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Post-Intensive Care Risk-adjusted Alerting and Monitoring (PICRAM Phase 2)

Portfolio Eligibility
Automatically eligible
ISRCTN 32008295
MREC N° 12\SC\0357
UKCRN ID 12730
Research Summary
Patients discharged from intensive care units (ICU) have a very high risk of subsequently deteriorating on hospital wards. PICRAM will develop ways of alerting clinicians to these deteriorations early. After ICU discharge, there is little information available about the normal course which patients’ vital signs follow if they are safely discharged from hospital. Using an ambulatory monitor we plan to continuously record vital signs from up to 500 patients who have spent more than three days in ICU from 2 hospitals (one teaching hospital – Oxford University Hospitals NHS Trust one large district general hospital – The Royal Berkshire NHS Trust). We will also recover vital signs from the 72 hours leading up to discharge from the ICU, (recorded in the standard clinical electronic database). These two sets of data will allow us to understand the patterns by which patient recovery is displayed in vital signs. We will develop ways by which clinicians can be alerted to patients who are not following these patterns of recovery, as these patients will be at greater risk of deterioration. Finally, we will recover data from the patient’s ICU stay. We have developed a large anonymised database from the standard clinical electronic databases of the two Intensive Care Units. We are using this to design tools to help clinicians recognise which patients are at risk of deterioration after discharge from intensive care. We will use data from the Intensive Care Unit stay of the patients whose vital signs we record after intensive care discharge to work out how best to merge the data from their time in Intensive Care with the vital signs recovery patterns to best identify patients who are deteriorating after ICU discharge. The use of prolonged ambulatory vital sign monitoring in post-intensive care patients is relatively novel. We will therefore record patients’ views on the wearability of the system and data on the functionality of the system.
Study Type Observational
Design Type Cohort study
Disease(s) All Critical care
Phase Pilot/Feasibility
Current Status Closed - in follow-up
Closure Date 12/19/2014
Global Sample Size 280
Global Recruitment to Date
Geographical Scope UK Multi-Centre
Lead Country England
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Main Inclusion Criteria
1. Participant is willing and able to give informed consent for participation in the study.
2. Aged 16 years or above.
3. Discharged from adult intensive care unit.
Main Exclusion Criteria
1. Patients discharged for palliative care.
2. Patients whose anatomy, condition or prior surgery precludes the use of the wearable monitoring equipment.
3. Patients who cannot understand written English and for whom no translator can be found.
4. Patients not able to give informed consent due to diminished capacity.
Chief Investigator(s)
Dr Duncan Young
Further details, please contact
Ms Julie Darbyshire

John Radcliffe Hospital
Kadoorie Centre for Critical Care Research
Level 3
Headley Way
Funder(s) Wellcome Trust
Sponsor(s) University of Oxford
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