Development of a smartphone-based device to detect fluid overload among postpartum women with hypertensive disorders of pregnancy

开发基于智能手机的设备来检测患有妊娠期高血压疾病的产后妇女的液体超负荷

• 批准号: 10437610
• 负责人: Alisse Hauspurg
• 金额: $ 15.15万
• 依托单位: MAGEE-WOMEN'S RES INST AND FOUNDATION
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-01 至 2024-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10437610
• 关键词: Accelerometer; Address; Adherence; Algorithms; Ambulatory Monitoring; Blood Pressure; Blood Pressure Monitors; Blood Volume; Breathing; Cardiovascular system; Caring; Cellular Phone; Congestive; Coupled; Cues; Data; Development; Devices; Diuresis; Echocardiography; Effectiveness; Fluid overload; Future; Goals; Heart failure; Home; Home Blood Pressure Monitoring; Hospitals; Hypertension; Institution; Lead; Left; Liquid substance; Lung; Maternal Mortality; Measures; Mission; Modeling; Monitor; Morbidity - disease rate; Optic Nerve; Outpatients; Patient Education; Patients; Photoplethysmography; Physiologic pulse; Physiological; Population; Postpartum Hypertension; Postpartum Period; Postpartum Women; Pre-Eclampsia; Public Health; Randomized Controlled Trials; Research; Seizures; Starling (law); Stroke; Sturnus vulgaris; Symptoms; Technology; Testing; Tidal Volume; Time; United States; United States National Institutes of Health; Variant; Ventricular; Woman; aggressive therapy; base; blood pressure elevation; blood pressure reduction; cohort; design; disability; disparities in morbidity; disparity reduction; effective intervention; evidence base; experience; health care disparity; hospital readmission; hypertension treatment; improved; indexing; innovation; maternal morbidity; mortality; novel; novel strategies; postpartum care; pregnancy disorder; pregnancy hypertension; pressure; programs; prospective; randomized trial; remote assessment; respiratory; response; sensor; smartphone based assessment; treatment program; ultrasound

PROJECT ABSTRACT Hypertensive disorders of pregnancy contribute to a significant proportion of maternal morbidity and mortality and are the most common reason for hospital readmission postpartum. While treatment of hypertension is the cornerstone of postpartum management, emerging evidence suggests that implementation of robust remote blood pressure monitoring and treatment programs alone do not reduce maternal morbidity or hospital readmissions related to postpartum fluid overload and heart failure symptoms. The ability to predict which women will develop these complications and pursue more aggressive treatment with diuresis prior to hospital discharge or in the first week postpartum is limited. The overall goal of this line of research is to develop and implement a convenient congestion prediction device for home use in conjunction with home blood pressure monitoring in a postpartum population following a hypertensive disorder of pregnancy. In this application, the objective is to develop and test a smartphone-based device to predict fluid overload in patients with preeclampsia through three specific aims: 1) to build multiple smartphone-based devices to assess volume status via a congestion prediction index in postpartum women with preeclampsia, 2) to collect patient training data with the devices, optimize their accuracy in assessing volume status, and identify and create the final real-time device and 3) to validate the final device prospectively in response to known fluid changes among a new cohort of postpartum women with preeclampsia. The research proposed in this application is innovative in its novel adaptation of evidence-based approaches to fluid assessment in heart failure patients to an understudied postpartum population with significant morbidity, its use of a smartphone form factor and the design and the proposed testing of multiple devices to optimize effectiveness and convenience. This proposal is significant as it will provide an opportunity to develop and assess the feasibility of smartphone- based assessment of fluid status among postpartum women with preeclampsia. Effective interventions to improve postpartum hypertension care coupled with innovative remote strategies have broad implications for improving maternal morbidity and reducing disparities in care. Our findings will provide a valuable framework to inform a future randomized trial of remote assessment and management of fluid status in the postpartum period. Successful completion of this line of research would represent a transformation in postpartum management of women with preeclampsia and have a direct impact to improve hypertension and cardiovascular-related maternal morbidity and mortality.

项目摘要 妊娠期高血压疾病是造成孕产妇死亡的重要原因 和死亡率，并且是产后再入院的最常见原因。而 治疗高血压是产后管理的基石，新兴证据 建议实施强大的远程血压监测和治疗 计划本身并不能减少孕产妇发病率或与之相关的再入院率。 产后体液过多和心力衰竭症状。预测哪些女性会 出现这些并发症，并在 出院或产后第一周是有限的。这条路线的总体目标是 研究开发一种方便的家用交通拥堵预测装置 结合产后人群的家庭血压监测， 妊娠期高血压疾病。在这个应用程序中，目标是开发和测试一个 基于智能手机的设备通过三种方法预测先兆子痫患者的液体超负荷 具体目标：1）构建多个基于智能手机的设备，通过 先兆子痫产后妇女充血预测指数，2）收集患者 使用设备训练数据，优化其评估容量状态的准确性，并识别 并创建最终实时设备，以及3）作为响应，前瞻性地验证最终设备 一组新的先兆子痫产后妇女中已知的液体变化。的 在这项申请中提出的研究是创新的，在其新的适应证据为基础的 对心力衰竭患者进行液体评估的方法 具有显著发病率的人群，其使用智能手机的形状因素和设计， 建议测试多个设备，以优化有效性和便利性。这项建议是 重要的是，它将提供一个机会，开发和评估智能手机的可行性- 子痫前期妇女产后液体状态的评估。有效 干预措施，以改善产后高血压护理加上创新的远程 这些战略对降低孕产妇发病率和减少 在乎我们的研究结果将提供一个有价值的框架，为未来的随机试验提供信息。 远程评估和管理产后期间的液体状态。成功 这项研究的完成将代表产后管理的转变 对改善高血压有直接影响， 心血管相关的孕产妇发病率和死亡率。