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用于心力衰竭住院后出院护理以缓解症状并改善临床结局的数字健康技术。

Digital Health Technologies for Post-Discharge Care after Heart Failure Hospitalisation to Relieve Symptoms and Improve Clinical Outcomes.

作者信息

Krzesiński Paweł

机构信息

Department of Cardiology and Internal Diseases, Military Institute of Medicine-National Research Institute, Szaserow Street 128, 04-141 Warsaw, Poland.

出版信息

J Clin Med. 2023 Mar 19;12(6):2373. doi: 10.3390/jcm12062373.

Abstract

The prevention of recurrent heart failure (HF) hospitalisations is of particular importance, as each such successive event may increase the risk of death. Effective care planning during the vulnerable phase after discharge is crucial for symptom control and improving patient prognosis. Many clinical trials have focused on telemedicine interventions in HF, with varying effects on the primary endpoints. However, the evidence of the effectiveness of telemedicine solutions in cardiology is growing. The scope of this review is to present complementary telemedicine modalities that can support outpatient care of patients recently hospitalised due to worsening HF. Remote disease management models, such as video (tele) consultations, structured telephone support, and remote monitoring of vital signs, were presented as core components of telecare. Invasive and non-invasive monitoring of volume status was described as an important step forward to prevent congestion-the main cause of clinical decompensation. The idea of virtual wards, combining these facilities with in-person visits, strengthens the opportunity for education and enhancement to promote more intensive self-care. Electronic platforms provide coordination of tasks within multidisciplinary teams and structured data that can be effectively used to develop predictive algorithms based on advanced digital science, such as artificial intelligence. The rapid progress in informatics, telematics, and device technologies provides a wide range of possibilities for further development in this area. However, there are still existing gaps regarding the use of telemedicine solutions in HF patients, and future randomised telemedicine trials and real-life registries are still definitely needed.

摘要

预防心力衰竭(HF)复发住院尤为重要,因为每一次这样的连续事件都可能增加死亡风险。出院后脆弱阶段的有效护理规划对于症状控制和改善患者预后至关重要。许多临床试验都聚焦于心力衰竭的远程医疗干预,对主要终点的影响各不相同。然而,远程医疗解决方案在心脏病学方面有效性的证据正在增加。本综述的范围是介绍可以支持因心力衰竭恶化而近期住院患者门诊护理的补充性远程医疗模式。远程疾病管理模式,如视频(远程)会诊、结构化电话支持和生命体征远程监测,被视为远程护理的核心组成部分。对容量状态的有创和无创监测被描述为预防充血(临床失代偿的主要原因)向前迈出的重要一步。将这些设施与面对面就诊相结合的虚拟病房理念,增强了教育和强化的机会,以促进更强化的自我护理。电子平台提供多学科团队内任务的协调以及结构化数据,这些数据可有效地用于基于先进数字科学(如人工智能)开发预测算法。信息学、远程信息处理和设备技术的快速发展为该领域的进一步发展提供了广泛的可能性。然而,在心力衰竭患者中使用远程医疗解决方案仍存在差距,未来仍绝对需要进行随机远程医疗试验和实际病例登记。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c80/10058646/2b0803e85c55/jcm-12-02373-g001.jpg

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