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1.
J Sleep Res ; 33(2): e14044, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-37723617

RESUMO

In intensive care units, environmental factors like loud noises and bright lights can cause fear, anxiety, changes in vital signs, and sleep disturbances. The aim of this study was to find out how using earplugs and eye masks during the night affected sleep quality, anxiety, fear, and vital signs of patients in an intensive care unit. A total of 70 patients, 35 in the intervention and 35 in the control group, were included in this randomised controlled study. While the patients in the intervention group were provided with earplugs and eye masks for 3 nights in addition to their routine care, only routine care was given to the patients in the control group. The 'Introductory Information Form', 'Visual Analogue Scale-Fear (VAS-F)', 'Visual Analogue Scale-Anxiety (VAS-A)', 'Vital Signs Monitoring Form', and 'Richards-Campbell Sleep Questionnaire' were used for data collection. It was found that the mean scores of VAS-F, VAS-A, heart rate, diastolic and systolic blood pressure of the intervention group decreased significantly after the intervention, while their sleep quality increased significantly. In this study, it was found that using earplugs and eye masks for patients in an intensive care unit during the night was effective in improving patients' sleep quality and reducing fear, anxiety, and problems in vital signs.


Assuntos
Dispositivos de Proteção das Orelhas , Qualidade do Sono , Humanos , Sono/fisiologia , Unidades de Terapia Intensiva , Ansiedade , Inquéritos e Questionários , Medo , Pressão Sanguínea
2.
Int J Legal Med ; 2024 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-38861166

RESUMO

The authors present the case of a 58-year-old man found hanging from a radiator by his shoelaces. The time of death was approximately 6 h before the body was discovered. An autopsy was performed approximately 24 h after the body was found, which revealed hemorrhages in the thoracic aorta at the junctions of the posterior intercostal arteries. Before autopsy, a routine whole-body CT scan was performed. Histologic examination of the aorta and the posterior intercostal arteries revealed a fresh hemorrhage into the tunica adventitia of the aorta. To our knowledge, there is no case description of such findings in hanged persons in the literature. Conclusion: Hemorrhages into the tunica adventitia of the junction of the posterior costal arteries may occur in association with suicidal hanging. The significance of these hemorrhages as a sign of vitality may be debated.

3.
Br J Anaesth ; 132(3): 519-527, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38135523

RESUMO

BACKGROUND: Continuous and wireless vital sign monitoring is superior to intermittent monitoring in detecting vital sign abnormalities; however, the impact on clinical outcomes has not been established. METHODS: We performed a propensity-matched analysis of data describing patients admitted to general surgical wards between January 2018 and December 2019 at a single, tertiary medical centre in the USA. The primary outcome was a composite of in-hospital mortality or ICU transfer during hospitalisation. Secondary outcomes were the odds of individual components of the primary outcome, and heart failure, myocardial infarction, acute kidney injury, and rapid response team activations. Data are presented as odds ratios (ORs) with 95% confidence intervals (CIs) and n (%). RESULTS: We initially screened a population of 34,636 patients (mean age 58.3 (Range 18-101) yr, 16,456 (47.5%) women. After propensity matching, intermittent monitoring (n=12 345) was associated with increased risk of a composite of mortality or ICU admission (OR 3.42, 95% CI 3.19-3.67; P<0.001), and heart failure (OR 1.48, 95% CI 1.21-1.81; P<0.001), myocardial infarction (OR 3.87, 95% CI 2.71-5.71; P<0.001), and acute kidney injury (OR 1.32, 95% CI 1.09-1.57; P<0.001) compared with continuous wireless monitoring (n=7955). The odds of rapid response team intervention were similar in both groups (OR 0.86, 95% CI 0.79-1.06; P=0.726). CONCLUSIONS: Patients who received continuous ward monitoring were less likely to die or be admitted to ICU than those who received intermittent monitoring. These findings should be confirmed in prospective randomised trials.


