医院间新生儿和婴儿的心肺远程监护：一种集线器和辐条网络的良好工作范例。

Inter-hospital cardiorespiratory telemonitoring of newborns and infants: a wellworking example of a hub and spoke network.

机构信息

Meyer Children's Hospital IRCCS, Sleep Disorder Breathing and SIDS Center, Viale Pieraccini, 24, Florence, 50139, Italy.

Department of Paediatrics, Meyer Children's Hospital, University of Florence, Florence, Italy.

出版信息

Ital J Pediatr. 2023 Jan 13;49(1):5. doi: 10.1186/s13052-022-01407-2.

DOI:10.1186/s13052-022-01407-2

PMID:36635722

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9837930/

Abstract

BACKGROUND

Patients who experience cardiorespiratory events usually have to be moved to specialized centers to perform cardiorespiratory studies. To avoid the transfer of these patients to specialized centers, a network has been created based on an interchange system, where the recordings were uploaded in unspecialized centers (spokes) and downloaded by the Sleep Disorders Breathing (SDB) Center (hub) to be analyzed.

METHODS

The inter-hospital network was established in November 2008. Initially only 3 non-tertiary hospitals in the Tuscany Region joined the network. Currently, 12 Tuscany hospitals are included.

RESULTS

From November 2008 to December 2020, 625 recordings were collected belonging to 422 infants. No recurrent life-threatening episode or infant death occurred in the study population and none of the infants needed to be readmitted or be moved to a tertiary center, except infants who underwent home monitoring. The discharge diagnoses belong to the following categories: apnoea, respiratory problem of the newborn, syncope, gastroesophageal reflux, altered consciousness, transient loss of consciousness and cyanosis.

CONCLUSIONS

This study shows that the inter-hospital network is an efficient system that allows accurate and safe management of infants at risk for apnoea, bradycardia, and hypoxemia to remain in unspecialized centers, avoiding unnecessary transfers of patients and over - hospitalizations.

摘要

背景

经历心肺事件的患者通常必须转移到专门的中心进行心肺研究。为避免将这些患者转移到专门的中心，已经建立了一个基于交换系统的网络，其中在非专门中心（辐条）上传记录，并由睡眠障碍呼吸（SDB）中心（枢纽）下载进行分析。

方法

该医院间网络于 2008 年 11 月建立。最初，只有托斯卡纳地区的 3 家非三级医院加入了该网络。目前，有 12 家托斯卡纳医院包括在内。

结果

从 2008 年 11 月到 2020 年 12 月，共收集了 625 份属于 422 名婴儿的记录。在研究人群中，没有发生危及生命的复发性事件或婴儿死亡，也没有婴儿需要再次入院或转移到三级中心，除了接受家庭监测的婴儿。出院诊断属于以下类别：呼吸暂停、新生儿呼吸问题、晕厥、胃食管反流、意识改变、短暂性意识丧失和发绀。