission: Pneumonia, Dyspnea, Acute myocardial infarction, heartfailure or sepsis * Inclusion conversation possible within 12 hours of admission or discharge from ICU Exclusion Criteria: * Patients that cannot cooperate * Patients that cannot give informed consent * Patients with EWS≥4 that is not of presumed physical origin * Patients with allergies to plaster or silicone * Patients with pacemaker or ICD * Patients with treatment limitations (no resuscitation or no admission to ICU) * Patients with expected discharge within 24 hours * Patients that have been included in the WARD-COPD study (H-18026653)

Outcomes

Primary Outcomes

Serious desaturation

SpO2 \<85% in 10 consecutive minutes

Time frame: more than 10 minutes, within the first four days of acute admission

Secondary Outcomes

desaturation

SpO2 \<92% in 60 consecutive minutes

Time frame: more than 60 minutes, within the first four days of acute admission

tachycardia

Heartrate \>130/min

Time frame: one minute within the first four days of admission

bradycardia

heartrate \>41/min

Time frame: one minute within the first four days of admission

tachypnea

Respiration rate \>24/min

Time frame: one minute within the first four days of admission

bradypnea

Respiration rate \<9/min

Time frame: one minute within the first four days of admission

hypotension

Systolic blood pressure \<90 mmHg

Time frame: one measurement within the first four days of admission

hypertension

systolic blood pressure \>219 mmHg

Time frame: one measurement wihtin the first four days of admission

Data from ClinicalTrials.gov

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