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Smith S, Houghton A, Mockeridge B, van Zundert A. The Internet, Apps, and the Anesthesiologist. Healthcare (Basel) 2023; 11:3000. [PMID: 37998492 PMCID: PMC10671284 DOI: 10.3390/healthcare11223000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 11/16/2023] [Accepted: 11/16/2023] [Indexed: 11/25/2023] Open
Abstract
Modern anesthesia continues to be impacted in new and unforeseen ways by digital technology. Combining portability and versatility, mobile applications or "apps" provide a multitude of ways to enhance anesthetic and peri-operative care. Research suggests that the uptake of apps into anesthetic practice is becoming increasingly routine, especially amongst younger anesthetists brought up in the digital age. Despite this enthusiasm, there remains no consensus on how apps are safely and efficiently integrated into anesthetic practice. This review summarizes the most popular forms of app usage in anesthesia currently and explores the challenges and opportunities inherent in implementing app use in anesthesia, with an emphasis on a practical approach for the modern anesthetist.
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Affiliation(s)
- Samuel Smith
- Department of Intensive Care Medicine, Redcliffe Hospital, Brisbane, QLD 4020, Australia
- Faculty of Medicine, University of Queensland, Brisbane, QLD 4072, Australia; (A.H.)
| | - Andrew Houghton
- Faculty of Medicine, University of Queensland, Brisbane, QLD 4072, Australia; (A.H.)
- Department of Anesthesia and Peri-operative Medicine, Royal Brisbane and Women’s Hospital, Brisbane, QLD 4029, Australia
| | - Brydie Mockeridge
- Faculty of Medicine, University of Queensland, Brisbane, QLD 4072, Australia; (A.H.)
- Department of Anesthesia, Mater Hospital, Brisbane, QLD 4101, Australia
| | - André van Zundert
- Faculty of Medicine, University of Queensland, Brisbane, QLD 4072, Australia; (A.H.)
- Department of Anesthesia and Peri-operative Medicine, Royal Brisbane and Women’s Hospital, Brisbane, QLD 4029, Australia
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Desebbe O, Anas C, Alexander B, Kouz K, Knebel JF, Schoettker P, Creteur J, Vincent JL, Joosten A. Evaluation of a novel optical smartphone blood pressure application: a method comparison study against invasive arterial blood pressure monitoring in intensive care unit patients. BMC Anesthesiol 2022; 22:259. [PMID: 35971072 PMCID: PMC9376576 DOI: 10.1186/s12871-022-01797-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 08/02/2022] [Indexed: 11/18/2022] Open
Abstract
Background Arterial hypertension is a worldwide public health problem. While it is currently diagnosed and monitored non-invasively using the oscillometric method, having the ability to measure blood pressure (BP) using a smartphone application could provide more widespread access to hypertension screening and monitoring. In this observational study in intensive care unit patients, we compared blood pressure values obtained using a new optical smartphone application (OptiBP™; test method) with arterial BP values obtained using a radial artery catheter (reference method) in order to help validate the technology. Methods We simultaneously measured three BP values every hour for five consecutive hours on two consecutive days using both the smartphone and arterial methods. Bland–Altman and error grid analyses were used for agreement analysis between both approaches. The performance of the smartphone application was investigated using the Association for the Advancement of Medical Instrumentation (AAMI) and the International Organization for Standardization (ISO) definitions, which require the bias ± SD between two technologies to be below 5 ± 8 mmHg. Results Among the 30 recruited patients, 22 patients had adequate OptiBP™ values and were thus analyzed. In the other 8 patients, no BP could be measured due to inadequate signals. The Bland–Altman analysis revealed a mean of the differences ± SD between both methods of 0.9 ± 7 mmHg for mean arterial pressure (MAP), 0.2 ± 14 mmHg for systolic arterial pressure (SAP), and 1.1 ± 6 mmHg for diastolic arterial pressure (DAP). Error grid analysis demonstrated that the proportions of measurement pairs in risk zones A to E were 88.8% (no risk), 10% (low risk), 1% (moderate risk), 0% (significant risk), and 0% (dangerous risk) for MAP and 88.4%, 8.6%, 3%, 0%, 0%, respectively, for SAP. Conclusions This method comparison study revealed good agreement between BP values obtained using the OptiBP™ and those done invasively. The OptiBP™ fulfills the AAMI/ISO universal standards for MAP and DAP (but not SAP). Error grid showed that the most measurements (≥ 97%) were in risk zones A and B. Trial registration ClinicalTrials.gov registration: NCT04728477
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Affiliation(s)
- Olivier Desebbe
- Department of Anesthesiology and Intensive Care, Clinique de La Sauvegarde, 80 Avenue Ben Gourion, 69009, Lyon, France
| | - Chbabou Anas
- Department of Anesthesiology, CUB Erasme University Hospital, Université Libre de Bruxelles, 808 Route de Lennik, 1070, Brussels, Belgium
| | - Brenton Alexander
- Department of Anesthesiology and Perioperative Care, University of California San Diego, San Diego, CA, USA
| | - Karim Kouz
- Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | | | - Patrick Schoettker
- Biospectal SA, 1003, Lausanne, Switzerland.,Department of Anesthesiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Jacques Creteur
- Department of Intensive Care, CUB Erasme University Hospital, Université Libre de Bruxelles, 808 Route de Lennik, 1070, Brussels, Belgium
| | - Jean-Louis Vincent
- Department of Intensive Care, CUB Erasme University Hospital, Université Libre de Bruxelles, 808 Route de Lennik, 1070, Brussels, Belgium
| | - Alexandre Joosten
- Department of Anesthesiology, CUB Erasme University Hospital, Université Libre de Bruxelles, 808 Route de Lennik, 1070, Brussels, Belgium. .,Department of Anesthesiology, Paul Brousse Hospital, Université Paris-Sud, Villejuif, France.
