Authors: Mølgaard et al.
Journal: Anesthesia & Analgesia published: October 2025
Summary:
This randomized clinical trial evaluated whether continuous wireless vital sign monitoring with real-time alerts could improve postoperative outcomes after major noncardiac surgery. The authors note that complications occur in about one-third of patients after major surgery and are often preceded by abnormal vital signs that may be missed with routine intermittent ward monitoring.
The study included 400 adult patients undergoing major noncardiac surgery. Patients were randomized to either standard care with manual intermittent vital sign monitoring or standard care plus continuous wireless vital sign monitoring. In the intervention group, real-time alerts were sent to staff smartphones when abnormal vital signs were detected on the general postoperative ward.
The primary outcome was the cumulative duration of severe vital sign deviations, including low oxygen saturation, tachycardia, bradycardia, tachypnea, bradypnea, hypotension, and hypertension. Secondary outcomes included adverse events within 30 days.
The trial found no statistically significant reduction in the total cumulative duration of severe vital sign deviations. The median duration was 60 minutes per day in the continuous monitoring group compared with 76 minutes per day in the control group.
However, the intervention group had a significant reduction in time spent with oxygen saturation below 88%. The mean reduction in desaturation time was 47 minutes per day. The study also found fewer overall adverse events within 30 days in the intervention group. Adverse events occurred in 42.5% of control patients compared with 31.5% of patients who received continuous monitoring. Serious adverse events were not significantly different between groups.
Why this matters:
This study suggests that continuous vital sign monitoring on the surgical ward may help reduce important postoperative oxygen desaturation events and may reduce overall adverse events. However, it did not significantly reduce the combined total burden of all severe vital sign abnormalities in this trial.
Take-home point:
Continuous wireless vital sign monitoring with real-time alerts did not significantly reduce the total duration of combined severe vital sign deviations after major noncardiac surgery, but it did reduce critical desaturation time and was associated with fewer 30-day adverse events.
Thank you to Anesthesia & Analgesia for publishing this article and allowing us to summarize it.