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Postoperative Remote Automated Monitoring: Need for and State of the Science.

Authors:
Michael H McGillion Emmanuelle Duceppe Katherine Allan Maura Marcucci Stephen Yang Ana P Johnson Sara Ross-Howe Elizabeth Peter Ted Scott Carley Ouellette Shaunattonie Henry Yannick Le Manach Guillaume Paré Bernice Downey Sandra L Carroll Joseph Mills Andrew Turner Wendy Clyne Nazari Dvirnik Sandra Mierdel Laurie Poole Matthew Nelson Valerie Harvey Amber Good Shirley Pettit Karla Sanchez Prathiba Harsha David Mohajer Sem Ponnambalam Sanjeev Bhavnani Andre Lamy Richard Whitlock P J Devereaux

Can J Cardiol 2018 07 25;34(7):850-862. Epub 2018 Apr 25.

McMaster University, Faculty of Health Sciences, Hamilton, Ontario, Canada; Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada.

Worldwide, more than 230 million adults have major noncardiac surgery each year. Although surgery can improve quality and duration of life, it can also precipitate major complications. Moreover, a substantial proportion of deaths occur after discharge. Current systems for monitoring patients postoperatively, on surgical wards and after transition to home, are inadequate. On the surgical ward, vital signs evaluation usually occurs only every 4-8 hours. Reduced in-hospital ward monitoring, followed by no vital signs monitoring at home, leads to thousands of cases of undetected/delayed detection of hemodynamic compromise. In this article we review work to date on postoperative remote automated monitoring on surgical wards and strategy for advancing this field. Key considerations for overcoming current barriers to implementing remote automated monitoring in Canada are also presented.

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http://dx.doi.org/10.1016/j.cjca.2018.04.021DOI Listing
July 2018

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