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. 2023 Mar 2;182(5):1991–2003. doi: 10.1007/s00431-023-04881-w

Wireless monitoring devices in hospitalized children: a scoping review

Eva Senechal 1, Emily Jeanne 1, Lydia Tao 2, Robert Kearney 3, Wissam Shalish 1,2, Guilherme Sant’Anna 1,4,✉
PMCID: PMC9977642  PMID: 36859727

Abstract

The purpose of this study is to provide a structured overview of existing wireless monitoring technologies for hospitalized children. A systematic search of the literature published after 2010 was conducted in Medline, Embase, Scielo, Cochrane, and Web of Science. Two investigators independently reviewed articles to determine eligibility for inclusion. Information on study type, hospital setting, number of participants, use of a reference sensor, type and number of vital signs monitored, duration of monitoring, type of wireless information transfer, and outcomes of the wireless devices was extracted. A descriptive analysis was applied. Of the 1130 studies identified from our search, 42 met eligibility for subsequent analysis. Most included studies were observational studies with sample sizes of 50 or less published between 2019 and 2022. Common problems pertaining to study methodology and outcomes observed were short duration of monitoring, single focus on validity, and lack information on wireless transfer and data management.

  Conclusion: Research on the use of wireless monitoring for children in hospitals has been increasing in recent years but often limited by methodological problems. More rigorous studies are necessary to establish the safety and accuracy of novel wireless monitoring devices in hospitalized children.

What is Known:

• Continuous monitoring of vital signs using wired sensors is the standard of care for hospitalized pediatric patients.

However, the use of wires may pose significant challenges to optimal care.

What is New:

• Interest in wireless monitoring for hospitalized pediatric patients has been rapidly growing in recent years.

• However, most devices are in early stages of clinical testing and are limited by inconsistent clinical and technological reporting.

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Supplementary Information

The online version contains supplementary material available at 10.1007/s00431-023-04881-w.

Keywords: Wireless monitoring, Wearable technology, NICU, PICU, Pediatric care, Monitoring

Introduction

Continuous monitoring of vital signs is a standard practice in hospitalized patients especially those treated in acute and intensive care units [1]. Routinely monitored signs include but are not limited to heart rate (HR), respiratory rate (RR), oxygen saturation (SpO2), body temperature, and blood pressure [2]. These signals are obtained by wired sensors and help health care providers (HCP) detect changes in patient conditions, and guide treatment decisions. Implementation of continuous monitoring has been associated with better outcomes and lower mortality [3, 4]. However, current monitoring technologies pose challenges associated with the use of multiple wires connecting the sensors to the monitors [5–7].

Wires often become tangled, decrease patient mobility, and may negatively impact patient experience. In the neonatal intensive care unit (NICU), premature babies have fragile skin which is susceptible to damage from the wires [8]. Additionally, repeated removal and reapplication of wired sensors can cause harm to the skin, disturb infants’ rest, and act as barriers for Kangaroo care [9, 10]. The wires may touch the floor and require frequent disinfection procedures [5]. In the PICU, wired technologies impact the ability of patients to engage in health-promoting activities such as physical contact with family and play [11, 12]. Despite all these challenges, monitoring technology has remained largely unchanged since the 1970s [6, 13, 14]. In surveys of different ICU nurses and physicians, nearly all favored the implementation of wireless monitoring technologies, and expressed their belief that this would improve patient care [6, 7].

In recent years, there has been increased research and development of wireless monitoring technologies [14–16]. However, most available devices for infants and children are primarily used for home monitoring of healthy infants and children [17–19], and with variable accuracy [16, 20]. At the hospitals, devices must comply with specific regulatory requirements and be supported by clinical evidence [21, 22]. Thus, due to rapid technological advances, the aim of this scoping review is to provide a structured overview of existing wireless monitoring technology for hospitalized children.

Methods

This scoping review followed the 5-step framework of Arksey and O’Malley [23]. A protocol has been made publicly available on Open Science Framework prior to data collection (https://doi.org/10.17605/OSF.IO/WYPV3) and the reporting followed the PRISMA for Scoping Reviews (PRISMA-ScR) guidelines [24].

