Implementation of a Wireless Device for Real-Time Telemedical Assistance of Home-Ventilated Amyotrophic Lateral Sclerosis Patients: A Feasibility Study
Implementation of a Wireless Device for Real-Time Telemedical Assistance of Home-Ventilated Amyotrophic Lateral Sclerosis Patients: A Feasibility Study
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DOI：
10.1089/tmj.2010.0042
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发表时间：
2010-10-01
期刊：
影响因子：
--
通讯作者：
de Carvalho, Mamede
中科院分区：
文献类型：
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作者：
Lopes de Almeida, Jos Pedro;Pinto, Anabela C.;de Carvalho, Mamede
神经肌肉疾病涵盖了广泛的疾病类别，给患者、家庭和社会带来了重大负担。远程家庭监测通过确保及时传输数据并在病情恶化之前提示医疗支持，为更密切的后续行动提供了另一种选择。我们在一家诊所使用TeleHome监测设备对患有呼吸衰竭的肌萎缩侧索硬化症患者进行监测。该仪器直接充当从外部仪器(如双水平呼吸机)接收的参数的数字记录器，并包含用于直接连接到互联网的内部调制解调器，从而允许在需要时双向灵活地收集数据和参数变化。对患者和所有参与的治疗师对该系统的使用和接受情况进行了调查。研究人员发现，该仪器使用方便、有效，对患者和治疗师都是实用的。因此，它可以集成到基于大型呼吸康复中心的常规家庭护理应用中。该设备经过了广泛的测试，在一项正在进行的随机对照研究中，正在调查这种管理策略是否能够加速呼吸机适应过程，并在同时具有经济可行性的情况下减少卫生服务的总体利用率。我们的结论是，家庭远程监护对慢性患者的管理具有积极的贡献，并应在不久的将来考虑提高对此的认识。这种便携式远程监护设备提供了一种适当的方法，通过对家庭环境中的长期通风监测来更好地了解和识别通风模式。
Neuromuscular disorders encompass a wide category of illnesses with a significant burden on the patient, family, and society. Telehome monitoring presents an alternative for closer follow-up, by ensuring timely transmission of data and prompting medical support before deterioration occurs. We used telehome monitoring devices for amyotrophic lateral sclerosis patients with respiratory failure in a clinic. This instrument directly acts as a digital recorder of parameters received from an external instrument, such as the bi-level ventilator, and contains an internal modem for direct connection to the Internet, thereby allowing bidirectional flexibility in collecting data and parameter changes whenever needed. The use and acceptance of the system was investigated with patients and all therapists involved. The instrument was found to be user-friendly and effective by the researchers, being practical for both patients and therapists. Therefore, it can be integrated into a routine home care application based on a large respiratory rehabilitation center. The device was extensively tested, and in an ongoing randomized controlled study it is being investigated whether this management strategy is able to hasten the ventilator adaptation process and to diminish the overall utilization of health services, with concurrent economic viability. We conclude that home telemonitoring represents a positive contribution to the management of chronic patients and raised awareness of it should be considered in a near future. This portable telemonitoring device provides an opportune approach to better understand and recognize a ventilatory pattern through long-term ventilation monitoring in the home environment.