Wearable alert system for detecting postoperative hypotension

用于检测术后低血压的可穿戴警报系统

基本信息

批准号：
10760370
负责人：
Joshua Kim
金额：
$ 29.59万
依托单位：
VENA VITALS, INC.
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-08-11 至 2025-02-10
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10760370
关键词：
Acute Renal Failure with Renal Papillary Necrosis Address Anesthesia procedures Arterial Lines Blood Pressure Cardiac Caregivers Caring Cessation of life Cost efficiency Data Detection Deterioration Devices Drops Early Diagnosis Environment Event Follow-Up Studies Frequencies Funding General Ward Hospitals Hour Hypotension Hypotensives Hypoxemia Intensive Care Units Intervention Location Manuals Measures Methods Modeling Monitor Notification Nurses Operating Rooms Operative Surgical Procedures Palpable Patient Monitoring Patient-Focused Outcomes Patients Personal Satisfaction Phase Physiologic pulse Pilot Projects Postoperative Period Recovery Reporting Resources Risk Sensitivity and Specificity Signal Transduction Small Business Innovation Research Grant Spottings Stroke System Technology Time United States National Institutes of Health cardiac intensive care unit caregiver interventions cerebrovascular clinical care clinical practice cost detection platform experience falls feasibility testing hemodynamics high risk hospital readmission improved machine learning classifier machine learning model myocardial injury non-invasive monitor pressure prevent risk of major adverse events risk stratification standard of care ward wearable device wireless

项目摘要

Project Summary This project aims to develop a low-cost, comfortable, and easy-to-use wearable alert system that tracks continuous BP non-invasively in patients to notify caregivers of hypotensive events in the postoperative setting. Postoperative hypotension (POH), when a patient’s mean arterial pressure (MAP) falls to unsafe levels, commonly <70 mmHg, can occur frequently in the time span between leaving the operating room and prior to discharge from the hospital. POH is a serious and common condition that has been shown to be independently associated with poor patient outcomes such as acute kidney injury, stroke, hospital re-admission, myocardial injury, and death.1–9 During surgery and recovery in the post anesthesia care unit (PACU) or the intensive care unit (ICU), a patient’s hemodynamics are closely monitored to support timely interventions and treatment. However, once the patient is transferred to a lower ward for recovery, patient monitoring is dramatically reduced. The current method to monitor a patient’s BP in the general ward, which relies on intermittent spot-checks performed manually every 4-6 hours by the nurse using an oscillometric BP cuff, is insufficient for detecting POH events. A recent study showed that almost 50% of hypotensive events went undetected by routine vital assessments. There is an unmet need for a technology that comfortably monitors a patient’s BP in the postoperative setting. Our core technology is able to non-invasively measure rapid BP changes at any location with a palpable pulse. The proposed project aims build upon the core technology to create a wearable alert system that informs caregivers of postoperative hypotensive episodes. To do so, a machine learning (ML) classifier for detection of hypotensive episodes will be developed through monitoring in the ICU. This ML classifier will undergo feasibility testing in the PACU and then a pilot study in the general ward. Successful completion of the proposed aims will result in a proof- of-concept wearable alert system that continuously monitors BP in the postoperative environment in a low-profile, wireless, and comfortable manner. Such a technology has huge potential to change clinical practice through earlier detection of patient deterioration, allowing more timely intervention and ultimately improved patient outcomes.

项目概要该项目旨在开发一种低成本、舒适且易于使用的可穿戴警报系统，无创地跟踪患者的连续血压，以通知护理人员患者的低血压事件术后低血压（POH），即患者的平均动脉压。 (MAP) 降至不安全水平，通常<70 mmHg，在以下时间跨度内经常发生：离开手术室和出院前发生的 POH 是一种严重且常见的情况。已被证明与不良患者预后独立相关的病症，例如如急性肾损伤、中风、再次入院、心肌损伤和死亡。1–9 在麻醉后监护病房 (PACU) 或重症监护病房 (ICU) 进行手术和恢复，密切监测患者的血流动力学，以支持及时的干预和治疗。然而，一旦患者被转移到下层病房进行康复，患者监测就无法进行。目前在普通病房监测患者血压的方法大大减少。依靠护士每 4-6 小时手动进行间歇性抽查，使用最近的一项研究表明，示波血压袖带不足以检测 POH 事件。常规生命评估未发现 50% 的低血压事件。需要一种能够在术后环境中舒适地监测患者血压的技术。核心技术能够以非侵入方式测量任何位置的快速血压变化拟议项目旨在以核心技术为基础，打造一款可穿戴设备。警报系统可以通知护理人员术后低血压发作。为此，需要一台机器。用于检测低血压发作的学习（ML）分类器将通过以下方式开发该 ML 分类器将在 PACU 中进行可行性测试，然后进行可行性测试。普通病房试点研究的成功完成将产生证明- 概念可穿戴式警报系统，可在术后环境中持续监测血压这种技术以低调、无线和舒适的方式具有巨大的潜力。通过及早发现患者病情恶化来改变临床实践，以便更及时地干预并最终改善患者的治疗结果。