Identifying relevant studies

A search strategy was developed with input from a McGill University Health Center librarian. Literature searches were conducted in the following six databases: MEDLINE, EMBASE, Scielo, Cochrane, and Web of Science. The initial search strategy was synthesized for MEDLINE and subsequently translated for other databases. The key search terms are provided in Supplementary Table 1. The results were limited to those published between January 1st 2010 and Aug 13th 2022. Articles prior to 2010 were excluded due to rapid technological advances. No language restrictions were applied.

Inclusion/exclusion criteria

Included publications must comprise hospitalized pediatric patients and wireless technology for continuous monitoring. Detailed inclusion and exclusion criteria used to select articles are summarized in Supplementary Table 2.

Selecting studies

Results from all database searches were exported into EndNote (Clarivate Analytics, Philadelphia, USA) and duplicates automatically removed. The remaining references were transferred into the systematic review software Covidence (Veritas Health Innovation, Melbourne, Australia) for a second deduplication. Using this software, the eligibility of each article was assessed using inclusion and exclusion criteria as guide through a two-stage screening process by two independent reviewers. First, titles and abstracts screening, then a full-text review were completed independently by the two of three reviewers (ES, EJ, LT). In both stages, any conflicts were discussed and resolved by the reviewers until a consensus was reached.

Charting the data, collating, and reporting results

A standardized data collection form was developed to extract the information of interest. For each included article, data extraction was completed by two independents of three reviewers (ES, EJ, LT). The following information was collected: authors, conflict of interest, year of publication, type of study, site of study, number of participants, and participant characteristics; location and means of device placement, signals obtained by device, duration of monitoring period, means of wireless information transfer, and employment of reference sensors; and the main objective, and outcomes and/or findings of the studies. The quality of included articles was not appraised as the goal of this review is to generally describe the breadth of the research involving wireless monitoring technology. A descriptive analytical approach was used to chart and summarize the data. Both quantitative and qualitative syntheses were conducted.

Results

The database search yielded a total of 1442 results. Full references were exported to EndNote where 112 duplicates were removed. The remaining were exported to Covidence, and 9 additional duplicates were removed. Overall, 1330 articles were screened by title and abstract, 310 by full-text review, and ultimately 42 articles were included in this review (see Supplementary Fig. 1).

Demographics

Included articles were published in 40 distinct journals, with diverse topics of focus (full list provided in Supplementary Table 3). Twenty-one (50%) [25–45] of the included articles were from North America, 12 (29%) [30, 46–56] from Europe, and 9 from Asia (21%) [49, 57–64]. The included studies were conducted in 15 different countries, most commonly in the USA (n = 20, 48%) [25–29, 31–45], India (n = 4, 10%) [57, 58, 61, 63], and Netherlands (n = 3, 7%) [47, 55, 56]. A total of 32 (76%) articles were published between 2019 and 2022 [25–31, 33, 35–39, 41–43, 45, 46, 48–51, 53–55, 57, 59–62, 65, 66] (Fig. 1). Thirty-nine (93%) of the articles were prospective observational studies [25–42, 45–56, 58–66].

Fig. 1.

Fig. 1

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Year of publication. Legend: Bar chart representing year of publication for all included articles

Methodologies

Hospital site

The most common study hospital sites were neonatal intensive care units (n = 19, 45%) and pediatric wards (n = 36, 36%). Distribution of study site can be seen in Table 1 (and Fig. 2).

Table 1.