Assuntos
Injúria Renal Aguda , Insuficiência Cardíaca , Infarto do Miocárdio , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Injúria Renal Aguda/diagnóstico , Insuficiência Cardíaca/diagnóstico , Monitorização Fisiológica , Estudos Prospectivos , Sinais Vitais/fisiologia , Adolescente , Adulto Jovem , Adulto , Idoso , Idoso de 80 Anos ou mais
4.
Support Care Cancer ; 32(3): 188, 2024 Feb 24.
Artigo em Inglês | MEDLINE | ID: mdl-38400942

RESUMO

PURPOSE: Pediatric patients with cancer often develop chemotherapy-induced fever in neutropenia (FN), requiring emergency broad-spectrum antibiotics. Continuous temperature monitoring can lead to earlier FN detection and therapy with improved outcomes. We aimed to compare the feasibility of continuous core temperature monitoring with timely data availability between two wearable devices (WDs) in pediatric oncology patients undergoing chemotherapy. METHODS: In this prospective observational two-center study, 20 patients (median age: 8 years) undergoing chemotherapy simultaneously wore two WDs (CORE®, Everion®) for 14 days. The predefined goal was core temperature recorded in sufficient quality and available within ≤ 30 min during ≥ 18/24 h for ≥ 7/14 days in more than 15 patients. RESULTS: More patients reached the goal with CORE® (n = 13) versus Everion® (n = 3) (difference, 50% p < 0.001). After correcting for the transmission bottleneck caused by two WDs transmitting via one gateway, these numbers increased (n = 15 versus n = 14; difference, 5%; p = 0.69). CORE® measurements corresponded better to ear temperatures (n = 528; mean bias, - 0.07 °C; mean absolute difference, 0.35 °C) than Everion® measurements (n = 532; - 1.06 °C; 1.10 °C). Acceptance rates for the WDs were 95% for CORE® and 89% for Everion®. CONCLUSION: The CORE® fulfilled the predefined feasibility criterion (15 of 20 patients) after correction for transmission bottleneck, and the Everion® nearly fulfilled it. Continuous core temperature recording of good quality and with timely data availability was feasible from preschool to adolescent patients undergoing chemotherapy for cancer. These results encourage the design of randomized controlled trials on continuously monitored core temperature in pediatric patients. CLINICALTRIALS: gov (NCT04914702) on June 7, 2021.


Assuntos
Neoplasias , Dispositivos Eletrônicos Vestíveis , Pré-Escolar , Adolescente , Humanos , Criança , Temperatura , Temperatura Corporal , Neoplasias/tratamento farmacológico , Estudos Prospectivos
5.
World J Surg ; 48(8): 1902-1911, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38890767

RESUMO

BACKGROUND: Patients undergoing major oncological abdominal surgery are prone to postoperative complications, making early recognition crucial. Clinical deterioration is often preceded by changes in vital signs, which are typically measured thrice a day by a nurse. However, intermittent measurements may delay recognizing clinical deterioration. Continuous vital parameter monitoring may lead to earlier recognition and management of complications and reduce nursing workload. OBJECTIVE: To compare vital parameter measurements between ward nurses and a wireless continuous monitoring system (Sensium® wireless patch) and assess whether this patch can detect clinical deterioration earlier in patients with complications in the first postoperative week. METHODS: Vital parameters (heart rate, respiratory rate, and temperature) were collected in patients undergoing an oncological resection of the liver, colorectal, or pancreas. Sensium® patch measurements were compared to nurses' measurements to assess the percentages of discordant measurements. In patients with complications in the first postoperative week, time discrepancies between nurses and Sensium® patch measurements were identified in cases of clinical deterioration (respiratory rate ≥15/min, heart rate ≥100/min, and temperature ≥38°C). RESULTS: Among 227 patients, 22% of the patients experienced complications. Nurse and Sensium® measurements were discrepant in 586/2272 measurements (26%). In 506/586 discrepancies (86%), this was due to the respiratory rate (difference ≥4/min). Compared to nurses, the Sensium® patch detected an elevated respiratory rate 14 h earlier and heart rate 2 h earlier within complications in the first postoperative week. For temperature, no difference was observed. CONCLUSION: Continuous monitoring with the Sensium® wireless patch holds promise for earlier recognition of complications in patients who underwent major oncological abdominal surgery.


