Changes in respiratory vital signs that accompany respiratory compromise often precede in-hospital deterioration and are associated with increased mortality.([FOOTNOTE=Barfod, C., Lauritzen, M. M., Danker, J. K., et al. Abnormal vital signs are strong predictors for intensive care unit admission and in-hospital mortality in adults triaged in the emergency department - a prospective cohort study. Scand J Trauma Resusc Emerg Med. 2012;20:28.],[ANCHOR=],[LINK=]),([FOOTNOTE=Buist, M., Bernard, S., Nguyen, T. V., Moore, G., & Anderson, J. Association between clinically abnormal observations and subsequent in-hospital mortality: a prospective study. Resuscitation. 2004;62(2):137-141.],[ANCHOR=],[LINK=]),([FOOTNOTE=Chaboyer, W., Thalib, L., Foster, M., Ball, C., & Richards, B. Predictors of adverse events in patients after discharge from the intensive care unit. Am J Crit Care. 2008;17(3):255-263; quiz 264.],[ANCHOR=],[LINK=])

Many in-hospital declines may be preventable with better respiratory monitoring and early intervention.([FOOTNOTE=Lee, L. A., Caplan, R. A., Stephens, L. S., et al. Postoperative opioid-induced respiratory depression: a closed claims analysis. Anesthesiology. 2015;122(3):659-665.],[ANCHOR=],[LINK=]),([FOOTNOTE=Quach, J. L., Downey, A. W., Haase, M., Haase-Fielitz, A., Jones, D., & Bellomo, R. Characteristics and outcomes of patients receiving a medical emergency team review for respiratory distress or hypotension. J Crit Care. 2008;23(3):325-331.],[ANCHOR=],[LINK=]),([FOOTNOTE=Taenzer, A. H., Pyke, J. B., McGrath, S. P., & Blike, G. T. Impact of pulse oximetry surveillance on rescue events and intensive care unit transfers: a before-and-after concurrence study. Anesthesiology. 2010;112(2):282-287.],[ANCHOR=],[LINK=])

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Respiratory Compromise Often Precedes In-Hospital Deterioration

Research has demonstrated that respiratory dysfunction is a known precursor of many in-hospital adverse events, and its presence prior to the adverse events is associated with a higher rate of mortality.([FOOTNOTE=Considine J. The role of nurses in preventing adverse events related to respiratory dysfunction: literature review. J Adv Nurs 2005; 49(6):624-33.],[ANCHOR=],[LINK=]) Clinical studies evaluating the relationship between abnormal vital sign observations and patient outcome have shown the respiratory parameters are the most predictive of adverse outcome.1-3, ([FOOTNOTE=Ljunggren M, Castren M, Nordberg M, et al. The association between vital signs and mortality in a retrospective cohort study of an unselected emergency department population. Scand J Trauma Resusc Emerg Med. 2016;24:21.],[ANCHOR=],[LINK=]), ([FOOTNOTE=Peberdy MA, Ornato J P, Larkin GL, et al. Survival from in-hospital cardiac arrest during nights and weekends. JAMA. 2008;299(7):785-792.],[ANCHOR=],[LINK=]),([FOOTNOTE=Vohra HA, Goldsmith IR, Rosin MD, et al. The predictors and outcome of recidivism in cardiac ICUs. Eur J Cardiothorac Surg. 2005;27(3):508-511.],[ANCHOR=],[LINK=])

Decline of Respiratory Compromise May Be Preventable With Better Monitoring

Multiple clinical studies have evaluated the utility of integrating continuous monitoring of patient respiratory status to increase early identification of respiratory compromise and improve outcome.6,([FOOTNOTE=Sun Z, Sessler DI, Dalton JE, et al. Postoperative Hypoxemia Is Common and Persistent: A Prospective Blinded Observational Study. Anesth Analg. 2015;121(3):709-715.],[ANCHOR=],[LINK=])

Learn more about each of these studies outlining the importance of continuous monitoring.


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