• Niels Kant, Guido M Peters, Brenda J Voorthuis, Groothuis-OudshoornCatharina G MCGMTechnical Medical Centre, Department of Health Technology and Services Research, University of Twente, Enschede, The Netherlands., Mark V Koning, Bart P L Witteman, Myra Rinia-Feenstra, and DoggenCarine J MCJM0000-0003-4766-4333Scientific Bureau, Rijnstate Hospital, Rijnstate Research Center, Wagnerlaan 55, PO Box 9555, 6800 TA, Arnhem, The Netherlands. cdoggen@rijnstate.nl.Technical Medical Centre, Department of Health Technology and Servic.
• Department of Anesthesiology and Pain Management, Rijnstate Hospital, Arnhem, The Netherlands.
• J Clin Monit Comput. 2022 Oct 1; 36 (5): 1449-1459.

AbstractOur aim was to determine the agreement of heart rate (HR) and respiratory rate (RR) measurements by the Philips Biosensor with a reference monitor (General Electric Carescape B650) in severely obese patients during and after bariatric surgery. Additionally, sensor reliability was assessed. Ninety-four severely obese patients were monitored with both the Biosensor and reference monitor during and after bariatric surgery. Agreement was defined as the mean absolute difference between both monitoring devices. Bland Altman plots and Clarke Error Grid analysis (CEG) were used to visualise differences. Sensor reliability was reflected by the amount, duration and causes of data loss. The mean absolute difference for HR was 1.26 beats per minute (bpm) (SD 0.84) during surgery and 1.84 bpm (SD 1.22) during recovery, and never exceeded the 8 bpm limit of agreement. The mean absolute difference for RR was 1.78 breaths per minute (brpm) (SD 1.90) during surgery and 4.24 brpm (SD 2.75) during recovery. The Biosensor's RR measurements exceeded the 2 brpm limit of agreement in 58% of the compared measurements. Averaging 15 min of measurements for both devices improved agreement. CEG showed that 99% of averaged RR measurements resulted in adequate treatment. Data loss was limited to 4.5% of the total duration of measurements for RR. No clear causes for data loss were found. The Biosensor is suitable for remote monitoring of HR, but not RR in morbidly obese patients. Future research should focus on improving RR measurements, the interpretation of continuous data, and development of smart alarm systems.© 2021. The Author(s), under exclusive licence to Springer Nature B.V.

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