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Updated: Mar 27, 2026

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Continuous vs Intermittent Postoperative Vital Sign Monitoring: A Cluster Randomized Crossover Trial.

Ashish K Khanna1,2,3, Nathaniel Sean O'Connell4, Amit K Saha1,2

  • 1Division of Critical Care Medicine, Department of Anesthesiology, Wake Forest University School of Medicine, Atrium Health Wake Forest Baptist Medical Center, Winston-Salem, North Carolina.

JAMA Network Open
|March 26, 2026
PubMed
Summary
This summary is machine-generated.

Continuous monitoring of vital signs in postoperative patients reduced the duration of oxygen desaturation. This early detection may prevent serious complications, highlighting the need for further patient-centered outcome studies.

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Area of Science:

  • Medical monitoring
  • Postoperative care
  • Clinical trials

Background:

  • Continuous postoperative monitoring can detect vital sign abnormalities missed by intermittent monitoring.
  • Early recognition of abnormalities may prompt interventions to mitigate harmful perturbations in blood pressure, heart rate, and oxygen saturation.

Purpose of the Study:

  • To test if continuous unblinded monitoring of vital signs decreases blood pressure, heart rate, and oxygen saturation abnormalities compared to intermittent monitoring.
  • To evaluate the impact of continuous monitoring on patient recovery after noncardiac surgery.

Main Methods:

  • A multiple crossover randomized cluster trial was conducted in two postoperative hospital wards.
  • Patients undergoing noncardiac surgery were monitored using either continuous unblinded or clinician-blinded intermittent vital sign monitoring over a 1-year period.
  • Primary outcomes included durations of hypotension, hypoxemia, and tachycardia exceeding alert thresholds within 48 hours post-admission.

Main Results:

  • Continuous monitoring significantly reduced the duration of oxygen saturation below 90% by approximately 30 minutes over 48 hours (P=.002).
  • No significant reductions were observed in the durations of hypotension or tachycardia.
  • The number of interventions, such as new oxygen therapy, was similar between continuous and intermittent monitoring groups.

Conclusions:

  • Continuous vital sign monitoring effectively reduced the duration of desaturation in patients recovering from noncardiac surgery on general hospital wards.
  • While continuous monitoring showed benefits for oxygen saturation, further research is needed to explore its impact on other vital signs and patient outcomes.
  • Robust patient-centered outcomes trials are warranted to fully assess the benefits of continuous monitoring in postoperative care.