Methodological components of included papers

Included articles n = 42 Ref
Study site*: n (%)
  NICU 19 (45) [26–28, 30, 32–35, 37, 43, 47, 49, 56, 59, 62, 63, 65, 66]
  Pediatric ward 15 (36) [25, 31, 38, 39, 41, 42, 44–46, 48, 50, 54, 57, 60, 64]
  Hospital (other/unspecified) 8 (19) [36, 40, 42, 51, 53, 55, 61, 66]
  PICU 5 (12) [28, 29, 33, 43, 52]
Age of participants*: n (%)
  Infant (< 1 year) 28 (67) [26–30, 32–35, 37, 41, 43, 46, 47, 49, 50, 53, 56–66]
  Toddler to early childhood (≥ 1 to 5 years) 18 (43) [25, 28, 29, 40, 41, 43–46, 48, 50–52, 54, 60, 63–65]
  Middle childhood (> 5 to 10 years) 20 (48) [25, 31, 35, 38–41, 43–46, 48, 50–52, 54, 55, 60, 63, 64]
  Adolescence (> 10 to < 18 years) 20 (48) [25, 31, 36, 38–46, 48, 50–52, 55, 60, 63, 64]
Duration of monitoring*: n (%)
  < 1 h 13 (31) [26, 33, 41, 45, 49, 52, 53, 56, 58, 59, 61, 65, 66]
  1–8 h 8 (19) [30, 32, 35, 37, 60, 62–64]
  > 8–24 h 7 (17) [25, 28, 29, 34, 36, 38, 43]
  > 24 h 7 (17) [40, 42, 46–48, 51, 57]
  Overnight (unspecified hours) 2 (5) [44, 55]
  N/A 5 (12) [27, 31, 44, 50, 55]
Type of statistical analysis n (%)
  Bland-Altmann 14 (33) [27–29, 35, 37, 44, 49, 52, 53, 59–61, 64, 65]
  Correlation coefficient (r) 10 (24) [29, 32, 36, 38, 50, 53, 54, 59, 60, 62]
Outcomes reported n (%)
  Validity 33 (79) [26–35, 37, 38, 40, 41, 44, 45, 47, 49–53, 55–65]
  Feasibility 17 (40) [25–27, 34, 36, 38, 41, 43, 46, 47, 51, 54, 55, 58, 63, 64, 66]
  Clinical 11 (26) [25, 28, 31, 35, 36, 38, 39, 42, 46, 54, 57]
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In certain cases, more than one study site or age category was included in study thus each category included was counted

NICU neonatal intensive care unit, PICU pediatric intensive care unit

*Data are presented as n (%)

Fig. 2.

Fig. 2

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Study location. Legend: Bar chart representing study location for all included studies. Some studies included more than one study site; therefore, total study sites are greater than number of included articles

Population

The median number of participants included in the studies was 24 (range: 1–982). Thirty-eight studies (90%) had a sample size of ≤ 100 [25–45, 47–49, 51–61, 63, 65, 66], and 30 (71%) of ≤ 50 [25–39, 41, 45, 47, 48, 51–53, 55, 56, 58, 59, 61, 63, 65, 66]. The distribution of sample sizes ≤ 100 is shown in Fig. 3.

Fig. 3.

Fig. 3

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Number of studies with 100 or less participants. Legend: Histogram representing distribution of the 39 included studies with sample sizes of 100 or less, and 3 included studies with sample sizes greater than 100 are not included in the histogram. On the right side, statistics table represents mean, median, mode, standard deviation, minimum, maximum, and range of 41 of included studies; one study excluded as no information about sample size was provided, data reported as missing

Distribution of age groups was classified based on the Center of Disease Control’s stratification[67]. The most common age group included infants < 1 year, followed by toddler to early childhood (≥ 1 to 5 years). The frequency of each pediatric age group is available on Table 1. While this review excluded articles consisting only of adult participants, it included studies which had both children and adult participants. Nine (21%) included articles featured adult participants [35, 36, 38–40, 42, 45, 50, 63], and 25 (60%) articles included samples spanning multiple age categories [25, 28, 29, 31, 35, 36, 38–46, 48, 50–52, 54, 55, 60, 63–65].

Devices

The included devices consisted of new technologies, novel clinical uses, and evaluations of pre-existing technologies. The most common pre-existing wireless devices were the Empatica E3 and E4 wristbands (Empatica Inc., Cambridge, MA) [31, 36, 38–40].

Duration of monitoring was analyzed in terms of longest period of continuous monitoring with wireless device specified in the study, or maximum duration specified in the protocol. The most common duration of monitoring, reported by 13 (31%) studies, was under an hour. The frequency of monitoring periods can be found in Table 1.

In 29 (69%) [26–30, 32, 33, 35, 37–39, 44, 45, 47, 49, 50, 52, 53, 56–66] articles, a reference device was used to evaluate performance of the proposed wireless technology.

