The role of the Corsano CardioWatch in continuous vital sign monitoring for early sepsis detection

IF 8.8 1区 医学 Q1 CRITICAL CARE MEDICINE
Sven-Olaf Kuhn, Sebastian Gibb, Matthias Gründling
{"title":"The role of the Corsano CardioWatch in continuous vital sign monitoring for early sepsis detection","authors":"Sven-Olaf Kuhn, Sebastian Gibb, Matthias Gründling","doi":"10.1186/s13054-025-05365-z","DOIUrl":null,"url":null,"abstract":"<p>Sepsis is a critical medical emergency frequently associated with significant organ failure and high mortality rates. Early detection is crucial, as delays in treatment substantially increase the risk of fatal outcomes with each passing hour. However, no specific molecular marker or definitive blood test for sepsis detection exists.</p><p>Early warning scores (EWS), such as the National Early Warning Score (NEWS), are widely used in hospitals to identify clinical deterioration. In general hospital wards, sepsis detection relies primarily on intermittent vital sign measurements, including heart rate (HR), blood pressure (BP), and body temperature, with less frequent monitoring of oxygen saturation (SpO<sub>2</sub>) and respiratory rate (RR). However, these measurements are typically taken only a few times daily, creating a gap where early signs of deterioration may go unnoticed—especially at night or in outpatient settings.</p><p>A recent study demonstrated that an electronic alert system integrating qSOFA components, refreshing electronic medical records (EMRs) every four hours, significantly reduced 90-day in-hospital mortality [1]. This underscores the potential of continuous sepsis screening via biosensors as a valuable strategy for improving patient safety and reducing sepsis-related mortality.</p><h3>The emergence of wearable biosensors for sepsis detection</h3><p>Advancements in wearable and wireless sensors now allow real-time, continuous monitoring of vital signs. These cost-effective solutions enhance patient observation and facilitate early intervention by triggering alarms when physiological parameters indicate potential deterioration. However, ensuring high data quality, system interoperability, and intelligent alerting remains challenging.</p><p>Several wearable biosensors have shown promising results. Most available devices are still limited in how many parameters they can measure accurately. Additionally, many devices require adhesive electrodes on the chest or additional sensors for measuring temperature in the armpit or SpO<sub>2</sub> at the fingertip. These features often reduce patient comfort and adherence to continuous monitoring.</p><p>Biosensors must be minimally invasive and comfortable to wear for extended periods for optimal patient acceptance. Current wrist-worn biosensors offer a promising solution by providing high-quality data on vital parameters necessary for calculating the NEWS2 score, which the British NHS endorses as an improvement over the original NEWS. This score helps assess the severity of a patient's condition and ensures timely critical care interventions.</p><h3>Pilot study: feasibility of remote wireless monitoring</h3><p>In a pilot study, we assessed the feasibility of wireless remote monitoring in general hospital wards using a smart, cable-free wrist device (Corsano CardioWatch 287-2) designed for continuous vital sign measurement in long-term hospitalized patients (Fig. 1). The primary goal was to facilitate early detection of sepsis and improve patient outcomes through timely intervention.</p><figure><figcaption><b data-test=\"figure-caption-text\">Fig. 1</b></figcaption><picture><source srcset=\"//media.springernature.com/lw685/springer-static/image/art%3A10.1186%2Fs13054-025-05365-z/MediaObjects/13054_2025_5365_Fig1_HTML.png?as=webp\" type=\"image/webp\"/><img alt=\"figure 1\" aria-describedby=\"Fig1\" height=\"348\" loading=\"lazy\" src=\"//media.springernature.com/lw685/springer-static/image/art%3A10.1186%2Fs13054-025-05365-z/MediaObjects/13054_2025_5365_Fig1_HTML.png\" width=\"685\"/></picture><p>Overview of continuous remote monitoring system using AI-enhanced NEWS2 for early sepsis detection</p><span>Full size image</span><svg