Application-based remote interstage home monitoring for infants with shunt- or duct-dependent pulmonary perfusion
ObjectiveInterstage home monitoring (IHM) programs are considered standard of care after Norwood palliation and have led to substantial improvements in clinical outcomes. This study aims to evaluate an application-based remote IHM program for infants with shunt- or duct-dependent pulmonary circulati...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2025-01-01
|
| Series: | Frontiers in Cardiovascular Medicine |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2024.1493698/full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1841558799259795456 |
|---|---|
| author | Lisa-Maria Rosenthal Lisa-Maria Rosenthal Lisa-Maria Rosenthal Friederike Danne Sophie de Belsunce Lisa Spath Chiara-Aiyleen Badur Joachim Photiadis Felix Berger Felix Berger Katharina Schmitt Katharina Schmitt Katharina Schmitt |
| author_facet | Lisa-Maria Rosenthal Lisa-Maria Rosenthal Lisa-Maria Rosenthal Friederike Danne Sophie de Belsunce Lisa Spath Chiara-Aiyleen Badur Joachim Photiadis Felix Berger Felix Berger Katharina Schmitt Katharina Schmitt Katharina Schmitt |
| author_sort | Lisa-Maria Rosenthal |
| collection | DOAJ |
| description | ObjectiveInterstage home monitoring (IHM) programs are considered standard of care after Norwood palliation and have led to substantial improvements in clinical outcomes. This study aims to evaluate an application-based remote IHM program for infants with shunt- or duct-dependent pulmonary circulation. The primary goals were to discharge infants from the hospital while minimizing mortality, optimizing somatic growth, and enhancing caregivers' confidence in the clinical management at home.MethodsInfants with shunt-dependent single ventricle physiology or complex biventricular physiology requiring staged palliation with aortopulmonary shunt were enrolled for the study. Caregivers completed a comprehensive education program on the clinical management of their child at home and were asked to remotely send monitoring data using an application. We analyzed demographic data and clinical outcomes; evaluated patient acceptance and adherence, as well as data entry patterns and metrics; and compared these to a historical control group monitored in a non-remote IHM program and with a propensity score-matched cohort adjusted for baseline characteristics.ResultsWe enrolled 30 infants in the remote IHM program between July 2021 and May 2024. The median duration of IHM was 110 days (IQR 75–140). A median of 353 (IQR 351–743) data entries were sent per patient during IHM of which 0.8% (IQR 0.3–1.9) were pathological. Readmissions (63%) and interventions (57%) were common, mainly due to cyanosis and infections. As all infants survived stage II palliation, interstage mortality could be reduced to 0% compared to 10.3% in the historical control group and was significantly lower compared to the propensity score-matched cohort with 14% (P = 0.032).ConclusionApplication-based remote IHM for infants with duct- or shunt-dependent pulmonary perfusion is feasible, with high acceptance and adherence. The program significantly reduced interstage mortality compared to traditional monitoring methods. Remote patient monitoring (RPM) improves communication between caregivers and healthcare teams, allowing for early intervention and optimized patient outcomes. RPM has the potential to improve outcomes, enhance patient safety, and reduce family burden in this high-risk population. |
| format | Article |
| id | doaj-art-d55d56285ee64146956fc722880e3e2c |
| institution | Kabale University |
| issn | 2297-055X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj-art-d55d56285ee64146956fc722880e3e2c2025-01-06T06:58:56ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-01-011110.3389/fcvm.2024.14936981493698Application-based remote interstage home monitoring for infants with shunt- or duct-dependent pulmonary perfusionLisa-Maria Rosenthal0Lisa-Maria Rosenthal1Lisa-Maria Rosenthal2Friederike Danne3Sophie de Belsunce4Lisa Spath5Chiara-Aiyleen Badur6Joachim Photiadis7Felix Berger8Felix Berger9Katharina Schmitt10Katharina Schmitt11Katharina Schmitt12Department of Congenital Heart Disease—Pediatric Cardiology, Deutsches Herzzentrum der Charité (DHZC), Berlin, GermanyBerlin Institute of Health, Berlin, GermanyGerman Centre for Cardiovascular Research, Partner Site Berlin, Berlin, GermanyDepartment of Congenital Heart Disease—Pediatric Cardiology, Deutsches Herzzentrum der Charité (DHZC), Berlin, GermanyDepartment of Congenital Heart Disease—Pediatric Cardiology, Deutsches Herzzentrum der Charité (DHZC), Berlin, GermanyDepartment of Congenital Heart Disease—Pediatric Cardiology, Deutsches Herzzentrum der Charité (DHZC), Berlin, GermanyDepartment of Congenital Heart Disease—Pediatric Cardiology, Deutsches Herzzentrum der Charité (DHZC), Berlin, GermanyDepartment of Congenital Heart Surgery, Deutsches Herzzentrum der Charité (DHZC), Berlin, GermanyDepartment of Congenital Heart Disease—Pediatric Cardiology, Deutsches Herzzentrum der Charité (DHZC), Berlin, GermanyGerman Centre for Cardiovascular Research, Partner Site Berlin, Berlin, GermanyDepartment of Congenital Heart Disease—Pediatric Cardiology, Deutsches Herzzentrum der Charité (DHZC), Berlin, GermanyGerman Centre for Cardiovascular Research, Partner Site Berlin, Berlin, GermanyDepartment of Developmental Pediatrics, Deutsches Herzzentrum der Charité (DHZC), Berlin, GermanyObjectiveInterstage home monitoring (IHM) programs are considered standard of