Assuntos
Complicações Pós-Operatórias , Sinais Vitais , Humanos , Feminino , Masculino , Monitorização Fisiológica/métodos , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/epidemiologia , Idoso , Pessoa de Meia-Idade , Procedimentos Cirúrgicos do Sistema Digestório/efeitos adversos , Procedimentos Cirúrgicos do Sistema Digestório/métodos , Diagnóstico Precoce , Estudos Prospectivos , Tecnologia sem Fio
6.
Acta Anaesthesiol Scand ; 68(2): 274-279, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37735843

RESUMO

BACKGROUND: Vital sign monitoring is considered an essential aspect of clinical care in hospitals. In general wards, this relies on intermittent manual assessments performed by clinical staff at intervals of up to 12 h. In recent years, continuous monitoring of vital signs has been introduced to the clinic, with improved patient outcomes being one of several potential benefits. The aim of this study was to determine the workload difference between continuous monitoring and manual monitoring of vital signs as part of the National Early Warning Score (NEWS). METHODS: Three wireless sensors continuously monitored blood pressure, heart rate, respiratory rate, and peripheral oxygen saturation in 20 patients admitted to the general hospital ward. The duration needed for equipment set-up and maintenance for continuous monitoring in a 24-h period was recorded and compared with the time spent on manual assessments and documentation of vital signs performed by clinical staff according to the NEWS. RESULTS: The time used for continuous monitoring was 6.0 (IQR 3.2; 7.2) min per patient per day vs. 14 (9.7; 32) min per patient per day for the NEWS. Median difference in duration for monitoring of vital signs was 9.9 (95% CI 5.6; 21) min per patient per day between NEWS and continuous monitoring (p < .001). Time used for continuous monitoring in isolated patients was 6.6 (4.6; 12) min per patient per day as compared with 22 (9.7; 94) min per patient per day for NEWS. CONCLUSION: The use of continuous monitoring was associated with a significant reduction in workload in terms of time for monitoring as compared with manual assessment of vital signs.


Assuntos
Sinais Vitais , Carga de Trabalho , Humanos , Sinais Vitais/fisiologia , Frequência Cardíaca , Taxa Respiratória , Monitorização Fisiológica/métodos
7.
Prehosp Emerg Care ; : 1-12, 2024 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-39088816

RESUMO

OBJECTIVES: The use of machine learning to identify patient 'clusters' using post-return of spontaneous circulation (ROSC) vital signs may facilitate identification of patient subgroups at high risk of rearrest and mortality. Our objective was to use k-means clustering to identify post-ROSC vital sign clusters and determine whether these clusters were associated with rearrest and mortality.METHODS: The ESO Data Collaborative 2018-2022 datasets were used for this study. We included adult, non-traumatic OHCA patients with >2 post-ROSC vital sign sets. Patients were excluded if they had an EMS-witnessed OHCA or were encountered during an interfacility transfer. Unsupervised (k-means) clustering was performed using minimum, maximum, and delta (last minus first) systolic blood pressure (BP), heart rate, SpO2, shock index, and pulse pressure. The assessed outcomes were mortality and rearrest. To explore the association between rearrest, mortality, and cluster, multivariable logistic regression modeling was used.RESULTS: Within our cohort of 12,320 patients, five clusters were identified. Patients in cluster 1 were hypertensive, patients in cluster 2 were normotensive, patients in cluster 3 were hypotensive and tachycardic (n = 2,164; 17.6%), patients in cluster 4 were hypoxemic and exhibited increasing systolic BP, and patients in cluster 5 were severely hypoxemic and exhibited a declining systolic BP. The overall proportion of patients who experienced mortality stratified by cluster was 63.4%(c1), 68.1%(c2), 78.8%(c3), 84.8%(c4), and 86.6%(c5). In comparison to the cluster with the lowest mortality (c1), each other cluster was associated with greater odds of mortality and rearrest.CONCLUSIONS: Unsupervised k-means clustering yielded 5 post-ROSC vital sign clusters that were associated with rearrest and mortality.