aria-hidden=\"true\" focusable=\"false\" height=\"16\" role=\"img\" width=\"16\"><use xlink:href=\"#icon-eds-i-chevron-right-small\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"></use></svg></figure><p>The Corsano CardioWatch is a CE-marked medical device certified under EU MDR standards and cleared by FDA 510(k). It continuously measures pulse rate, heart rate variability (R-R intervals), ECG, SpO<sub>2</sub>, respiration rate, blood pressure, core body temperature, activity, and sleep. Data is transmitted wirelessly from the wristband to a smartphone, integrated into the hospital-wide Wi-Fi system, and stored in a secure health cloud for further analysis. Continuous blood pressure monitoring without a cuff was advantageous, improving patient compliance and ease of use.</p><p>Our study, which included 34 patients wearing the wristband for 14 days, demonstrated high comfort and adherence, with no reports of discomfort and only two cases of mild skin irritation associated with the silicone strap, both of which were resolved by switching to a fabric strap. Data transmission was seamless, with Bluetooth efficiently relaying information from the wristband to mobile devices and subsequently via Wi-Fi to the cloud. The quality of the recorded physiological data was consistently high, stable, and sufficiently detailed for detecting early signs of clinical deterioration, including sepsis-related changes. The system reliably captured and stored continuous measurements without significant data loss or signal degradation, underscoring its suitability for integration into automated early warning systems to enhance clinical decision-making and patient safety. Additionally, the device’s compatibility with remote inpatient, outpatient, and home care settings highlights its potential for broader clinical integration, offering a scalable and effective solution for long-term monitoring.</p><p>The Corsano CardioWatch wearable sensor offers a transformative approach to sepsis detection by enabling continuous, real-time monitoring of vital signs. Integrating these devices with early warning systems, such as NEWS2, can enhance the early identification of clinical deterioration, reduce hospital mortality, and improve overall patient management.</p><p>Despite data quality, interoperability, and intelligent alerting challenges, research and development in wearable technology continue to refine their clinical utility. Future studies should explore how AI-driven predictive models can enhance biosensor-based early warning systems, paving the way for a new era in patient safety and clinical care.</p><p>All data used and analyzed during the current study are available from the corresponding author upon reasonable request.</p><dl><dt style=\"min-width:50px;\"><dfn>AI:</dfn></dt><dd>\n<p>Artificial Intelligence</p>\n</dd><dt style=\"min-width:50px;\"><dfn>EWS:</dfn></dt><dd>\n<p>Early Warning Score</p>\n</dd><dt style=\"min-width:50px;\"><dfn>NEWS:</dfn></dt><dd>\n<p>National Early Warning Score</p>\n</dd><dt style=\"min-width:50px;\"><dfn>HR:</dfn></dt><dd>\n<p>Heart Rate</p>\n</dd><dt style=\"min-width:50px;\"><dfn>BP:</dfn></dt><dd>\n<p>Blood Pressure</p>\n</dd><dt style=\"min-width:50px;\"><dfn>SpO<sub>2</sub> :</dfn></dt><dd>\n<p>Oxygen saturation</p>\n</dd><dt style=\"min-width:50px;\"><dfn>RR:</dfn></dt><dd>\n<p>Respiratory Rate</p>\n</dd><dt style=\"min-width:50px;\"><dfn>ECG:</dfn></dt><dd>\n<p>Electrocardiography</p>\n</dd><dt style=\"min-width:50px;\"><dfn>qSOFA:</dfn></dt><dd>\n<p>Quick-SOFA-score, Sequential Organ Failure Assessment</p>\n</dd><dt style=\"min-width:50px;\"><dfn>EMRs:</dfn></dt><dd>\n<p>Electronic Medical Records</p>\n</dd><dt style=\"min-width:50px;\"><dfn>CE:</dfn></dt><dd>\n<p>Conformité Européenne</p>\n</dd><dt style=\"min-width:50px;\"><dfn>EU MDR:</dfn></dt><dd>\n<p>European Medical Device Regulation</p>\n</dd></dl><ol data-track-component=\"outbound reference\" data-track-context=\"references section\"><li data-counter=\"1.\"><p>Arabi YM, Alsaawi A, Alzahrani M, et al. Electronic sepsis screening among patients admitted to hospital wards: a stepped-wedge cluster randomized trial. JAMA. 2025;333(9):763–773. https://doi.org/10.1001/jama.2024.25982.