Associations of Home Monitoring Data to Interventional Catheterization for Infants with Recurrent Coarctation of the Aorta and Hypoplastic Left Heart Syndrome
Abstract The post-Norwood interstage period for infants with hypoplastic left heart syndrome is a high-risk time with 10–20% of infants having a complication of recurrent coarctation of the aorta (RCoA). Many interstage programs utilize mobile applications allowing caregivers to submit home physiologic data and videos to the clinical team. This study aimed to investigate if caregiver-entered data resulted in earlier identification of patients requiring interventional catheterization for RCoA. Retrospective home monitoring data were extracted from five high-volume Children’s High Acuity Monitoring Program®-affiliated centers (defined as contributing > 20 patients to the registry) between 2014 and 2021 after IRB approval. Demographics and caregiver-recorded data evaluated include weight, heart rate (HR), oxygen saturation ($ SpO_{2} $), video recordings, and ‘red flag’ concerns prior to interstage readmissions. 27% (44/161) of infants required interventional catheterization for RCoA. In the 7 days prior to readmission, associations with higher odds of RCoA included (mean bootstrap coefficient, [90% CI]) increased number of total recorded videos (1.65, [1.07–2.62]) and days of recorded video (1.62, [1.03–2.59]); increased number of total recorded weights (1.66, [1.09–2.70]) and days of weights (1.56, [1.02–2.44]); increasing mean $ SpO_{2} $ (1.55, [1.02–2.44]); and increased variation and range of HR (1.59, [1.04–2.51]) and (1.71, [1.10–2.80]), respectively. Interstage patients with RCoA had increased caregiver-entered home monitoring data including weight and video recordings, as well as changes in HR and $ SpO_{2} $trends. Identifying these items by home monitoring teams may be beneficial in clinical decision-making for evaluation of RCoA in this high-risk population..
| Medienart: |
Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:44 |
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| Enthalten in: |
Pediatric cardiology - 44(2023), 7 vom: 08. Juli, Seite 1462-1470 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Patel, Parth S. [VerfasserIn] |
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| Links: |
Volltext [lizenzpflichtig] |
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| Themen: |
Cardiac catheterization |
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| Anmerkungen: |
© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. |
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| doi: |
10.1007/s00246-023-03224-8 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 520 | |a Abstract The post-Norwood interstage period for infants with hypoplastic left heart syndrome is a high-risk time with 10–20% of infants having a complication of recurrent coarctation of the aorta (RCoA). Many interstage programs utilize mobile applications allowing caregivers to submit home physiologic data and videos to the clinical team. This study aimed to investigate if caregiver-entered data resulted in earlier identification of patients requiring interventional catheterization for RCoA. Retrospective home monitoring data were extracted from five high-volume Children’s High Acuity Monitoring Program®-affiliated centers (defined as contributing > 20 patients to the registry) between 2014 and 2021 after IRB approval. Demographics and caregiver-recorded data evaluated include weight, heart rate (HR), oxygen saturation ($ SpO_{2} $), video recordings, and ‘red flag’ concerns prior to interstage readmissions. 27% (44/161) of infants required interventional catheterization for RCoA. In the 7 days prior to readmission, associations with higher odds of RCoA included (mean bootstrap coefficient, [90% CI]) increased number of total recorded videos (1.65, [1.07–2.62]) and days of recorded video (1.62, [1.03–2.59]); increased number of total recorded weights (1.66, [1.09–2.70]) and days of weights (1.56, [1.02–2.44]); increasing mean $ SpO_{2} $ (1.55, [1.02–2.44]); and increased variation and range of HR (1.59, [1.04–2.51]) and (1.71, [1.10–2.80]), respectively. Interstage patients with RCoA had increased caregiver-entered home monitoring data including weight and video recordings, as well as changes in HR and $ SpO_{2} $trends. Identifying these items by home monitoring teams may be beneficial in clinical decision-making for evaluation of RCoA in this high-risk population. | ||
| 650 | 4 | |a Hypoplastic left heart syndrome | |
| 650 | 4 | |a Interstage monitoring | |
| 650 | 4 | |a Coarctation of the aorta | |
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