care after Norwood palliation and have led to substantial improvements in clinical outcomes. This study aims to evaluate an application-based remote IHM program for infants with shunt- or duct-dependent pulmonary circulation. The primary goals were to discharge infants from the hospital while minimizing mortality, optimizing somatic growth, and enhancing caregivers' confidence in the clinical management at home.MethodsInfants with shunt-dependent single ventricle physiology or complex biventricular physiology requiring staged palliation with aortopulmonary shunt were enrolled for the study. Caregivers completed a comprehensive education program on the clinical management of their child at home and were asked to remotely send monitoring data using an application. We analyzed demographic data and clinical outcomes; evaluated patient acceptance and adherence, as well as data entry patterns and metrics; and compared these to a historical control group monitored in a non-remote IHM program and with a propensity score-matched cohort adjusted for baseline characteristics.ResultsWe enrolled 30 infants in the remote IHM program between July 2021 and May 2024. The median duration of IHM was 110 days (IQR 75–140). A median of 353 (IQR 351–743) data entries were sent per patient during IHM of which 0.8% (IQR 0.3–1.9) were pathological. Readmissions (63%) and interventions (57%) were common, mainly due to cyanosis and infections. As all infants survived stage II palliation, interstage mortality could be reduced to 0% compared to 10.3% in the historical control group and was significantly lower compared to the propensity score-matched cohort with 14% (P = 0.032).ConclusionApplication-based remote IHM for infants with duct- or shunt-dependent pulmonary perfusion is feasible, with high acceptance and adherence. The program significantly reduced interstage mortality compared to traditional monitoring methods. Remote patient monitoring (RPM) improves communication between caregivers and healthcare teams, allowing for early intervention and optimized patient outcomes. RPM has the potential to improve outcomes, enhance patient safety, and reduce family burden in this high-risk population.https://www.frontiersin.org/articles/10.3389/fcvm.2024.1493698/fullremote patient monitoringinterstage monitoringapplication-based monitoringsingle ventricle heart diseaseNorwood palliationshunt-dependent pulmonary perfusion |
| spellingShingle | Lisa-Maria Rosenthal Lisa-Maria Rosenthal Lisa-Maria Rosenthal Friederike Danne Sophie de Belsunce Lisa Spath Chiara-Aiyleen Badur Joachim Photiadis Felix Berger Felix Berger Katharina Schmitt Katharina Schmitt Katharina Schmitt Application-based remote interstage home monitoring for infants with shunt- or duct-dependent pulmonary perfusion Frontiers in Cardiovascular Medicine remote patient monitoring interstage monitoring application-based monitoring single ventricle heart disease Norwood palliation shunt-dependent pulmonary perfusion |
| title | Application-based remote interstage home monitoring for infants with shunt- or duct-dependent pulmonary perfusion |
| title_full | Application-based remote interstage home monitoring for infants with shunt- or duct-dependent pulmonary perfusion |
| title_fullStr | Application-based remote interstage home monitoring for infants with shunt- or duct-dependent pulmonary perfusion |
| title_full_unstemmed | Application-based remote interstage home monitoring for infants with shunt- or duct-dependent pulmonary perfusion |
| title_short | Application-based remote interstage home monitoring for infants with shunt- or duct-dependent pulmonary perfusion |
| title_sort | application based remote interstage home monitoring for infants with shunt or duct dependent pulmonary perfusion |
| topic | remote patient monitoring interstage monitoring application-based monitoring single ventricle heart disease Norwood palliation shunt-dependent pulmonary perfusion |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2024.1493698/full |
| work_keys_str_mv | AT lisamariarosenthal applicationbasedremoteinterstagehomemonitoringforinfantswithshuntorductdependentpulmonaryperfusion AT lisamariarosenthal applicationbasedremoteinterstagehomemonitoringforinfantswithshuntorductdependentpulmonaryperfusion AT lisamariarosenthal applicationbasedremoteinterstagehomemonitoringforinfantswithshuntorductdependentpulmonaryperfusion AT friederikedanne applicationbasedremoteinterstagehomemonitoringforinfantswithshuntorductdependentpulmonaryperfusion AT sophiedebelsunce applicationbasedremoteinterstagehomemonitoringforinfantswithshuntorductdependentpulmonaryperfusion AT lisaspath applicationbasedremoteinterstagehomemonitoringforinfantswithshuntorductdependentpulmonaryperfusion AT chiaraaiyleenbadur applicationbasedremoteinterstagehomemonitoringforinfantswithshuntorductdependentpulmonaryperfusion AT joachimphotiadis applicationbasedremoteinterstagehomemonitoringforinfantswithshuntorductdependentpulmonaryperfusion AT felixberger applicationbasedremoteinterstagehomemonitoringforinfantswithshuntorductdependentpulmonaryperfusion AT felixberger applicationbasedremoteinterstagehomemonitoringforinfantswithshuntorductdependentpulmonaryperfusion AT katharinaschmitt applicationbasedremoteinterstagehomemonitoringforinfantswithshuntorductdependentpulmonaryperfusion AT katharinaschmitt applicationbasedremoteinterstagehomemonitoringforinfantswithshuntorductdependentpulmonaryperfusion AT katharinaschmitt applicationbasedremoteinterstagehomemonitoringforinfantswithshuntorductdependentpulmonaryperfusion |