Reduction of unexpected, life-threatening events in postoperative cardiac surgical patients; the role of computerized surveillance.
With increasing use of computerized surveillance (CS) in critical care, a key question is whether it favorably influences clinical outcome. Knowing that two intensive care unit beds would soon have CS capability, we embarked on an uninterrupted prospective study in which the incidence of sudden, unexpected life-threatening events (SULTE) was compared in post-open heart surgery patients whose subsystem performances were evaluated by conventional methods (CM) as opposed to those who would be followed by CS involving automatic acquisition and generation of 30 cardio-respiratory variables. We evaluated 211 patients, 91 with CM and 120 by CS. Since CS availability was limited, sicker patients were given priority for the two CS beds. Despite the obvious bias in favor of CM, there was a statistically significant reduction (P less than 0.001) in the incidence of SULTE in those patients followed by CS (1 of 120 patients: 0.8%; no SULTE-related deaths) in comparison to the CM patients (11 of 91 patients: 12%; two SULTE-related deaths.) The data suggest that computerized surveillance can play a role in reducing morbidity and possibly mortality in postoperative cardiac surgical patients.
D000328:Adult; D001784:Blood Gas Analysis; D002302:Cardiac Output; D006348:Cardiac Surgical Procedures; D003201:Computers; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D011182:Postoperative Care; D011183:Postoperative Complications / Q000517:prevention & control*; D012119:Respiration