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Codesign of remote data collection for chronic management of pediatric home mechanical ventilation

Carolyn C Foster1,2,3, Aaron J Kaat4, Avani V Shah5,6

  • 1Division of Advanced General Pediatrics and Primary Care, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.

Pediatric Pulmonology
|September 13, 2023
PubMed

Insights

Remote patient monitoring (RPM) is feasible and acceptable for children on invasive home mechanical ventilation (IHMV). This technology captures clinically significant vital sign changes during ventilator breaks, improving IHMV management.

Area of Science:

  • Pediatric Pulmonology
  • Biomedical Engineering
  • Health Informatics

Background:

  • Outpatient monitoring of children with invasive home mechanical ventilation (IHMV) is crucial but faces access challenges.
  • This study investigated the feasibility and acceptability of remote data collection for chronic IHMV management.

Purpose of the Study:

  • To assess the feasibility and acceptability of remote patient monitoring (RPM) for children using IHMV.
  • To evaluate the clinical utility of RPM in capturing vital sign changes during ventilator use.

Main Methods:

  • A codesign study involving an IHMV program, nurses, and parents of children (0-17 years) using IHMV.
  • Parents utilized an RPM bundle for 8 weeks to collect physiological data (HR, RR, SpO2, EtCO2, ventilator pressures).
  • User feedback was analyzed using qualitative methods and the System Usability Scale (SUS); mixed-effects models analyzed vital sign differences.

Main Results:

  • RPM data were collected for a mean of 83.7% of weeks, with high usability scores (Nurses: 84.8, Parents: 91.8).
  • Over 90% of parents found RPM feasible and relevant for their child's care.
  • Significant increases in end-tidal carbon dioxide (EtCO2) and respiratory rate (RR) were observed during ventilator breaks.

Conclusions:

  • Remote patient monitoring (RPM) is a feasible and acceptable method for managing children with IHMV.
  • RPM effectively captures clinically meaningful vital sign variations, supporting its utility in IHMV care.
  • This technology enhances the management of children requiring invasive home mechanical ventilation.
Abstract

Keywords:
bronchopulmonary dysplasiachildren with medical complexityhome mechanical ventilationlong-term mechanical ventilationremote patient monitoring

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