Proceedings of the Anaesthetic Research Society Meeting: Protocol presentation: evaluation of a device to detect early respiratory deterioration

Sheila Rodgers, Gordon Drummond, Jennifer Tocher, D K Arvind, A Waite, C Weir, J Smith

Research output: Contribution to journalArticlepeer-review

Abstract

We have developed a small non-invasive device that senses body movement and reliably measures respiratory rate in patients after abdominal surgery.1 Respiratory rate is a good marker of developing illness2 and can predict ITU referral and outcome.3 Intensive surveillance with pulse oximetry can reduce emergencies and ITU admission.4 If reliable frequent measures of respiratory rate are included into a routine physiological warning score, it is possible that:

the ‘weak link’ in the early detection of deterioration might be strengthened;

early detection would allow prompt escalation of care and improve outcome.

We present the plans we have for testing these hypotheses. We propose:

validation of the device in acute medical patients (problem: consent in acute illness).

In this time period, we hope to obtain CE marking and MHRA approval.

A feasibility study to define several aspects of use of a new device:

○ staff attitude, response, and use of a new monitor,

○ influence of more intensive monitoring on interventions,

○ methods to measure outcome.

Population: we plan to study ‘level 1’, that is, patients receiving ward-based care, because patients considered at risk of substantial postoperative morbidity are generally given higher levels of care which include more intensive monitoring. Patients would be studied before and after routine and emergency colorectal and urological surgery (we have two suitably sized local units) with a phased introduction and assessment using the following: Surgical Apgar, P-Possum, Charlson age–comorbidity index, Duke activity status Index, Scottish index of multiple deprivation 2009 followed by measures after surgery, using: calls to hospital at night team, postoperative morbidity score, EuroQol EQ-5D and SF-12, dependency-weighted LOS and 28 day mortality, TrakCare' electronic patient record system, and other clinical management indicators.

We would value general comments but specifically comments on consent procedures, assessment tools, and study design.
Original languageEnglish
Pages (from-to)709P-721P
JournalBritish Journal of Anaesthesia
Volume108
Issue number4
DOIs
Publication statusPublished - 2012

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