8.
Langenbecks Arch Surg ; 409(1): 76, 2024 Feb 27.
Artigo em Inglês | MEDLINE | ID: mdl-38409295

RESUMO

PURPOSE: To assess the association of postoperative C-reactive protein (CRP), leucocytes and vital signs in the first three postoperative days (PODs) with major complications after oncological colorectal resections in a tertiary referral centre for colorectal cancer in The Netherlands. METHODS: A retrospective cohort study, including 594 consecutive patients who underwent an oncological colorectal resection at Maastricht University Medical Centre between January 2016 and December 2020. Descriptive analyses of patient characteristics were performed. Logistic regression models were used to assess associations of leucocytes, CRP and Modified Early Warning Score (MEWS) at PODs 1-3 with major complications. Receiver operating characteristic curve analyses were used to establish cut-off values for CRP. RESULTS: A total of 364 (61.3%) patients have recovered without any postoperative complications, 134 (22.6%) patients have encountered minor complications and 96 (16.2%) developed major complications. CRP levels reached their peak on POD 2, with a mean value of 155 mg/L. This peak was significantly higher in patients with more advanced stages of disease and patients undergoing open procedures, regardless of complications. A cut-off value of 170 mg/L was established for CRP on POD 2 and 152 mg/L on POD 3. Leucocytes and MEWS also demonstrated a peak on POD 2 for patients with major complications. CONCLUSIONS: Statistically significant associations were found for CRP, Δ CRP, Δ leucocytes and MEWS with major complications on POD 2. Patients with CRP levels ≥ 170 mg/L on POD 2 should be carefully evaluated, as this may indicate an increased risk of developing major complications.


Assuntos
Neoplasias Colorretais , Cirurgia Colorretal , Humanos , Proteína C-Reativa/metabolismo , Estudos Retrospectivos , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Curva ROC , Neoplasias Colorretais/diagnóstico , Sinais Vitais , Biomarcadores
9.
Am J Emerg Med ; 80: 149-155, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38608467

RESUMO

OBJECTIVE: The shock index (SI), the ratio of heart rate to systolic blood pressure, is a clinical tool for assessing injury severity. Age-adjusted SI models may improve predictive value for injured children in the out-of-hospital setting. We sought to characterize the proportion of children in the prehospital setting with an abnormal SI using established criteria, describe the age-based distribution of SI among injured children, and determine prehospital interventions by SI. METHODS: We performed a multi-agency retrospective cross-sectional study of children (<18 years) in the prehospital setting with a scene encounter for suspected trauma and transported to the hospital between 2018 and 2022 using the National Emergency Medical Services (EMS) Information System datasets. Our exposure of interest was the first calculated SI. We identified the proportion of children with an abnormal SI when using the SI, pediatric age-adjusted (SIPA); and the pediatric SI (PSI) criteria. We developed and internally validated an age-based distributional model for the SI using generalized additive models for location, scale, and shape to describe the age-based distribution of the SI as a centile or Z-score. We evaluated EMS interventions (basic airway interventions, advanced airway interventions, cardiac interventions, vascular access, intravenous fluids, and vasopressor use) in relation to both the SIPA, PSI, and distributional SI values. RESULTS: We analyzed 1,007,863 pediatric EMS trauma encounters (55.0% male, median age 13 years [IQR, 8-16 years]). The most common dispatch complaint was for traffic/transport related injury (32.9%). When using the PSI and SIPA, 13.1% and 16.3% were classified as having an abnormal SI, respectively. There were broad differences in the percentage of encounters classified as having an abnormal SI across the age range, varying from 5.1 to 22.8% for SIPA and 3.7-20.1% for PSI. The SIPA values ranged from the 75th to 95th centiles, while the PSI corresponded to an SI greater than the 90th centile, except in older children. The centile distribution for SI declined during early childhood and stabilized during adolescence and demonstrated a difference of <0.1% at cutoff values. An abnormal PSI, SIPA and higher SI centiles (>90th centile and >95th centiles) were associated with interventions related to basic and advanced airway management, cardiac procedures, vascular access, and provision of intravenous fluids occurred with greater frequency at higher SI centiles. Some procedures, including airway management and vascular access, had a smaller peak at lower (<10th) centiles. DISCUSSION: We describe the empiric distribution of the pediatric SI across the age range, which may overcome limitations of extant criteria in identifying patients with shock in the prehospital setting. Both high and low SI values were associated with important, potentially lifesaving EMS interventions. Future work may allow for more precise identification of children with significant injury using cutpoint analysis paired to outcome-based criteria. These may additionally be combined with other physiologic and mechanistic criteria to assist in triage decisions.


