JMIR Publications

ABSTRACT

Background:

Changes in respiratory rate are a key marker of clinical deterioration. However, in a general ward setting intermittent manual respiratory rate measurements are conducted meaning these changes are often undetected.

Objective:

To improve the frequency and quality of captured respiratory rate data and to reduce clinical staff burden from manual measurements, a prototype respiratory rate monitoring system consisting of a biosensor paired to a cloud connected hub was developed for use in the ward setting. The COVID-19 advanced respiratory physiology (CARP) study was established to evaluate respiratory rate data capture by this system in a real-world clinical setting in the context of increased monitoring requirements during the COVID-19 pandemic.

Methods:

The CARP single center prospective observational cohort study was conducted in the Queen Elizabeth University Hospital in Glasgow, Scotland. The study explored the feasibility of continuous respiratory rate capture by the PneumoWave DC_PT sensor. A total of 68 consenting participants with COVID-19 who were receiving treatment in the respiratory ward or high dependency unit were recruited and wore the PneumoWave DC_PT sensor until discharge or transfer to the intensive therapy unit. The data captured by the sensor for these participants is presented in this evaluation.

Results:

Sensor derived respiratory rate measurements were acquired for 91.0% of the total measurement hours. In contrast, manual respiratory rate counts performed in the ward setting as per routine practice, were acquired for 16.1% of possible hours during the study. Minute-by-minute respiratory rate data capture was also investigated. Usable respiratory rate measurements were obtained by the sensor for 47.0% of minutes across the total sensor measurement period. Notable increases in minute-by-minute respiratory rate measurements were observed in overnight periods when large scale body movements precluding accurate respiratory measurement were reduced.

Conclusions:

The prototype PneumoWave DC_PT sensor acquired high levels of respiratory rate data from study participants. The study results justify further investigation into the accuracy of the sensor acquired respiratory rate measurements compared to gold standard measurements of respiratory rate. Additionally the sensor has potential utility for wider use cases and the feasibility of the sensor for adoption into clinical practice both for patients requiring acute monitoring of respiratory status, and for patient populations vulnerable to respiratory instability including opiate users and patients with respiratory infections should be explored. Clinical Trial: The trial was registered at clinicaltrials.gov (reference NCT04668313).