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Introduction

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.

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.

Conclusion

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