Assuntos
Serviços Médicos de Emergência , Choque , Ferimentos e Lesões , Humanos , Criança , Estudos Retrospectivos , Masculino , Feminino , Pré-Escolar , Estudos Transversais , Adolescente , Lactente , Ferimentos e Lesões/terapia , Ferimentos e Lesões/diagnóstico , Choque/diagnóstico , Choque/terapia , Frequência Cardíaca/fisiologia , Pressão Sanguínea/fisiologia , Recém-Nascido
10.
BMC Anesthesiol ; 24(1): 18, 2024 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-38195443

RESUMO

BACKGROUND: Intensive care unit (ICU) patients often experience significant physiological stress. This study evaluated the effect of a defined family visitation protocol on physiological responses in the ICU. METHODS: A randomized, block-randomized clinical trial was conducted on 78 ICU patients at Imam Reza Hospital between February 8, 2017, and August 8, 2017. The intervention group received protocol-based visits, and the control group continued with standard visitation. Block randomization was utilized for group assignments. The primary outcome was the measurement of physiological signs using designated monitoring devices. Data were analyzed using SPSS version 22, employing independent t-tests, Mann-Whitney U test, repeated measures analysis, and Friedman's test. RESULTS: The results showed no significant differences in systolic blood pressure, diastolic blood pressure, mean arterial pressure, respiratory rate, and arterial blood oxygen levels between the two groups. However, heart rate in the intervention group was significantly lower in three stages before, during, and after the meaningful visiting (P = 0.008). CONCLUSION: Protocol-based scheduled family visits in the ICU may reduce physiological stress, as evidenced by a decrease in patients' heart rate. Implementing tailored visitation protocols sensitive to patient preferences and clinical contexts is advisable, suggesting the integration of family visits into standard care practices for enhanced patient outcomes. TRIAL REGISTRATION: IRCT20161229031654N2; 25/01/2018; Iranian Registry of Clinical Trials ( https://en.irct.ir ).


Assuntos
Cuidados Críticos , Unidades de Terapia Intensiva , Visitas a Pacientes , Humanos , Frequência Cardíaca , Irã (Geográfico)
11.
Proc Natl Acad Sci U S A ; 118(20)2021 05 18.
Artigo em Inglês | MEDLINE | ID: mdl-33972445

RESUMO

Vital signs monitoring is a fundamental component of ensuring the health and safety of women and newborns during pregnancy, labor, and childbirth. This monitoring is often the first step in early detection of pregnancy abnormalities, providing an opportunity for prompt, effective intervention to prevent maternal and neonatal morbidity and mortality. Contemporary pregnancy monitoring systems require numerous devices wired to large base units; at least five separate devices with distinct user interfaces are commonly used to detect uterine contractility, maternal blood oxygenation, temperature, heart rate, blood pressure, and fetal heart rate. Current monitoring technologies are expensive and complex with implementation challenges in low-resource settings where maternal morbidity and mortality is the greatest. We present an integrated monitoring platform leveraging advanced flexible electronics, wireless connectivity, and compatibility with a wide range of low-cost mobile devices. Three flexible, soft, and low-profile sensors offer comprehensive vital signs monitoring for both women and fetuses with time-synchronized operation, including advanced parameters such as continuous cuffless blood pressure, electrohysterography-derived uterine monitoring, and automated body position classification. Successful field trials of pregnant women between 25 and 41 wk of gestation in both high-resource settings (n = 91) and low-resource settings (n = 485) demonstrate the system's performance, usability, and safety.


Assuntos
Monitorização Fisiológica/instrumentação , Gravidez/fisiologia , Dispositivos Eletrônicos Vestíveis , Tecnologia sem Fio/instrumentação , Feminino , Recursos em Saúde , Frequência Cardíaca Fetal , Humanos , Contração Uterina , Sinais Vitais
12.
Scand J Prim Health Care ; 42(2): 338-346, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38459974

RESUMO

OBJECTIVE: To compare management and documentation of vital signs, symptoms and infection severity in pneumonia patients seeking primary care and emergency care without referral. DESIGN: Medical record review of vital signs, examination findings and severity of pneumonia. SETTING: Primary and emergency care. SUBJECTS: Two hundred and forty patients diagnosed with pneumonia. MAIN OUTCOME MEASURES: Vital signs, examination findings and severity of pneumonia. Assessments of pneumonia severity according to the reviewers, the traffic light score and CRB-65. RESULTS: Respiratory rate, blood pressure, heart rate and oxygen saturation were less often documented in primary care (p < .001). Chest X-ray was performed in 5% of primary care patients vs. 88% of emergency care patients (p < .01). Primary care patients had longer symptom duration, higher oxygen saturation and lower respiratory rate. In total, the reviewers assessed 63% of all pneumonias as mild and 9% as severe. The traffic light scoring model identified 11 patients (9%) in primary care and 53 patients (44%) in emergency care at high risk of severe infection. CONCLUSIONS: Vital signs were documented less often in primary care than in emergency care. Patients in primary care appear to have a less severe pneumonia, indicating attendance to the correct care level. The traffic light scoring model identified more patients at risk of severe infection than CRB-65, where the parameters were documented to a limited extent.


