The investigators plan to determine whether unblinded continuous ward monitoring with the GE Portrait Mobile Monitoring Solution and nursing alerts reduces vital sign abnormalities in patients recovering from major noncardiac surgery.
Primary Aim. Determine whether unblinded continuous ward monitoring with the GE Portrait Mobile Monitoring Solution and nursing alerts reduces vital sign abnormalities in patients recovering from major noncardiac surgery. Primary hypothesis. Unblinded continuous ward monitoring and nurse alerts reduces vital sign abnormalities during the initial 48 postoperative hours after major non-cardiac surgery while patients remain hospitalized. Secondary Aim. Determine whether continuous ward saturation, ventilation, and pulse rate monitoring reduces a composite of substantive respiratory and cardiovascular interventions. Secondary hypothesis. Unblinded continuous ward monitoring increases a composite of clinical interventions for desaturation, hypoventilation, tachypnea, tachycardia, and bradycardia within 48 hours after major non-cardiac surgery.
Study Type
OBSERVATIONAL
Enrollment
227
Unblinded postoperative GE Portrait monitoring
Blinded postoperative GE Portrait monitoring
Cleveland Clinic Foundation
Cleveland, Ohio, United States
Hypoxemia
Area of oxygen saturation defined as SpO2 ≤85%.
Time frame: 48 postoperative hours.
Inadequate or excessive ventilation
Area of inadequate or excessive ventilation defined as respiratory rate ≤4/min or ≥30/min.
Time frame: 48 postoperative hours.
Bradycardia and tachycardia
Area of inadequate or excessive heart rate defined as ≤40/min or ≥130/min.
Time frame: 48 postoperative hours.
The fraction of patients who have a composite of interventions potentially related to postoperative vital sign abnormalities.
Determine whether continuous ward saturation, ventilation, and pulse rate monitoring reduces substantive respiratory and cardiovascular interventions. Each intervention will be considered dichotomously (occurred or not), and together constitute a composite outcome: * Supplemental oxygen (or substantive dose escalation as indicated by a new administration method) excluding oxygen that patients are already using when they arrive on the ward; * New-onset inhaled drugs (e.g., steroids, bronchodilators); * Naloxone or flumazenil administration; * Non-invasive ventilatory support including bag \& mask ventilation, but excluding use of home CPAP and similar devices; * Bolus fluid administration (e.g., \>500 ml); * Drug treatments for bradycardia (e.g., new onset atropine or glycopyrrolate) and discontinuing drugs that promote bradycardia such as beta blockers; * Drug treatment for tachycardia (e.g., new onset beta blockers and calcium channel blockers).
Time frame: 48 postoperative hours.
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