With around 80% of hospitalized patients being prescribed intravenous (IV) fluid therapy^[1], physicians need fast and reliable insight into how patients are responding so they can effectively manage changes in their blood volume.

Incorrect intravascular volume can lead to severe complications, and even death. Reduced oxygen levels in organs can occur from a low volume, while fluid overload can result in swelling and organ damage, including respiratory failure. It’s been reported that 20% of patients on IV fluid therapy suffer complications due to incorrect fluid administration^[2] – so it’s essential that physicians get it right.

Studies show that a higher cumulative fluid balance is an important factor associated with 28-day mortality^[3]. In a European study of patients admitted to the intensive care unit (ICU), each 1 liter of positive fluid balance during the first 72 hours was associated with a 10% increase in mortality after adjustments for other risk factors.^[4]

With September designated as Sepsis Awareness Month, and the tenth annual World Sepsis Day this September 13th, there is a renewed focus on this global health crisis which affects up to 50 million people a year and is associated with 20% of all deaths worldwide.

Sepsis is a life-threatening condition which occurs when the body’s response to infection starts a chain reaction that injures its own tissues and organs. If not identified and treated rapidly, sepsis can lead to shock, organ failure and death. For those that survive, the physical damage caused by sepsis can negatively affect their health for the rest of their lifetime. .

While anyone can get sepsis from a bacterial or viral infection (including COVID-19), those most at risk are patients in intensive care or recovering from a procedure, people with weakened immune systems, chronic health conditions and the elderly.

Despite being a common cause of death in hospitals, sepsis is frequently underdiagnosed in the crucial early stages. And while educational campaigns to raise staff awareness and the development of hospital systems such as the ‘Sepsis Six Bundle’ have helped deliver prompt treatment, there is still scope for improvement. 

We’re all familiar with the scene: a critically ill patient is rushed into hospital and wheeled through the corridors on a gurney, a team of doctors running alongside. A clear bag of fluid is hooked up and the fluid drips intravenously into the patient’s bloodstream.

We assume this fluid is helping to keep the patient alive, to keep their organs functioning, but do we know that the patient is benefitting from this fluid intervention? Do we know if it’s the right fluid composition for this patient? Is it being administered at the right rate and in the correct quantity? 

These decisions often have to be made under extreme pressure in emergency wards and acute admission units. However, in many cases they are little more than guesswork, with insufficient information to go on, and this is putting patients at risk.

Non-invasive beat-by-beat monitoring can give medical staff the insight they need to be far more precise with fluid loading and thus eradicate the risk currently posed to patients.

While the world has been focusing on COVID-19, another pandemic has been growing in prevalence across the globe. Heart failure (HF) is on the rise and has been for some time. It currently affects around 26 million people worldwide and that figure is expected to go on rising.

Not only is HF a leading cause of death, particularly among the elderly population, the continuing treatment of HF survivors and those at risk also places an immense financial burden on the world’s health systems. 

In 2020, Giuseppe Lippi and Fabian Sanchis-Gomar aimed to provide an objective analysis of the worldwide epidemiological burden of HF. In their report, Global epidemiology and future trends of heart failure, they calculated the annual global expenditure on HF treatment to be US$ 346.17billion.

In a hospital, blood pressure is typically measured in one of two ways. For patients in need of continuous blood pressure monitoring (eg in the ICU or operating theatre), intra-arterial monitoring is the standard practice, involving the insertion of a catheter into an artery and the patient’s blood pressure being displayed continuously on a pressure wave monitor.

For the patient’s journey beyond the ICU, however, such invasive blood pressure (IBP) monitoring becomes impractical, for several reasons. In this article, we will look at those reasons and how a wearable continuous blood pressure monitor can improve the situation for patients, clinicians and hospitals.

VitalStream™, Featuring Patented Pulse Decomposition Analysis™ technology becomes the World’s First Wireless Wearable Monitor for Continuous Blood Pressure and Advanced Hemodynamics – All with a single, easy-to-apply Finger Sensor

The most common intervention performed in hospitals is the measurement of vital signs.  While nurses are confident about their ability to gather and interpret the data needed to identify patients at risk of deterioration, there are concerns about the frequency of observation and at times the accuracy of vital sign measurements.

A continuous, wearable vitals monitor could transform this aspect of critical care, affording patients greater comfort and less stress, while providing their clinical team with accurate, real-time information from anywhere in the hospital. Nurses will be able to spend more time using their observational skills at the bedside, while doctors will be able to intervene sooner when signs of deterioration are detected.

As we will see, this is a far cry from the way vital signs monitoring is implemented today.

The application of continuous blood pressure monitoring has historically been limited to the intensive Care Unit (ICU) and Post-Anesthesia Care Unit (PACU), due to the cost and invasiveness of the equipment. However, the development of ICU grade wearable patient monitors is opening up opportunities to widen the use of continuous blood pressure monitors across the healthcare spectrum, bringing numerous benefits.

Among the many benefits being brought to the healthcare service by wireless patient monitoring is the facility to escalate home care for both chronic and acute conditions.

Physicians have long recognized the benefits of care at home but hospitals have been reluctant to send acute patients home because it would have impacted on their revenue under the fee-for-service model. Now that the Centers for Medicare & Medicaid Services (CMS) have removed that obstacle by introducing the Acute Hospital Care At Home waiver, the road is clear for home care to grow apace. And wireless patient monitoring is making it possible.

As new variants of the COVID-19 virus continue to pile pressure on already strained health services around the world, what hope is there for the future of medicine? With an ageing global population and a growing shortage of medical professionals, how can the healthcare industry get on top of the burgeoning workload to create breathing space for medical practitioners and better outcomes for all patients?

Hope lies with digital technology. While front line medicine and cutting-edge technology have always gone hand in hand, there remains considerable capacity for healthcare in general to reap the benefits of digital. The technology exists to greatly increase the capacity, inclusivity, accuracy, speed, efficiency, personalization and ultimately the outcomes of healthcare. The question is, how quickly can we bring it to bear?