Abstract
Respiratory compromise is a common and potentially dangerous complication of patients admitted to general care units of hospitals. There are several distinct and disparate pathophysiologic trajectories of respiratory deterioration that hospitalized patients may suffer. Obstructive sleep apnea and preexisting cardiopulmonary disease increase the risk of respiratory failure after major surgery. Patients in general care units of hospitals currently receive only intermittent monitoring of vital signs. Early warning systems that utilize analysis of intermittently collected vital signs may result in earlier recognition of clinical deterioration. Continuous monitoring of oximetry and capnography may allow the detection of pathophysiologic abnormalities earlier in patients in general care units, but the evidence for improved clinical outcomes remains weak. Increased monitoring may lead to increased monitor alarms that can have negative effects on patient care.
- monitoring
- physiologic
- vital signs
- clinical deterioration
- respiratory insufficiency
- conscious sedation
- hospital rapid-response team
- biomedical informatics
Footnotes
- Correspondence: James P Lamberti MD, Department of Medicine, Inova Fairfax Hospital, Falls Church, Virginia. E-mail: james.lamberti{at}inova.org
Dr Lamberti has disclosed relationships with Boehringer Ingelheim, GlaxoSmithKline, Janssen, Philips, Portola, and Sunovion.
Dr Lamberti presented a version of this paper at the 58th Respiratory Care Journal Conference, Monitoring Respiratory Function in Adult Acute Care, held June 10–11, 2019, in St Petersburg, Florida.
↵* Timothy R Myers MBA RRT RRT-NPS FAARC is Chief Business Officer of the AARC.
↵† Dean R Hess PhD RRT FAARC is Managing Editor of Respiratory Care.
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