</p></li></ol><p>Download references<svg aria-hidden=\"true\" focusable=\"false\" height=\"16\" role=\"img\" width=\"16\"><use xlink:href=\"#icon-eds-i-download-medium\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"></use></svg></p><p>We sincerely appreciate the support of Corsano Health B.V.: Casper van Eijk and Peter Stas. Corsano Health supplied the CardioWatch, the mobile phones and manages the cloud database.</p><p>Corsano Health supplied the CardioWatch, the mobile phones and manages the cloud database.</p><h3>Authors and Affiliations</h3><ol><li><p>Department of Anesthesia and Intensive Care Medicine, Greifswald University Medicine, Greifswald, Germany</p><p>Sven-Olaf Kuhn, Sebastian Gibb &amp; Matthias Gründling</p></li></ol><span>Authors</span><ol><li><span>Sven-Olaf Kuhn</span>View author publications<p><span>You can also search for this author in</span><span>PubMed<span> </span>Google Scholar</span></p></li><li><span>Sebastian Gibb</span>View author publications<p><span>You can also search for this author in</span><span>PubMed<span> </span>Google Scholar</span></p></li><li><span>Matthias Gründling</span>View author publications<p><span>You can also search for this author in</span><span>PubMed<span> </span>Google Scholar</span></p></li></ol><h3>Contributions</h3><p>SOK and MG wrote the main manuscript text and prepared Fig. 1. All authors reviewed the manuscript.</p><h3>Corresponding author</h3><p>Correspondence to Sven-Olaf Kuhn.</p><h3>Ethics approval and consent to participate</h3>\n<p>The studies involving human participants were reviewed and approved by the Ethics Committee of Greifswald University Hospital (BB 050/24). The patients provided their written informed consent to participate in this study.</p>\n<h3>Consent for publication</h3>\n<p>Not applicable.</p>\n<h3>Competing interests</h3>\n<p>The authors declare no competing interests.</p><h3>Publisher's Note</h3><p>Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.</p><p><b>Open Access</b> This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.</p>\n<p>Reprints and permissions</p><img alt=\"Check for updates. 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The role of the Corsano CardioWatch in continuous vital sign monitoring for early sepsis detection. <i>Crit Care</i> <b>29</b>, 144 (2025). https://doi.org/10.1186/s13054-025-05365-z</p><p>Download citation<svg aria-hidden=\"true\" focusable=\"false\" height=\"16\" role=\"img\" width=\"16\"><use xlink:href=\"#icon-eds-i-download-medium\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"></use></svg></p><ul data-test=\"publication-history\"><li><p>Received<span>: </span><span><time datetime=\"2025-02-28\">28 February 2025</time></span></p></li><li><p>Accepted<span>: </span><span><time datetime=\"2025-03-09\">09 March 2025</time></span></p></li><li><p>Published<span>: </span><span><time datetime=\"2025-04-01\">01 April 2025</time></span></p></li><li><p>DOI</abbr><span>: </span><span>https://doi.org/10.1186/s13054-025-05365-z</span></p></li></ul><h3>Share this article</h3><p>Anyone you share the following link with will be able to read this content:</p><button data-track=\"click\" data-track-action=\"get shareable link\" data-track-external=\"\" data-track-label=\"button\" type=\"button\">Get shareable link</button><p>Sorry, a shareable link is not currently available for this article.</p><p data-track=\"click\" data-track-action=\"select share url\" data-track-label=\"button\"></p><button data-track=\"click\" data-track-action=\"copy share url\" data-track-external=\"\" data-track-label=\"button\" type=\"button\">Copy to clipboard</button><p> Provided by the Springer Nature SharedIt content-sharing initiative </p>","PeriodicalId":10811,"journal":{"name":"Critical Care","volume":"8 1","pages":""},"PeriodicalIF":8.8000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Critical Care","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s13054-025-05365-z","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CRITICAL CARE MEDICINE","Score":null,"Total":0}
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Abstract

