P24 COVID-19 advanced respiratory physiology (CARP) wearable respiratory monitoring: early insights

S. Lua, D. Lowe, A. Taylor, M. Sim, B. Henderson, C. Trueman, O. Meredith, S. Burns, P. McGuinness, C. Carlin
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Abstract

P24 Figure 1CARP trial wearable respiratory rate, respiratory support and outcome data from 3 patients with severe COVID-19[Figure omitted. See PDF]Results156 patients were screened, with 77 recruited to the CARP trial. 32 patients required non-invasive respiratory support, of which 14 were escalated to mechanical intubation. 17 patients died within trial.Bland-Altman analyses of paired RR data confirmed that wearable sensor data shows good agreement with critical care RR monitoring (Phillips Intellivue MX700), and that ward-based intermittent clinician RR measurements were imprecise.From the initial utility review of CARP physiology data visualisations, rising hourly average RR >25/min is associated with subsequent patient deterioration. Improving and stable hourly average RR of <25/min associates with stable respiratory failure and improvement to hospital discharge (figure 1).ConclusionContinuous wearable respiratory rate remote monitoring in COVID-19 inpatients is feasible. Planned machine learning and time-series analyses of the detailed physiology and clinical endpoint data will determine appropriate cut-offs and feature importance for deteriorating patient risk predictions. The CARP clinical dashboard provides an infrastructure for future implementation and evaluation of these AI insights.
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P24 COVID-19高级呼吸生理学(CARP)可穿戴呼吸监测:早期见解
P24图1 3例重症COVID-19患者carp试验可穿戴呼吸率、呼吸支持及转归数据[图略]。结果156名患者被筛选,其中77名被招募到CARP试验中。32例患者需要无创呼吸支持,其中14例升级为机械插管。17名患者在试验期间死亡。Bland-Altman对配对RR数据的分析证实,可穿戴传感器数据与重症监护RR监测(Phillips Intellivue MX700)吻合良好,基于病房的间歇临床医生RR测量不精确。从CARP生理学数据可视化的初始效用回顾来看,每小时平均RR >25/min的上升与随后的患者恶化有关。改善并稳定<25/min的小时平均RR与稳定的呼吸衰竭和出院改善相关(图1)。结论持续可穿戴式呼吸率远程监测在COVID-19住院患者中是可行的。有计划的机器学习和详细的生理和临床终点数据的时间序列分析将确定适当的截止点,并对恶化的患者风险预测具有重要意义。CARP临床指示板为这些人工智能见解的未来实现和评估提供了基础设施。
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