Outcomes

The reported outcomes were broken into three different categories of interest: validity, feasibility, and clinical outcomes: (a) validity—device accuracy, sensitivity, and performance; (b) feasibility—user experience, healthcare worker experience, safety, systematic implementation benefits and/or challenges; and (c) clinical outcomes—patients’ condition [1]. Validity outcomes were reported in 33 (79%) of the included studies. The frequency of each type of outcomes is shown in Table 1. Thirteen (31%) studies only provided basic descriptive statistics: measure of central tendency or basic measures of variation and frequencies [26, 30, 34, 41, 43, 45–48, 51, 55, 56, 58]. For studies which did report more complex statistical analysis, the types of analysis are reported in Table 1.

Device features

Signals monitored

Only the signals for which data was collected in the study were included in the analysis. Therefore, when discussing signals monitored by a device, these refer to signals reported in that study rather than signals the device is capable of monitoring. The median number of signals monitored by devices was 1 (see Fig. 4) and median number of vital signs (HR, RR, temperature, and SpO2) monitored by included devices was also 1 (see Fig. 5). One study focused exclusively on feasibility-related outcomes and did not report signal data [36]. Eleven (26%) studies did not report monitoring of any vital signs. Twenty-three (55%) devices monitored at least one non-vital sign. The most common vital sign monitored was heart rate which was assessed in twenty-five (60%) devices (see Fig. 6). Twenty-three (55%) devices included monitoring of at least one non-vital sign [25, 27–32, 34, 35, 37–41, 43, 48, 51, 54, 55, 58, 59, 62, 65]. The most common non-vital sign monitored was movement which was assessed in 13 (31%) studies [25, 27, 28, 30–32, 35, 37–40, 43, 58]. Information on signals monitored by device is shown in Table 2.

Fig. 4.

Fig. 4

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Number of signals monitored. Legend: Bar chart representing number of signals monitored by wireless device(s) for all included studies

Fig. 5.

Fig. 5

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Number of vital signs signals monitored. Legend Bar chart representing number of vital signals monitored by wireless device(s) for all included studies

Fig. 6.

Fig. 6

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Percentage of devices monitoring each vital sign. Legend: Pie charts representing percentage of wireless devices in 42 included studies monitoring each vital signa. a represents percent of included devices monitoring heart rate, b represents percent of included devices monitoring oxygen saturation, c represents percent of included devices monitoring temperature, and d represents percent of included devices monitoring respiratory rate

Table 2.

Number and type of signals reported for included devices

Included articles n (%) Ref
Number of signals reported: 42 (100)
  0 1 (2) [36]
  1 21 (50) [26, 30, 32–34, 39, 41, 42, 45, 49, 50, 52–55, 57, 60, 62–65]
  2 5 (12) [25, 40, 44, 56, 61]
  3 8 (19) [29, 31, 38, 46, 47, 58, 59, 66]
  4 2 (5)
  5 2 (5) [27, 28]
  6 2 (5) [43, 51]
  7 1 (2) [48]
Number of vital signs reported 42 (100)
  0 11 (26) [30, 32, 34, 36, 39–41, 54, 55, 62, 65]
  1 15 (36) [25, 26, 29, 31, 33, 42, 45, 49, 50, 52, 53, 57, 60, 63, 64]
  2 7 (17) [38, 43, 44, 56, 58, 59, 61]
  3 5 (12) [35, 37, 46, 47, 66]
  4 4 (10) [27, 28, 48, 51]
Vital signs 42 (100)
  Heart rate 25 (60) [25–29, 31, 35, 37, 38, 42, 44–53, 56, 58, 59, 61, 66]
  Temperature 13 (31) [27, 28, 35, 37, 38, 47, 48, 51, 57, 58, 60, 63, 64]
  Oxygenation saturation 12 (29) [27, 28, 33, 43, 44, 46–48, 51, 56, 61, 66]
  Respiratory rate 10 (24) [27, 28, 35, 37, 43, 46, 48, 51, 59, 66]
Method used to obtain HR: 25 (100)
  Pulse oximetry 11 (44) [25, 26, 29, 31, 38, 42, 44, 49, 51, 52, 61]
  Electrocardiography (ECG) 10 (40) [26–28, 37, 45–47, 50, 53, 59]
Method used to obtain SpO2: 12 (100)
  Pulse oximetry 9 (75) [27, 28, 33, 43, 44, 46, 51, 61, 66]
  Near infrared spectroscopy 2 (17) [47, 56]
Method used to obtain RR: 10 (100)
  Impedance pneumography 3 (30) [28, 46, 51]
  Accelerometry 2 (20) [35, 37]
  Not specified 2 (20) [48, 51]
Type of wireless information transfer: 42 (100)
  Bluetooth 20 (48) [27–29, 33–35, 37, 38, 45, 46, 48–51, 55, 59, 61–63, 66]
  Not specified 14 (33) [25, 26, 31, 32, 39, 40, 44, 47, 52–54, 56, 58, 60]
  No wireless information transfer 5 (12) [30, 36, 42, 43, 57]
  Wi-Fi 4 (10) [41, 64–66]
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In certain cases, more than one study site or age category was included in study thus each category included was counted