Pneumonia patients attending primary care have less affected vital signs than those attending emergency care.Vital signs were less documented in primary care than in emergency care.Patients with pneumonia seem to attend the correct level of care when they have the possibility to choose without a referral.CRB-65 was not possible to count in most primary care patients due to lack of documentation.


Assuntos
Serviços Médicos de Emergência , Pneumonia , Humanos , Serviço Hospitalar de Emergência , Pneumonia/diagnóstico , Pneumonia/terapia , Documentação , Encaminhamento e Consulta , Atenção Primária à Saúde
13.
J Med Internet Res ; 26: e46691, 2024 Jun 20.
Artigo em Inglês | MEDLINE | ID: mdl-38900529

RESUMO

BACKGROUND: Early warning scores (EWS) are routinely used in hospitals to assess a patient's risk of deterioration. EWS are traditionally recorded on paper observation charts but are increasingly recorded digitally. In either case, evidence for the clinical effectiveness of such scores is mixed, and previous studies have not considered whether EWS leads to changes in how deteriorating patients are managed. OBJECTIVE: This study aims to examine whether the introduction of a digital EWS system was associated with more frequent observation of patients with abnormal vital signs, a precursor to earlier clinical intervention. METHODS: We conducted a 2-armed stepped-wedge study from February 2015 to December 2016, over 4 hospitals in 1 UK hospital trust. In the control arm, vital signs were recorded using paper observation charts. In the intervention arm, a digital EWS system was used. The primary outcome measure was time to next observation (TTNO), defined as the time between a patient's first elevated EWS (EWS ≥3) and subsequent observations set. Secondary outcomes were time to death in the hospital, length of stay, and time to unplanned intensive care unit admission. Differences between the 2 arms were analyzed using a mixed-effects Cox model. The usability of the system was assessed using the system usability score survey. RESULTS: We included 12,802 admissions, 1084 in the paper (control) arm and 11,718 in the digital EWS (intervention) arm. The system usability score was 77.6, indicating good usability. The median TTNO in the control and intervention arms were 128 (IQR 73-218) minutes and 131 (IQR 73-223) minutes, respectively. The corresponding hazard ratio for TTNO was 0.99 (95% CI 0.91-1.07; P=.73). CONCLUSIONS: We demonstrated strong clinical engagement with the system. We found no difference in any of the predefined patient outcomes, suggesting that the introduction of a highly usable electronic system can be achieved without impacting clinical care. Our findings contrast with previous claims that digital EWS systems are associated with improvement in clinical outcomes. Future research should investigate how digital EWS systems can be integrated with new clinical pathways adjusting staff behaviors to improve patient outcomes.


Assuntos
Escore de Alerta Precoce , Sinais Vitais , Humanos , Feminino , Masculino , Pessoa de Meia-Idade , Idoso , Reino Unido , Hospitais , Unidades de Terapia Intensiva
14.
Sensors (Basel) ; 24(13)2024 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-39000830

RESUMO

Millimeter-wave radar-based identification technology has a wide range of applications in persistent identity verification, covering areas such as security production, healthcare, and personalized smart consumption systems. It has received extensive attention from the academic community due to its advantages of being non-invasive, environmentally insensitive and privacy-preserving. Existing identification algorithms mainly rely on a single signal, such as breathing or heartbeat. The reliability and accuracy of these algorithms are limited due to the high similarity of breathing patterns and the low signal-to-noise ratio of heartbeat signals. To address the above issues, this paper proposes an algorithm for multimodal fusion for identity recognition. This algorithm extracts and fuses features derived from phase signals, respiratory signals, and heartbeat signals for identity recognition purposes. The spatial features of signals with different modes are first extracted by the residual network (ResNet), after which these features are fused with a spatial-channel attention fusion module. On this basis, the temporal features are further extracted with a time series-based self-attention mechanism. Finally, the feature vectors of the user's vital sign modality are obtained to perform identity recognition. This method makes full use of the correlation and complementarity between different modal signals to improve the accuracy and reliability of identification. Simulation experiments show that the algorithm identity recognition proposed in this paper achieves an accuracy of 94.26% on a 20-subject self-test dataset, which is much higher than that of the traditional algorithm, which is about 85%.


