Perioperative medicine & outcomes
Incidence, severity and detection of blood pressure and heart rate perturbations in postoperative ward patients after noncardiac surgery
Authors' conclusion
Substantial hemodynamic disturbances persisted despite implementing continuous portable ward monitoring coupled with nursing alarms and interventions. A significant proportion of these changes would have gone undetected using traditional intermittent monitoring.
Study context
- Population
- Adults recovering from non-cardiac surgery on the postoperative general ward
- Participants
- 14,623 adults
- Outcome
- Sustained BP and heart rate perturbations
Methodological detailscontinuous wireless noninvasive monitoring, Wireless noninvasive monitor recorded BP and heart rate at 15-s intervals; nursing intervention encouraged as clinically indicated
- Continuous wireless noninvasive monitoring
- Wireless noninvasive monitor recorded BP and heart rate at 15-s intervals; nursing intervention encouraged as clinically indicated
Main finding
As reported in the abstract
- MAP <65 mmHg for >15 sustained min
- 7%
- MAP <75 mmHg for 15 sustained min
- 23%
- MAP >110 mmHg for at least 60 sustained min
- 67%
- SBP <90 mmHg for 15 sustained min
- about a fifth of all patients
- SBP >160 mmHg sustained for 30 min
- 40%
- Tachycardia >100 beats/min for at least continuous 15 min
- 40%
- Bradycardia <50 beats/min for 5 sustained min
- 15%
Observational data: associations, not effects.
Further findings
Episodes missed by conventional vital sign assessments at 4-h intervals
- MAP <65 mmHg sustained >15 min
- 54%
- MAP >130 mmHg sustained >30 min
- 20%
- Heart rate > 120 beats/min sustained <10 min
- 36%
- Heart rate <40 beats/min sustained >3 min
- 68%
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Incidence, severity and detection of blood pressure and heart rate perturbations in postoperative ward patients after noncardiac surgery. J Clin Anesth. Published 8 June 2023. doi:10.
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