HR heart rate, SpO2 oxygen saturation, RR respiratory rate

*Data are presented as n (%)

Additionally for HR, SpO2, and RR, the method by which the signal was obtained was assessed. The most common methods used to obtain HR and SpO2 were pulse oximetry (n = 11, 44%) and (n = 9, 75%), respectively. The most common method used to obtain RR was impedance pneumography (n = 3, 30%). Details for methods used to obtain these vital signs can be found in Table 3.

Table 3.

Location and method of placement for included devices

a n (%) Ref
Means of securing device 42 (100)
  Band OR elastic OR strap 26 (62) [25, 26, 28, 29, 31–33, 35, 36, 38–40, 42–44, 46, 48, 51, 52, 56–59, 61, 63, 66]
  Adhesive 15 (36) [27–29, 35, 37, 41, 45, 46, 54, 55, 60, 63–66]
  Garment 5 (12) [34, 41, 47, 49, 54]
  Non-contact 3 (7) [30, 44, 66]
  Not secured 3 (7) [50, 53, 62]
Device placement on body*: n (%) 42 (100)
  Upper extremity 21 (50) [25, 28, 29, 31, 33, 35, 36, 38–40, 42–44, 46, 51, 52, 56, 57, 59, 63, 66]
  Torso 18 (43) [26–29, 35, 37, 45–47, 50, 53–56, 59, 60, 64, 65]
  Lower extremity 10 (24) [27–29, 31, 33, 35, 39, 51, 61, 66]
  Head 8 (19) [32, 34, 34, 41, 43, 49, 56, 62]
  Not on body 2 (5) [30, 66]
  Not specified 2 (5) [48, 58]
  Neck
Heart rate monitoring device placement*: n (%) 25 (100)
  Torso 13 (52) [26–29, 35, 37, 45–47, 50, 53, 59, 66]
  Upper extremity 8 (32) [25, 31, 38, 42, 44, 50–52]
  Lower extremity 3 (12) [51, 59, 61]
  Head 2 (8) [49, 56]
  Not specified 2 (8) [48, 58]
Temperature monitoring device placement*: n (%) 13 (100)
  Torso 8 (62) [27, 28, 35, 37, 47, 60, 63, 64]
  Upper extremity 5 (38) [28, 35, 38, 51, 57]
  Lower extremity 4 (31) [27, 28, 35, 51]
  Not specified 1 (8) [48]
Oxygen saturation monitoring device placement*: n (%) 12 (100)
  Upper extremity 8 (67) [27, 28, 33, 43, 44, 46, 51, 66]
  Lower extremity 5 (42) [27, 28, 51, 61, 66]
  Head 2 (17) [47, 56]
  Not specified 1 (8) [48]
Respiration rate monitoring device placement*: n (%) 10 (100)
  Torso 8 (80) [27, 28, 35, 37, 43, 46, 59, 66]
  Upper extremity 1 (10) [51]
  Lower extremity 1 (10) [51]
  Not specified 1 (10) [48]
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In certain cases, more than one site on body was used for vital monitoring thus each category included was counted

*Data are presented as n (%)

Bluetooth was the most common method for wireless information transfer with 27 (48%) of the included devices were Bluetooth enabled. Details about wireless information transfer can be found in Table 2.