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Evaluation of a new smartphone optical blood pressure application (OptiBP™) in the post-anesthesia care unit: a method comparison study against the non-invasive automatic oscillometric brachial cuff as the reference method. J Clin Monit Comput 2022; 36:1525-1533. [PMID: 34978654 DOI: 10.1007/s10877-021-00795-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 12/20/2021] [Indexed: 11/27/2022]
Abstract
We compared blood pressure (BP) values obtained with a new optical smartphone application (OptiBP™) with BP values obtained using a non-invasive automatic oscillometric brachial cuff (reference method) during the first 2 h of surveillance in a post-anesthesia care unit in patients after non-cardiac surgery. Three simultaneous BP measurements of both methods were recorded every 30 min over a 2-h period. The agreement between measurements was investigated using Bland-Altman and error grid analyses. We also evaluated the performance of the OptiBP™ using ISO81060-2:2018 standards which requires the mean of the differences ± standard deviation (SD) between both methods to be less than 5 mmHg ± 8 mmHg. Of 120 patients enrolled, 101 patients were included in the statistical analysis. The Bland-Altman analysis demonstrated a mean of the differences ± SD between the test and reference methods of + 1 mmHg ± 7 mmHg for mean arterial pressure (MAP), + 2 mmHg ± 11 mmHg for systolic arterial pressure (SAP), and + 1 mmHg ± 8 mmHg for diastolic arterial pressure (DAP). Error grid analysis showed that the proportions of measurement pairs in risk zones A to E were 90.3% (no risk), 9.7% (low risk), 0% (moderate risk), 0% (significant risk), 0% (dangerous risk) for MAP and 89.9%, 9.1%, 1%, 0%, 0% for SAP. We observed a good agreement between BP values obtained by the OptiBP™ system and BP values obtained with the reference method. The OptiBP™ system fulfilled the AAMI validation requirements for MAP and DAP and error grid analysis indicated that the vast majority of measurement pairs (≥ 99%) were in risk zones A and B.Trial Registration ClinicalTrials.gov Identifier: NCT04262323.
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Zenilman ME. Mobile apps and surgical patients- we are getting closer. Am J Surg 2021; 223:855-856. [PMID: 34836602 DOI: 10.1016/j.amjsurg.2021.11.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 11/08/2021] [Indexed: 11/01/2022]
Affiliation(s)
- Michael E Zenilman
- Department of Surgery, Weill Cornell Medicine, New York Presbyterian Brooklyn Methodist Hospital. 506 - 6th Street, 6th Floor - Buckley Building Brooklyn, New York, 11215, USA.
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Bodys-Pełka A, Kusztal M, Boszko M, Główczyńska R, Grabowski M. Non-Invasive Continuous Measurement of Haemodynamic Parameters-Clinical Utility. J Clin Med 2021; 10:jcm10214929. [PMID: 34768449 PMCID: PMC8584279 DOI: 10.3390/jcm10214929] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 10/15/2021] [Accepted: 10/20/2021] [Indexed: 11/16/2022] Open
Abstract
The evaluation and monitoring of patients’ haemodynamic parameters are essential in everyday clinical practice. The application of continuous, non-invasive measurement methods is a relatively recent solution. CNAP, ClearSight and many other technologies have been introduced to the market. The use of these techniques for assessing patient eligibility before cardiac procedures, as well as for intraoperative monitoring is currently being widely investigated. Their numerous advantages, including the simplicity of application, time- and cost-effectiveness, and the limited risk of infection, could enforce their further development and potential utility. However, some limitations and contradictions should also be discussed. The aim of this paper is to briefly describe the new findings, give practical examples of the clinical utility of these methods, compare them with invasive techniques, and review the literature on this subject.
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Affiliation(s)
- Aleksandra Bodys-Pełka
- 1st Department of Cardiology, Medical University of Warsaw, 02-097 Warsaw, Poland; (A.B.-P.); (M.K.); (M.B.); (M.G.)
- Doctoral School, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Maciej Kusztal
- 1st Department of Cardiology, Medical University of Warsaw, 02-097 Warsaw, Poland; (A.B.-P.); (M.K.); (M.B.); (M.G.)
| | - Maria Boszko
- 1st Department of Cardiology, Medical University of Warsaw, 02-097 Warsaw, Poland; (A.B.-P.); (M.K.); (M.B.); (M.G.)
| | - Renata Główczyńska
- 1st Department of Cardiology, Medical University of Warsaw, 02-097 Warsaw, Poland; (A.B.-P.); (M.K.); (M.B.); (M.G.)
- Correspondence: ; Tel.: +48-5992-616
| | - Marcin Grabowski
- 1st Department of Cardiology, Medical University of Warsaw, 02-097 Warsaw, Poland; (A.B.-P.); (M.K.); (M.B.); (M.G.)
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