Sepsis is a critical medical emergency frequently associated with significant organ failure and high mortality rates. Early detection is crucial, as delays in treatment substantially increase the risk of fatal outcomes with each passing hour. However, no specific molecular marker or definitive blood test for sepsis detection exists.

Early warning scores (EWS), such as the National Early Warning Score (NEWS), are widely used in hospitals to identify clinical deterioration. In general hospital wards, sepsis detection relies primarily on intermittent vital sign measurements, including heart rate (HR), blood pressure (BP), and body temperature, with less frequent monitoring of oxygen saturation (SpO2) and respiratory rate (RR). However, these measurements are typically taken only a few times daily, creating a gap where early signs of deterioration may go unnoticed—especially at night or in outpatient settings.

A recent study demonstrated that an electronic alert system integrating qSOFA components, refreshing electronic medical records (EMRs) every four hours, significantly reduced 90-day in-hospital mortality [1]. This underscores the potential of continuous sepsis screening via biosensors as a valuable strategy for improving patient safety and reducing sepsis-related mortality.

The emergence of wearable biosensors for sepsis detection

Advancements in wearable and wireless sensors now allow real-time, continuous monitoring of vital signs. These cost-effective solutions enhance patient observation and facilitate early intervention by triggering alarms when physiological parameters indicate potential deterioration. However, ensuring high data quality, system interoperability, and intelligent alerting remains challenging.

Several wearable biosensors have shown promising results. Most available devices are still limited in how many parameters they can measure accurately. Additionally, many devices require adhesive electrodes on the chest or additional sensors for measuring temperature in the armpit or SpO2 at the fingertip. These features often reduce patient comfort and adherence to continuous monitoring.

Biosensors must be minimally invasive and comfortable to wear for extended periods for optimal patient acceptance. Current wrist-worn biosensors offer a promising solution by providing high-quality data on vital parameters necessary for calculating the NEWS2 score, which the British NHS endorses as an improvement over the original NEWS. This score helps assess the severity of a patient's condition and ensures timely critical care interventions.

Pilot study: feasibility of remote wireless monitoring

In a pilot study, we assessed the feasibility of wireless remote monitoring in general hospital wards using a smart, cable-free wrist device (Corsano CardioWatch 287-2) designed for continuous vital sign measurement in long-term hospitalized patients (Fig. 1). The primary goal was to facilitate early detection of sepsis and improve patient outcomes through timely intervention.

Fig. 1
Abstract Image

Overview of continuous remote monitoring system using AI-enhanced NEWS2 for early sepsis detection

Full size image

The Corsano CardioWatch is a CE-marked medical device certified under EU MDR standards and cleared by FDA 510(k). It continuously measures pulse rate, heart rate variability (R-R intervals), ECG, SpO2, respiration rate, blood pressure, core body temperature, activity, and sleep. Data is transmitted wirelessly from the wristband to a smartphone, integrated into the hospital-wide Wi-Fi system, and stored in a secure health cloud for further analysis. Continuous blood pressure monitoring without a cuff was advantageous, improving patient compliance and ease of use.

Our study, which included 34 patients wearing the wristband for 14 days, demonstrated high comfort and adherence, with no reports of discomfort and only two cases of mild skin irritation associated with the silicone strap, both of which were resolved by switching to a fabric strap. Data transmission was seamless, with Bluetooth efficiently relaying information from the wristband to mobile devices and subsequently via Wi-Fi to the cloud. The quality of the recorded physiological data was consistently high, stable, and sufficiently detailed for detecting early signs of clinical deterioration, including sepsis-related changes. The system reliably captured and stored continuous measurements without significant data loss or signal degradation, underscoring its suitability for integration into automated early warning systems to enhance clinical decision-making and patient safety. Additionally, the device’s compatibility with remote inpatient, outpatient, and home care settings highlights its potential for broader clinical integration, offering a scalable and effective solution for long-term monitoring.

The Corsano CardioWatch wearable sensor offers a transformative approach to sepsis detection by enabling continuous, real-time monitoring of vital signs. Integrating these devices with early warning systems, such as NEWS2, can enhance the early identification of clinical deterioration, reduce hospital mortality, and improve overall patient management.

Despite data quality, interoperability, and intelligent alerting challenges, research and development in wearable technology continue to refine their clinical utility. Future studies should explore how AI-driven predictive models can enhance biosensor-based early warning systems, paving the way for a new era in patient safety and clinical care.

All data used and analyzed during the current study are available from the corresponding author upon reasonable request.

AI:

Artificial Intelligence

EWS:

Early Warning Score

NEWS:

National Early Warning Score

HR:

Heart Rate

BP:

Blood Pressure

SpO2 :

Oxygen saturation

RR:

Respiratory Rate

ECG:

Electrocardiography

qSOFA:

Quick-SOFA-score, Sequential Organ Failure Assessment

EMRs:

Electronic Medical Records

CE:

Conformité Européenne

EU MDR:

European Medical Device Regulation

  1. Arabi YM, Alsaawi A, Alzahrani M, et al. Electronic sepsis screening among patients admitted to hospital wards: a stepped-wedge cluster randomized trial. JAMA. 2025;333(9):763–773. https://doi.org/10.1001/jama.2024.25982.

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We sincerely appreciate the support of Corsano Health B.V.: Casper van Eijk and Peter Stas. Corsano Health supplied the CardioWatch, the mobile phones and manages the cloud database.

Corsano Health supplied the CardioWatch, the mobile phones and manages the cloud database.