Placement

Placement of the device was described in terms of major body regions where the wireless monitoring system was placed: head, neck, torso, upper extremity, and lower extremity [68]. Some studies included wireless sensors consisting of multiple or repeat units, involving multiple placement sites, as well as multiple options for device placement—every placement site, and alternative for a monitoring system was included. Broad placement categories were chosen due to variability of placement details provided and multiple sites based on patient size. The two most common device placement sites were upper extremity (n = 21, 50%) and torso (n = 18, 43%). Device placement was further analyzed in terms of placement of wireless device for each vital sign: (a) HR = torso (n = 13, 52%), (b) SpO2 = upper extremities (n = 8, 67%), (c) temperature = torso (n = 8, 62), and (d) RR = torso (n = 8, 80%). The distribution of wireless monitoring device placement is shown in Table 3.

Means of securing the sensors was also assessed and broken down into five categories: adhesives, band or elastic or strap, garment, non-contact, or not secured sensor. All studies specifying sensor securing type were collated together due to the interchangeable use of these terms in studies. Non-contact sensors refer to technologies not in contact with patient body, and not secured refers to sensors placed on patient without use of any means to secure it to the body.

Studies with monitoring systems consisting of more than one unit sometimes included more than one means of securing the sensors. The most common means of securing was band, elastic, or belt (n = 26, 62%). Information about methods used to secure devices can be found in Table 3.

Discussion

Study characteristics

Our search revealed that wireless monitoring technologies for hospitalized pediatric patients are rapidly growing field of research but most of these devices are at early stages of clinical testing. Most included articles were prospective observational studies published in the last 3 years, with small sample sizes, short monitoring period durations, and focused on validating the proposed technology. Most of the included articles aimed to validate the signals recorded by wireless technology with the use of a reference sensor. Interestingly, while most studies included the use of a reference sensor, only 14 (33%) studies reported using the Bland-Altmann method. Indeed, the lack of sophisticated statistical analysis in a significant portion of studies may be a result of the limited data collected with small sample sizes and short monitoring durations [69].

Analysis of population and study site revealed a focus on developing wireless monitoring for the NICU. This can be likely related to the increased negative effects of wired technologies on neonates such as tangling of wires complicating optimal routine care, barrier to Kangaroo Care, and increased risk of infection. The large portion of devices utilizing soft adhesives, bands, and straps may be advantageous for NICU patients, whose skin is susceptible to damage. Nevertheless, while our results demonstrated a special interest in infants, most studies included a range of pediatric participants.

Device characteristics

Novel monitoring technologies are exploring the addition of new signals. Most devices included monitoring of at least one non-vital signal showing an increased interest in expanding routine monitoring of other signals. The most common non-vital sign monitored was body movement which can be used to provide information about a variety of important signals. Movement may be a useful predictor of clinical outcomes [70]. Neonates are susceptible to infection, which is associated with reduced movement [71, 72]. Detection of a significant sudden reduction of movement could provide early cues of infection to caregivers.

Bluetooth was the preferred method of wireless information transfer, but a significant portion of studies failed to report method of wireless information transfer. Compared to Wi-Fi, Bluetooth has shorter range for data transfer and is less adapted for large amounts of data. However, Bluetooth does not require connection to the Internet, and has lower energy requirements [73, 74]. These features make it optimal for miniaturization and long battery duration which are important in devices for pediatric patients [74].

Future directions and improvements

The rapid growth of research on wireless monitoring technologies in hospitalized pediatric patients is part of a larger movement modernizing our healthcare technologies. Especially following the disruption caused by the COVID-19 pandemic, the pace of healthcare’s digital transformation has been accelerated [75]. This technological shift provides an important opportunity to improve aspects of care, including our standard monitoring practices. Some improvements observed in this review include the removal wires, addition of new signals to monitoring technologies, and safer methods of device administration. While these novel technologies have the potential to improve healthcare practices, they introduce new important risks such as wireless device reliability, accuracy, interference with other equipment, data and network safety, and costs of implementation. Therefore, it is important research supporting this transition be transparent and rigorous.

