Systematical conception, design and development of C++ software for transfer of biomedical data via the hardware API of a clinical patient monitor

Abstract

Patient monitoring in hospitals belongs to the most important clinical instruments to evaluate the health status of critically ill patients. Especially in the perioperative setting, the probability of patients experiencing adverse health conditions is still very high. Cardiopulmonary complications notably contribute to the patients health deteriorations, however, the acute organ injuries are the most serious reasons of perioperative mortality. Additional adverse effects such as patient comorbidity and surgical complexity increase the 48-hour and 30-day postoperative mortality about the 12 times and 4 times, respectively. Thus, early and accurate identification of the unfavorable effects is exceedingly important. Nevertheless, the common patient monitoring systems of modern hospitals merely capture the standard vital signs of patients missing novel vitals such as cumulative time of desaturation and hypotension. Whats more, the recorded biosignals are rarely persisted with a sufficient sampling resolution for further processing. Those restrictions make the evaluation process of biosignals much more difficult and substantially limit the decision-making process of clinicians in the perioperative setting. Although the most hospitals dispose of a sufficient hardware equipment, the recorded data isnt processed after its storage. This fact substantially limits the effectiveness of the risk prediction systems evoking a timely intervention of the clinical personnel. The present work introduces an easy-to-use, vital sign assessment system supporting the real-time evaluation and high-resolution, multiparametric analysis. The developed tool, Vital-signs REal-time Analysis for Clinical Translation (VREACT) provides a simple graphical environment facilitating the real-time, vital sign tracking as well as flexible biosignal recording ensuring a consistent data storage. The tool interacts with the specific patient monitoring device, Infinity® Delta ensuring the access to the physiological information. Finally, a short experiment evaluating the accuracy and consistency of the recorded experimental measurements was conducted. Hereby, a test measurement storing the recorded vital parameters across 3 different ICUs was performed. The experiment confirmed the potential of the high-resolution vital sign recorder in the perioperative setting. The tool delivered 20 consistent biosignal records consisted of standard and novel physiological parameters. Conclusively, the software enhanced the automation of the whole signal acquisition process and enabled a real-time remote tracking of the novel physiological parameters. In the future work, additional functions like an advanced database search or a predictive alarm system might extend the capabilities of the tool.