Authors and Affiliations

  1. Department of Anesthesia and Intensive Care Medicine, Greifswald University Medicine, Greifswald, Germany

    Sven-Olaf Kuhn, Sebastian Gibb & Matthias Gründling

Authors
  1. Sven-Olaf KuhnView author publications

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  2. Sebastian GibbView author publications

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  3. Matthias GründlingView author publications

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Contributions

SOK and MG wrote the main manuscript text and prepared Fig. 1. All authors reviewed the manuscript.

Corresponding author

Correspondence to Sven-Olaf Kuhn.

Ethics approval and consent to participate

The studies involving human participants were reviewed and approved by the Ethics Committee of Greifswald University Hospital (BB 050/24). The patients provided their written informed consent to participate in this study.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.

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Kuhn, SO., Gibb, S. & Gründling, M. The role of the Corsano CardioWatch in continuous vital sign monitoring for early sepsis detection. Crit Care 29, 144 (2025). https://doi.org/10.1186/s13054-025-05365-z

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Corsano CardioWatch在早期脓毒症检测中持续生命体征监测的作用
脓毒症是一种严重的医疗紧急情况,经常伴有严重的器官衰竭和高死亡率。早期发现至关重要,因为随着时间的推移,治疗的延误大大增加了致命后果的风险。然而,目前还没有专门的分子标记物或明确的血液检测方法来检测败血症。早期预警评分(EWS),如国家预警评分(NEWS),在医院广泛用于识别临床恶化。在普通医院病房,脓毒症的检测主要依靠间歇性的生命体征测量,包括心率(HR)、血压(BP)和体温,较少监测血氧饱和度(SpO2)和呼吸频率(RR)。然而,这些测量通常每天只进行几次,造成了一个缺口,早期恶化的迹象可能被忽视,特别是在夜间或门诊环境中。最近的一项研究表明,集成qSOFA组件的电子警报系统每4小时更新一次电子病历(EMRs),可显著降低90天内住院死亡率。这强调了通过生物传感器进行持续败血症筛查作为提高患者安全性和降低败血症相关死亡率的有价值策略的潜力。用于败血症检测的可穿戴生物传感器的出现可穿戴和无线传感器的进步现在可以实时、连续地监测生命体征。这些具有成本效益的解决方案加强了对患者的观察,并通过在生理参数显示潜在恶化时触发警报来促进早期干预。然而,确保高数据质量、系统互操作性和智能报警仍然具有挑战性。一些可穿戴生物传感器已经显示出了很好的结果。大多数可用的设备能够精确测量的参数数量仍然有限。此外,许多设备需要在胸部安装粘接电极或附加传感器来测量腋窝温度或指尖的SpO2。这些特征通常会降低患者的舒适度和对持续监测的依从性。生物传感器必须具有最小的侵入性,并且佩戴时间长且舒适,以获得最佳的患者接受度。目前的腕戴式生物传感器提供了一个很有前途的解决方案,它提供了计算NEWS2评分所需的重要参数的高质量数据,英国国家医疗服务体系认可这是对原始NEWS的改进。该评分有助于评估患者病情的严重程度,并确保及时进行重症监护干预。在一项初步研究中,我们评估了无线远程监护在综合医院病房的可行性,使用一种智能的、无电缆的手腕设备(Corsano CardioWatch 287-2),该设备设计用于长期住院患者的连续生命体征测量(图1)。主要目标是通过及时干预促进败血症的早期发现,改善患者的预后。Corsano CardioWatch是一种具有ce标志的医疗器械,已通过欧盟MDR标准认证,并获得FDA 510(k)的批准。它可以连续测量脉搏率、心率变异性(R-R间隔)、心电图、SpO2、呼吸率、血压、核心体温、活动和睡眠。数据从腕带无线传输到智能手机,集成到医院范围的Wi-Fi系统中,并存储在安全的健康云中以供进一步分析。不带袖带的连续血压监测是有利的,提高了患者的依从性和易用性。我们的研究包括34名佩戴腕带14天的患者,显示出高度的舒适性和依从性,没有不舒服的报告,只有两例与硅胶腕带相关的轻度皮肤刺激,这两例都通过改用织物腕带解决了。数据传输是无缝的,蓝牙有效地将信息从腕带传输到移动设备,然后通过Wi-Fi传输到云端。