OBJECTIVE: Delayed response to clinical deterioration as a result of intermittent vital sign monitoring is a cause of preventable morbidity and mortality. This review focuses on the clinical impact of multi-parameter continuous non-invasive monitoring of vital signs (CoNiM) in non-intensive care unit patients. DESIGN: Systematic review and meta-analysis of primary studies. Embase, MEDLINE, HMIC, PsycINFO and Cochrane were searched from April 1964 to 18 June 2019 with no language restriction. SETTING: The search was limited to hospitalised, non-intensive care unit adult patients who had two or more vital signs continuously monitored. PARTICIPANTS: All primary studies that evaluated the clinical impact of using multi-parameter CoNiM in adult hospital wards outside of the intensive care unit. MAIN OUTCOME MEASURES: Clinical impact of multi-parameter CoNiM. RESULTS: This systematic review identified 14 relevant studies from 3846 search results. Five studies were classified as Group A - associations found between measured vital signs and clinical parameters. Nine studies were classified as Group B - comparison between clinical outcomes of patients with and without multi-parameter CoNiM. Vital signs data from CoNiM were found to associate with type of presenting complaint, level of renal function and incidence of major clinical events. CoNiM also assisted in diagnosis by differentiating between patients with acute heart failure, stroke and sepsis (with sub-clustering of septic patients). In the meta-analysis, patients on multi-parameter CoNiM had a 39% decrease in risk of mortality (risk ratio [RR] 0.61; 95% confidence interval [95% CI] -0.39-0.95) when compared to patients with regular intermittent monitoring. There was a trend of reduced intensive care unit transfer (RR 0.86; 95% CI -0.67-1.11) and reduced rapid response team activation (RR 0.61; 95% CI 0.26-1.43). A trend towards reduced hospital length of stay was also found using weighted mean difference (WMD -3.32 days; 95% CI -8.82-2.19 days). CONCLUSION: There is evidence of clinical benefit in implementing CoNiM in non-intensive care unit patients. This review supports the use of multi-parameter CoNiM outside of intensive care unit with further large-scale RCTs required to further affirm clinical impact.
OBJECTIVE: Delayed response to clinical deterioration as a result of intermittent vital sign monitoring is a cause of preventable morbidity and mortality. This review focuses on the clinical impact of multi-parameter continuous non-invasive monitoring of vital signs (CoNiM) in non-intensive care unit patients. DESIGN: Systematic review and meta-analysis of primary studies. Embase, MEDLINE, HMIC, PsycINFO and Cochrane were searched from April 1964 to 18 June 2019 with no language restriction. SETTING: The search was limited to hospitalised, non-intensive care unit adult patients who had two or more vital signs continuously monitored. PARTICIPANTS: All primary studies that evaluated the clinical impact of using multi-parameter CoNiM in adult hospital wards outside of the intensive care unit. MAIN OUTCOME MEASURES: Clinical impact of multi-parameter CoNiM. RESULTS: This systematic review identified 14 relevant studies from 3846 search results. Five studies were classified as Group A - associations found between measured vital signs and clinical parameters. Nine studies were classified as Group B - comparison between clinical outcomes of patients with and without multi-parameter CoNiM. Vital signs data from CoNiM were found to associate with type of presenting complaint, level of renal function and incidence of major clinical events. CoNiM also assisted in diagnosis by differentiating between patients with acute heart failure, stroke and sepsis (with sub-clustering of septic patients). In the meta-analysis, patients on multi-parameter CoNiM had a 39% decrease in risk of mortality (risk ratio [RR] 0.61; 95% confidence interval [95% CI] -0.39-0.95) when compared to patients with regular intermittent monitoring. There was a trend of reduced intensive care unit transfer (RR 0.86; 95% CI -0.67-1.11) and reduced rapid response team activation (RR 0.61; 95% CI 0.26-1.43). A trend towards reduced hospital length of stay was also found using weighted mean difference (WMD -3.32 days; 95% CI -8.82-2.19 days). CONCLUSION: There is evidence of clinical benefit in implementing CoNiM in non-intensive care unit patients. This review supports the use of multi-parameter CoNiM outside of intensive care unit with further large-scale RCTs required to further affirm clinical impact.
Authors: Carlos Areia; Sarah Vollam; Louise Young; Christopher Biggs; Marco Pimentel; Mauro Santos; Neal Thurley; Stephen Gerry; Lionel Tarassenko; Peter Watkinson Journal: BMJ Open Date: 2021-05-18 Impact factor: 2.692
Authors: Justin C Niestroy; J Randall Moorman; Maxwell A Levinson; Sadnan Al Manir; Timothy W Clark; Karen D Fairchild; Douglas E Lake Journal: NPJ Digit Med Date: 2022-01-17
Authors: Mauro Santos; Sarah Vollam; Marco Af Pimentel; Carlos Areia; Louise Young; Cristian Roman; Jody Ede; Philippa Piper; Elizabeth King; Mirae Harford; Akshay Shah; Owen Gustafson; Lionel Tarassenko; Peter Watkinson Journal: J Med Internet Res Date: 2022-02-15 Impact factor: 7.076
Authors: Carlos Areia; Elizabeth King; Jody Ede; Louise Young; Lionel Tarassenko; Peter Watkinson; Sarah Vollam Journal: J Adv Nurs Date: 2021-10-15 Impact factor: 3.057
Authors: Carlos Areia; Christopher Biggs; Mauro Santos; Neal Thurley; Stephen Gerry; Lionel Tarassenko; Peter Watkinson; Sarah Vollam Journal: Crit Care Date: 2021-09-28 Impact factor: 9.097