Although this field remains emerging, the results from this review revealed common limitations of the available literature: small sample sizes, short monitoring durations, basic analysis methods, single focus on validity, and inconsistent reporting practices in terms of device placement, and method of wireless information. Future research could benefit from the implementation of standardized reporting practices which would promote high-quality research, comparability, and efficiency. Clear reporting standards are especially important in an interdisciplinary field such as medical technology. While clinical reporting standards such as Consolidated Standards Reporting Trials (CONSORT) and the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) provide instruction on clinical trials, they fail to reflect unique reporting needs of trials pertaining to novel technology [76, 77]. In the case of our scoping review, we see that both important clinical and technological aspects of research are poorly specified, or not reported. Thus, it appears research in this field would benefit from the developments of reporting guidelines based on recommendations interdisplinary panel of experts from medicine, engineering, and computer science. Development of these guidelines would standardize the reporting practices and improve the quality of research.

A recent study announced by the Montreal Children’s Hospital, focused on wireless monitoring technology for the NICU, was developed by a multidisciplinary team of engineers and clinicians. In their protocol (NCT04956354), consideration for validity and feasibility outcomes for both clinical and technical factors was considered. This protocol provides an example of rigorous reporting emerging from the collaboration of relevant multidisciplinary expertise.

Limitations

This scoping review has some limitations. First, due to advances in wireless technology, this scoping review excluded articles published prior to 2010. Second, more detailed descriptions about methods of securing device, devices placement, and duration of monitoring were not specified due to inconsistency of the published data. This review excludes devices studied outside of the hospital and may have excluded devices that can eventually be applied to hospitalized patients. However, the objective of this study was to review currently available monitoring technology for hospitalized pediatric patients. Ultimately, this scoping review provides a useful overview of the state of the art on the use of wireless monitoring technology for hospitalized pediatric patients.

Conclusion

There is a clear growing attention to wireless monitoring for hospitalized pediatric patients. Investigations have shown an interest in applying these technologies to a broad range of pediatric patients and to obtain additional biological signals. Future investigations would benefit from larger sample sizes, longer monitoring durations, inclusion of clinical outcomes, and standardized reporting methods.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 33 KB) (32.6KB, docx)
Supplementary file2 (DOCX 13 KB) (13.3KB, docx)
Supplementary file3 (DOCX 15 KB) (15.2KB, docx)
Supplementary file4 (DOCX 16 KB) (16.1KB, docx)

Acknowledgements

We would like to thank Amy Bergeron (McGill University Health Center librarian) for her guidance in developing the search strategy. We would also like to thank Montreal Children’s foundation for providing a scholarship for ES MSc. in Experimental Medicine through a grant for the Smart Hospital Project at the Montreal Children’s Foundation.

Abbreviations

HCP

Health care provider

HR

Heart rate

NICU

Neonatal intensive care unit

PICU

Pediatric intensive care unit

RR

Respiratory rate

SpO2

Oxygen saturation

Authors’ contributions

ES, GS, WS, RK, LT, SX, and EJ helped develop and organize the review project. Once project outlined, ES and GS worked together to develop search strategy and ES conducted search on relevant databases. GS, ES, WS, and EJ designed data extraction form. ES, EJ, and LT completed screening and data extraction for review. ES conducted collation, summary, and analysis of results. ES wrote manuscript, and GS, WS, LT, and EJ helped review and edit portions of manuscript.

Data Availability

Data will be made available upon reasonable request to authors.

Declarations

Ethics approval

N/A. This study was a retrospective review.

Consent to participate

N/A.

Consent for publication

N/A.

Conflict of interest

The authors have no competing interest to declare.

Footnotes

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Supplementary Materials

Supplementary file1 (DOCX 33 KB) (32.6KB, docx)
Supplementary file2 (DOCX 13 KB) (13.3KB, docx)
Supplementary file3 (DOCX 15 KB) (15.2KB, docx)
Supplementary file4 (DOCX 16 KB) (16.1KB, docx)

Data Availability Statement

Data will be made available upon reasonable request to authors.

Articles from European Journal of Pediatrics are provided here courtesy of Nature Publishing Group

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