A Cochrane review [Abstract] 1 included 3 studies with a total of 354 subjects within 3 days of stroke onset. One study represented 77% of the overall sample. All trials monitored blood pressure, ECG, oxygen saturation and body temperature. One trial also monitored respiratory frequency and EEG, two trials measured blood glucose. The duration of continuous monitoring lasted at least 72 hours in two trials, and 48 hours or longer in one trial. In intermittent monitoring group the majority of physiological variables were monitored every 4-6 hours. Continuous monitoring significantly reduced death and disability at 3 months or at discharge, if follow up was no longer available (OR 0.27, 95% CI 0.13 to 0.56; 3 trials, n=354) and was associated with a non-significant reduction in deaths from any cause at discharge (OR 0.72, 95% CI 0.28 to 1.85; 3 trials, n=354) compared with intermittent monitoring. Continuous monitoring was associated with a non-significant reduction of dependency (OR 0.79, 95% CI 0.30 to 2.06; 2 trials, n=86), death from vascular causes (OR 0.48, 95% CI 0.10 to 2.39; 3 trials, n=354), neurological complications (OR 0.81, 95% CI 0.46 to 1.43; 3 trials, n=354), length of stay (MD -5.24, 95% CI -10.51 to 0.03; 3 trials, n=354) and institutionalisation (OR 0.83, 95% CI 0.04 to 15.72; 2 trials, n=300). Cardiac complications (OR 8.65, 95% CI 2.52 to 29.66; 3 trials, n=354), fever (OR 2.17, 95% CI 1.22 to 3.84; 3 trials, n=354) and hypotension (OR 4.32, 95% CI 1.68 to 14.38; 3 trials, n=354) were detected significantly more often in participants who received continuous monitoring. No significant increase in adverse events due to immobility (pneumonia, other infections or deep vein thrombosis) was detected in participants who were continuously monitored compared with those allocated to intermittent monitoring.
Comment: The quality of the evidence is downgraded by study quality (lack of allocation concealment and blinding), imprecise results (few studies with small sample sizes) and indirectness (short follow up time).
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