记录的生理数据质量一贯高、稳定,且足够详细,可用于检测临床恶化的早期迹象,包括败血症相关的变化。该系统可靠地捕获和存储连续测量数据,没有重大数据丢失或信号退化,强调了其集成到自动预警系统的适用性,以提高临床决策和患者安全。此外,该设备与远程住院、门诊和家庭护理环境的兼容性突出了其更广泛的临床整合潜力,为长期监测提供了可扩展和有效的解决方案。Corsano CardioWatch可穿戴传感器通过持续实时监测生命体征,为败血症检测提供了一种革命性的方法。 将这些设备与早期预警系统(如NEWS2)集成,可以增强对临床恶化的早期识别,降低医院死亡率,并改善整体患者管理。尽管存在数据质量、互操作性和智能警报方面的挑战,可穿戴技术的研发仍在不断完善其临床应用。未来的研究应该探索人工智能驱动的预测模型如何增强基于生物传感器的早期预警系统,为患者安全和临床护理的新时代铺平道路。本研究中使用和分析的所有数据均可根据通讯作者的合理要求提供。AI:人工智能新闻:早期预警评分新闻:国家早期预警评分hr:心率bp:血压respo2:血氧饱和度rr:呼吸频率ecg:心电图sofa:快速sofa评分,序事性器官衰竭评估emrs:电子病历ce: conformit<e:1>欧洲医疗器械条例MDR:欧洲医疗器械法规arabi YM, Alsaawi A, Alzahrani M,等。住院病人的电子脓毒症筛查:一项楔步聚类随机试验。《美国医学协会杂志》上。2025, 333(9): 763 - 773。https://doi.org/10.1001/jama.2024.25982.Download参考资料我们衷心感谢Corsano Health b.v.: Casper van Eijk和Peter Stas的支持。Corsano Health提供了CardioWatch和移动电话,并管理着云数据库。Corsano Health提供了CardioWatch和移动电话,并管理着云数据库。德国格雷夫斯瓦尔德格雷夫斯瓦尔德大学医学院麻醉与重症监护医学系ven- olaf Kuhn, Sebastian Gibb &amp;Matthias grindlingauthorssven - olaf KuhnView作者出版物您也可以在pubmed谷歌ScholarSebastian GibbView作者出版物您也可以在pubmed谷歌ScholarMatthias grindlingview作者出版物您也可以在pubmed谷歌ScholarContributionsSOK和MG撰写了主要手稿文本并准备了图1。所有作者都审阅了手稿。通讯作者:斯文-奥拉夫·库恩通讯。涉及人类受试者的研究由Greifswald大学医院伦理委员会(BB 050/24)审查并批准。患者提供了参与本研究的书面知情同意书。发表同意不适用。利益竞争作者声明没有利益竞争。出版商声明:对于已出版的地图和机构关系中的管辖权要求,普林格·自然保持中立。开放获取本文遵循知识共享署名-非商业-非衍生品4.0国际许可协议,该协议允许以任何媒介或格式进行非商业用途、共享、分发和复制,只要您适当注明原作者和来源,提供知识共享许可协议的链接,并注明您是否修改了许可材料。根据本许可协议,您无权分享源自本文或其部分内容的改编材料。本文中的图像或其他第三方材料包含在文章的知识共享许可协议中,除非在材料的署名中另有说明。如果材料未包含在文章的知识共享许可中,并且您的预期用途不被法律法规允许或超过允许的用途,您将需要直接获得版权所有者的许可。要查看本许可的副本,请访问http://creativecommons.org/licenses/by-nc-nd/4.0/.Reprints和permissionsCite这篇文章kuhn, SO。吉布,S. &;Corsano CardioWatch在脓毒症早期持续生命体征监测中的作用。危重护理29,144(2025)。https://doi.org/10.1186/s13054-025-05365-zDownload引文收稿日期:2025年2月28日接受日期:2025年3月9日发布日期:2025年4月1日doi: https://doi.org/10.1186/s13054-025-05365-zShare这篇文章任何你分享以下链接的人都可以阅读到这篇文章:获取可共享链接对不起,这篇文章目前没有可共享链接。复制到剪贴板由施普林格自然共享内容倡议提供
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来源期刊
Critical Care
Critical Care 医学-危重病医学
CiteScore
20.60
自引率
3.30%
发文量
348
审稿时长
1.5 months
期刊介绍: Critical Care is an esteemed international medical journal that undergoes a rigorous peer-review process to maintain its high quality standards. Its primary objective is to enhance the healthcare services offered to critically ill patients. To achieve this, the journal focuses on gathering, exchanging, disseminating, and endorsing evidence-based information that is highly relevant to intensivists. By doing so, Critical Care seeks to provide a thorough and inclusive examination of the intensive care field.
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