Assuntos
Algoritmos , Radar , Humanos , Processamento de Sinais Assistido por Computador , Frequência Cardíaca/fisiologia , Respiração
15.
Sensors (Basel) ; 24(12)2024 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-38931550

RESUMO

The remote monitoring of vital signs via wearable devices holds significant potential for alleviating the strain on hospital resources and elder-care facilities. Among the various techniques available, photoplethysmography stands out as particularly promising for assessing vital signs such as heart rate, respiratory rate, oxygen saturation, and blood pressure. Despite the efficacy of this method, many commercially available wearables, bearing Conformité Européenne marks and the approval of the Food and Drug Administration, are often integrated within proprietary, closed data ecosystems and are very expensive. In an effort to democratize access to affordable wearable devices, our research endeavored to develop an open-source photoplethysmographic sensor utilizing off-the-shelf hardware and open-source software components. The primary aim of this investigation was to ascertain whether the combination of off-the-shelf hardware components and open-source software yielded vital-sign measurements (specifically heart rate and respiratory rate) comparable to those obtained from more expensive, commercially endorsed medical devices. Conducted as a prospective, single-center study, the research involved the assessment of fifteen participants for three minutes in four distinct positions, supine, seated, standing, and walking in place. The sensor consisted of four PulseSensors measuring photoplethysmographic signals with green light in reflection mode. Subsequent signal processing utilized various open-source Python packages. The heart rate assessment involved the comparison of three distinct methodologies, while the respiratory rate analysis entailed the evaluation of fifteen different algorithmic combinations. For one-minute average heart rates' determination, the Neurokit process pipeline achieved the best results in a seated position with a Spearman's coefficient of 0.9 and a mean difference of 0.59 BPM. For the respiratory rate, the combined utilization of Neurokit and Charlton algorithms yielded the most favorable outcomes with a Spearman's coefficient of 0.82 and a mean difference of 1.90 BrPM. This research found that off-the-shelf components are able to produce comparable results for heart and respiratory rates to those of commercial and approved medical wearables.


Assuntos
Frequência Cardíaca , Fotopletismografia , Taxa Respiratória , Processamento de Sinais Assistido por Computador , Software , Dispositivos Eletrônicos Vestíveis , Humanos , Fotopletismografia/métodos , Fotopletismografia/instrumentação , Taxa Respiratória/fisiologia , Frequência Cardíaca/fisiologia , Masculino , Feminino , Monitorização Fisiológica/métodos , Monitorização Fisiológica/instrumentação , Adulto , Estudos Prospectivos , Algoritmos
16.
Sensors (Basel) ; 24(14)2024 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-39065867

RESUMO

BACKGROUND: Temperature is considered one of the primary vital signs for detection of complications such as infections. Continuous wireless real-time axillary temperature monitoring is technologically feasible at the general ward, but no clinical validation studies exist. METHODS: This study compared axillary temperature with a urinary bladder thermometer in 40 major abdominal postoperative patients. The primary outcome was changes in axillary temperature registrations. Secondary outcomes were mean bias between the urinary bladder and the axillary temperatures. Intermittent frontal and tympanic temperature recordings were also collected. RESULTS: Forty patients were monitored for 50 min with an average core temperature of 36.8 °C. The mean bias was -1.0 °C (LoA -1.9 to -0) after 5 min, and -0.8 °C (LoA -1.6 to -0.1) after 10 min when comparing the axillary temperature with the urinary bladder temperature. After 20 min, the mean bias was -0.6 °C (LoA -1.3-0.1). During upper arm abduction, the axilla temperature was reduced to -1.6 °C (LoA -2.9 to -0.3) within 1 min. Temporal skin temperature measurement had a resulted in a mean bias of -0.1 °C (LOA -1.1 to -1.0) compared with central temperature. Compared with the mean tympanic temperature, it was -0.1 °C (LoA -0.9 to -1.0) lower than the urinay bladder temperature. CONCLUSIONS: Axillary temperature increased with time, reaching a mean bias of 1 °C between axillary and core temperature within 5 min. Opening the axillary resulted in rapidly lower temperature recordings. These findings may aid in use and designing corrections for continuous axillary temperature monitoring.


