Accuracy of a Wrist-Worn Heart Rate Sensing Device during Elective Pediatric Surgical Procedures

Abstract

The reliability of wearable photoplethysmography (PPG) sensors to measure heart rate (HR) in hospitalized patients has only been demonstrated in adults. We evaluated the accuracy of HR monitoring with a personal fitness tracker (PFT) in children undergoing surgery. HR monitoring was performed using a wrist-worn PFT (Fitbit Charge HR) in 30 children (8.21 ± 3.09 years) undergoing laparoscopy (n = 8) or open surgery (n = 22). HR values were analyzed preoperatively and during surgery. The accuracy of HR recordings was compared with measurements recorded during continuous electrocardiographic (cECG) monitoring; HRs derived from continuous monitoring with pulse oximetry (SpO2R) were used as a positive control. PFT-derived HR values were in agreement with those recorded during cECG (r = 0.99) and SpO2R (r = 0.99) monitoring. PFT performance remained high in children < 8 years (r = 0.99), with a weight < 30 kg (r = 0.99) and when the HR was < 70 beats per minute (bpm) (r = 0.91) or > 140 bpm (r = 0.99). PFT accuracy was similar during laparoscopy and open surgery, as well as preoperatively and during the intervention (r > 0.9). PFT–derived HR showed excellent accuracy compared with HRs measured by cECG and SpO2R during pediatric surgical procedures. Further clinical evaluation is needed to define whether PFTs can be used in different health care settings.

Comparison of a Wearable Tracker with Actigraph for Classifying Physical Activity Intensity and Heart Rate in Children

“…Firstly, the Fitbit Charge HR did not perform well detecting heart rate compared to the Polar heart rate monitor. The findings contrast with a previous study [34] that compared heart rate values with measurements recorded during continuous electrocardiographic (cECG) monitoring in children (8.21 ± 3.09 years) undergoing surgery. In the study, the Fitbit Charge HR-derived HR showed excellent accuracy compared to HRs measured by cECG and Pulse Oximetry (SpO2R) during pediatric surgical procedures.…”

Towards remote monitoring in pediatric care and clinical trials—Tolerability, repeatability and reference values of candidate digital endpoints derived from physical activity, heart rate and sleep in healthy children

“…HR has been proposed as a candidate biomarker in, among others, pediatric pulmonology, intensive care and psychiatry [ 25 – 27 ], and remote non-invasive HR monitoring could extend this measurement to the home-setting. In the past, Pelizzo et al have shown that HR measured via PPG technology can be reliable in children [ 28 ]. Although performed in a surgery setting, direct comparison to ECG-derived HR demonstrated reliability.…”

“…While these graphically presented prediction intervals could be used as a screening tool for pediatric patients, individual predictions that take weather condition, wear time and city of residence into account may be more appropriate and can be calculated using the model coefficients in S2 Table. HR has been proposed as a candidate biomarker in, among others, pediatric pulmonology, intensive care and psychiatry [25][26][27], and remote non-invasive HR monitoring could extend this measurement to the home-setting. In the past, Pelizzo et al have shown that HR measured via PPG technology can be reliable in children [28]. Although performed in a surgery setting, direct comparison to ECG-derived HR demonstrated reliability.…”

Objective Home-Monitoring of Physical Activity, Cardiovascular Parameters, and Sleep in Pediatric Obesity

“…Multiple candidate biomarkers based on HR were examined in this study. HR was registered through a photoplethysmography sensor, which has shown an acceptable validity in adults and has demonstrated to be accurate in measuring HR in children undergoing elective surgery [23, 24]. Patients had a higher average nighttime HR compared to controls, with similar absolute differences compared to previous research with other methods of HR monitoring [25].…”