Amir Offer, Ben-Gal Tuvia, Weinstein Jean Marc, Schliamser Jorge, Burkhoff Daniel, Abbo Aharon, Abraham William T
Cardio-Vascular Institute, Baruch Padeh Medical Center, Poriya, Israel; Faculty of Medicine in the Galilee, Bar Ilan University, Tiberias, Israel.
Department of Cardiology, Rabin Medical Center, Petah Tikva, Israel.
Int J Cardiol. 2017 Aug 1;240:279-284. doi: 10.1016/j.ijcard.2017.02.120. Epub 2017 Mar 3.
We tested whether remote dielectric sensing (ReDS)-directed fluid management reduces readmissions in patients recently hospitalized for heart failure (HF).
Pulmonary congestion is the most common cause of worsening HF leading to hospitalization. Accurate remote monitoring of lung fluid volume may guide optimal treatment and prevent re-hospitalization. ReDS technology is a quantitative non-invasive method for measuring absolute lung fluid volume.
Patients hospitalized for acute decompensated HF were enrolled during their index admission and followed at home for 90days post-discharge. Daily ReDS readings were obtained using a wearable vest, and were used as a guide to optimizing HF therapy, with a goal of maintaining normal lung fluid content. Comparisons of the number of HF hospitalizations during ReDS-guided HF therapy were made, both to the 90days prior to enrollment and to the 90days following discontinuation of ReDS monitoring.
Fifty patients were enrolled, discharged, and followed at home for 76.9±26.2days. Patients were 73.8±10.3years old, 40% had LVEF above 40%, and 38% were women. Compared to the pre- and post-ReDS periods, there were 87% and 79% reductions in the rate of HF hospitalizations, respectively, during ReDS-guided HF therapy. The hazard ratio between the ReDS and the pre-ReDS period was 0.07 (95% CI [0.01-0.54] p=0.01), and between the ReDS and the post-ReDS period was 0.11 (95% CI [0.014-0.88] p=0.037).
These findings suggest that ReDS-guided management has the potential to reduce HF readmissions in acute decompensated HF patients recently discharged from the hospital.
我们测试了远程介电传感（ReDS）指导下的液体管理是否能减少近期因心力衰竭（HF）住院患者的再入院率。
肺充血是导致HF恶化并需住院治疗的最常见原因。准确远程监测肺液体积可指导优化治疗并预防再次住院。ReDS技术是一种测量绝对肺液体积的定量非侵入性方法。
入选因急性失代偿性HF住院的患者，在其首次入院期间进行登记，并在出院后在家中随访90天。使用可穿戴背心获取每日ReDS读数，并将其作为优化HF治疗的指导，目标是维持正常肺液含量。对ReDS指导下的HF治疗期间HF住院次数与入组前90天以及停止ReDS监测后的90天进行比较。
50例患者入选、出院并在家中随访76.9±26.2天。患者年龄为73.8±10.3岁，40%的患者左心室射血分数（LVEF）高于40%，38%为女性。与ReDS治疗前和治疗后阶段相比，ReDS指导下的HF治疗期间HF住院率分别降低了87%和79%。ReDS治疗期与治疗前期之间的风险比为0.07（95%置信区间[0.01 - 0.54]，p = 0.01），ReDS治疗期与治疗后期之间的风险比为0.11（95%置信区间[0.014 - 0.88]，p = 0.037）。
这些发现表明，ReDS指导下的管理有可能降低近期出院的急性失代偿性HF患者的再入院率。
