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心力衰竭患者远程监测的影响因素:文献回顾与未来研究方向。

Influential Factors in Remote Monitoring of Heart Failure Patients: A Review of the Literature and Direction for Future Research.

机构信息

The Kite Research Institute, Toronto Rehabilitation Institute-University Health Network, University of Toronto, Toronto, ON M5G 2A2, Canada.

Institute of Biomedical Engineering, University of Toronto, Toronto, ON M5S 3G9, Canada.

出版信息

Sensors (Basel). 2021 May 21;21(11):3575. doi: 10.3390/s21113575.

Abstract

With new advances in technology, remote monitoring of heart failure (HF) patients has become increasingly prevalent and has the potential to greatly enhance the outcome of care. Many studies have focused on implementing systems for the management of HF by analyzing physiological signals for the early detection of HF decompensation. This paper reviews recent literature exploring significant physiological variables, compares their reliability in predicting HF-related events, and examines the findings according to the monitored variables used such as body weight, bio-impedance, blood pressure, heart rate, and respiration rate. The reviewed studies identified correlations between the monitored variables and the number of alarms, HF-related events, and/or readmission rates. It was observed that the most promising results came from studies that used a combination of multiple parameters, compared to using an individual variable. The main challenges discussed include inaccurate data collection leading to contradictory outcomes from different studies, compliance with daily monitoring, and consideration of additional factors such as physical activity and diet. The findings demonstrate the need for a shared remote monitoring platform which can lead to a significant reduction of false alarms and help in collecting reliable data from the patients for clinical use especially for the prevention of cardiac events.

摘要

随着技术的新进展,对心力衰竭(HF)患者的远程监测变得越来越普遍,并有潜力极大地改善护理效果。许多研究都集中在通过分析生理信号来实施 HF 管理系统,以便早期检测 HF 失代偿。本文回顾了最近探索重要生理变量的文献,比较了它们在预测 HF 相关事件中的可靠性,并根据所监测的变量(如体重、生物阻抗、血压、心率和呼吸率)来检查研究结果。综述的研究确定了监测变量与警报次数、HF 相关事件和/或再入院率之间的相关性。结果表明,与使用单个变量相比,使用多个参数组合的研究得出了更有希望的结果。讨论的主要挑战包括数据收集不准确,导致不同研究的结果相互矛盾,对日常监测的依从性,以及考虑其他因素,如身体活动和饮食。研究结果表明需要一个共享的远程监测平台,这可以显著减少误报,并有助于从患者那里收集可靠的数据用于临床使用,特别是用于预防心脏事件。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/affc/8196679/ffe5a7f5199b/sensors-21-03575-g001.jpg

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