Assuntos
Axila , Temperatura Corporal , Tecnologia sem Fio , Humanos , Masculino , Feminino , Temperatura Corporal/fisiologia , Pessoa de Meia-Idade , Idoso , Monitorização Fisiológica/métodos , Termômetros , Bexiga Urinária/fisiopatologia , Bexiga Urinária/fisiologia , Bexiga Urinária/cirurgia , Adulto
17.
Sensors (Basel) ; 24(11)2024 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-38894339

RESUMO

Vital sign monitoring is dominated by precise but costly contact-based sensors. Contactless devices such as radars provide a promising alternative. In this article, the effects of lateral radar positions on breathing and heartbeat extraction are evaluated based on a sleep study. A lateral radar position is a radar placement from which multiple human body zones are mapped onto different radar range sections. These body zones can be used to extract breathing and heartbeat motions independently from one another via these different range sections. Radars were positioned above the bed as a conventional approach and on a bedside table as well as at the foot end of the bed as lateral positions. These positions were evaluated based on six nights of sleep collected from healthy volunteers with polysomnography (PSG) as a reference system. For breathing extraction, comparable results were observed for all three radar positions. For heartbeat extraction, a higher level of agreement between the radar foot end position and the PSG was found. An example of the distinction between thoracic and abdominal breathing using a lateral radar position is shown. Lateral radar positions could lead to a more detailed analysis of movements along the body, with the potential for diagnostic applications.


Assuntos
Frequência Cardíaca , Radar , Respiração , Sinais Vitais , Humanos , Sinais Vitais/fisiologia , Monitorização Fisiológica/métodos , Monitorização Fisiológica/instrumentação , Frequência Cardíaca/fisiologia , Adulto , Masculino , Polissonografia/métodos , Feminino
18.
Sensors (Basel) ; 24(14)2024 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-39065897

RESUMO

This paper introduces and evaluates an innovative sensor for unobtrusive in-car respiration monitoring, mounted on the backrest of the driver's seat. The sensor seamlessly integrates into the vehicle, measuring breathing rates continuously without requiring active participation from the driver. The paper proves the feasibility of unobtrusive in-car measurements over long periods of time. Operation of the sensor was investigated over 12 participants sitting in the driver seat. A total of 107 min of driving in diverse conditions with overall coverage rate of 84.45% underscores the sensor potential to reliably capture physiological changes in breathing rate for fatigue and stress detection.


Assuntos
Taxa Respiratória , Humanos , Monitorização Fisiológica/métodos , Monitorização Fisiológica/instrumentação , Taxa Respiratória/fisiologia , Masculino , Condução de Veículo , Adulto , Respiração , Feminino , Automóveis
19.
Sensors (Basel) ; 24(14)2024 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-39065978

RESUMO

Medical support in crisis situations is a major challenge. Efficient implementation of the medical evacuation process especially in operations with limited human resources that may occur during armed conflicts can limit the loss of these resources. Proper evacuation of wounded soldiers from the battlefield can increase the chances of their survival and rapid return to further military operations. This paper presents the technical details of the decision support system for medical evacuation to support this process. The basis for the functioning of this system is the continuous measurement of vital signs of soldiers via a specialized measurement module with a set of medical sensors. Vital signs values are then transmitted via the communication module to the analysis and inference module, which automatically determines the color of medical triage and the soldier's chance of survival. This paper presents the results of tests of our system to validate it, which were carried out using test vectors of soldiers' vital signs, as well as the results of the system's performance on a group of volunteers who performed typical activities of tactical operations. The results of this study showed the usefulness of the developed system for supporting military medical services in military operations.


Assuntos
Militares , Humanos , Sinais Vitais/fisiologia , Medicina Militar/métodos , Monitorização Fisiológica/métodos , Monitorização Fisiológica/instrumentação , Triagem/métodos
20.
Sensors (Basel) ; 24(12)2024 Jun 19.
Artigo em Inglês | MEDLINE | ID: mdl-38931747

RESUMO

The development of non-contact techniques for monitoring human vital signs has significant potential to improve patient care in diverse settings. By facilitating easier and more convenient monitoring, these techniques can prevent serious health issues and improve patient outcomes, especially for those unable or unwilling to travel to traditional healthcare environments. This systematic review examines recent advancements in non-contact vital sign monitoring techniques, evaluating publicly available datasets and signal preprocessing methods. Additionally, we identified potential future research directions in this rapidly evolving field.


Assuntos
Sinais Vitais , Humanos , Sinais Vitais/fisiologia , Monitorização Fisiológica/métodos , Processamento de Sinais Assistido por Computador
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