Schüchtermann-Klinik Bad Rothenfelde, Bad Rothenfelde, Germany.
Institute for Cardiology and Sports Medicine, German Sports University Cologne, Cologne, Germany.
Artif Organs. 2020 Mar;44(3):248-256. doi: 10.1111/aor.13560. Epub 2019 Oct 7.
For the success of the treatment with a left ventricular assist device (LVAD), both adequate self-management by the patient and an optimum level of support from the implanting hospital are crucial. A smartphone application has recently been developed within the framework of a European research project for the close monitoring of LVAD patients in order to improve upon their current aftercare situation. Using this new tool, different relevant parameters (eg, weight, international normalized ratio [INR], medication, LVAD parameters, symptoms, and photos of the driveline exit) can be sent daily or as required to a corresponding clinical application at the hospital for evaluation. The objective of this study was to monitor the functionality, acceptance, and usability of this smartphone application in LVAD patients. Prospective single-center study: in total, 13 patients (60 ± 7 years, 92% male, 1027 ± 653 days after LVAD implantation) were requested to test the application for approx. 4 weeks. At the end of the study, all entered data were evaluated and the patients were questioned regarding the acceptance and the usability. During the study period of mean 34 ± 8 days, a total of 453 data records (mean 35 ± 7 per patient) arrived at the hospital. In addition, a total of 19 photos of the driveline exit site were also sent via smartphone. The clinical application registered a total of 160 conspicuities. These comprised 126 INR deviations (target range 2.3-2.8) and 34 symptoms (mainly nosebleeds). The smartphone application functioned reliably, was well received by the patients and was graded highly for acceptance and usability. The results show that smartphone applications can definitely be used to improve aftercare in LVAD therapy in selected patients. Long-term studies are now needed to investigate the extent to which complications can be prevented, healthcare costs reduced, and quality of life increased.
为了确保左心室辅助装置（LVAD）治疗的成功，患者的充分自我管理和植入医院的最佳支持水平都至关重要。最近，在一个欧洲研究项目的框架内，开发了一种智能手机应用程序，用于密切监测 LVAD 患者，以改善他们当前的后续护理情况。使用这个新工具，不同的相关参数（例如，体重、国际标准化比值 [INR]、药物、LVAD 参数、症状和移植物出口的照片）可以每天或根据需要发送到医院的相应临床应用程序进行评估。本研究的目的是监测这款智能手机应用程序在 LVAD 患者中的功能、接受度和可用性。这是一项前瞻性单中心研究：总共邀请了 13 名患者（60±7 岁，92%为男性，LVAD 植入后 1027±653 天）试用该应用程序约 4 周。在研究结束时，评估了所有输入的数据，并询问了患者对该应用程序的接受度和可用性。在平均 34±8 天的研究期间，总共向医院发送了 453 条数据记录（平均每位患者 35±7 条）。此外，还通过智能手机总共发送了 19 张移植物出口部位的照片。临床应用程序共记录了 160 个异常情况。这些异常包括 126 次 INR 偏差（目标范围 2.3-2.8）和 34 次症状（主要是鼻出血）。智能手机应用程序可靠运行，受到患者的欢迎，并在接受度和可用性方面获得了很高的评分。结果表明，智能手机应用程序肯定可以用于改善选定患者的 LVAD 治疗后的护理。现在需要进行长期研究，以调查在多大程度上可以预防并发症、降低医疗保健成本和提高生活质量。
