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Use of an Enuresis Alarm to Guide Timing of Post-Void Residual Volume Assessment in Infants and Medically-Complex,
Peter Y Cai1, Andrea Balthazar1, Regina L Tham1
1Department of Urology, Boston Children's Hospital, 300 Longwood Avenue, Hunnewell 3, Boston, MA 02115.
Insights
Enuresis alarms help detect more voids and decrease post-void residual (PVR) in infants and medically complex children. This method improves PVR measurement accuracy in non-verbal, non-toilet trained pediatric patients.
Area of Science:
- Pediatric Urology
- Medical Device Technology
Background:
- Accurate post-void residual (PVR) measurement is crucial for managing bladder dysfunction in pediatric patients.
- Non-verbal, non-toilet trained children present unique challenges for timely PVR assessment.
- Current methods for PVR measurement in these populations can be inefficient and less accurate.
Purpose of the Study:
- To evaluate the feasibility and efficacy of using enuresis alarms to guide PVR measurement timing.
- To compare PVR measurements obtained with alarm-guided timing versus routine care in pediatric cohorts.
- To assess the impact of alarm use on the number of detected voids and PVR volume.
Main Methods:
- Prospective enrollment of two groups: 15 infants (Group 1) and 15 medically-complex pediatric patients (Group 2).
- An 8-hour study period included a 4-hour alarm intervention and a 4-hour routine care control period.
- Primary endpoint: PVR volume analyzed via linear regression; Secondary endpoint: number of detected voids analyzed using Mann-Whitney U test.
Main Results:
- Significantly more voids were detected with alarms in both infants (3 vs 2, P=.0029) and medically-complex patients (3 vs 1, P=.0312).
- Alarm use was associated with a mean decrease in PVR volume of 21.09 mL in medically-complex patients (P=.035).
- A non-significant mean decrease of 2.23 mL in PVR volume was observed for infants (P=.363).
Conclusions:
- Enuresis alarms effectively increase detected voids in non-verbal pediatric patients.
- Alarm-guided PVR measurement shows potential for reducing PVR volume in medically-complex children.
- This approach may enhance the accuracy of PVR measurement in challenging pediatric populations.
Objective:
To test the feasibility and efficacy of using an enuresis alarm to guide the timing of post-void residual (PVR) measurement in two different cohorts of non-verbal, non-toilet trained pediatric patients.
Methods:
We prospectively enrolled 15 infants (Group 1) and 15 medically-complex patients (Group 2) to undergo an 8-hour study period that included a 4-hour intervention period with alarm (PVR after alarm trigger) and a 4-hour control period of routine care (PVR when nurses observe wet diapers). The primary endpoint of PVR volume was analyzed using linear regression with volume as the dependent variable and both study period and patient weight as independent variables. Secondary endpoint of the number of detected voids was analyzed using Mann-Whitney U test.
Results:
In Group 1, the median number of voids detected was significantly greater in the alarm versus routine care periods (3 vs 2, P = .0029). Use of alarm was associated with a non-significant mean decrease of 2.23 mL (95% CI -7.09 to 2.63, P = .363) in PVR volume for infants. In Group 2, the median number of detected voids were also significantly different in the alarm versus routine care periods (3 vs 1, P = .0312). Use of alarm was associated with a mean decrease of 21.09 mL (95% CI -40.60 to -1.58, P = .035) in PVR volume.
Conclusion:
An enuresis alarm facilitated detecting significantly more voids in both infants and medically-complex, non-verbal children and was also associated with a decrease in PVR volume in the latter group. Such use of enuresis alarms may prove useful to measure PVR more accurately in these challenging populations.
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