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 怀孕的高血压疾病有助于孕产妇的发病率很大 和死亡率，是产后医院再入院的最常见原因。尽管 高血压治疗是产后管理的基石，即新兴的证据 表明实施强大的远程血压监测和治疗 仅计划就不会降低母亲的发病率或与医院的再入院 产后液体超负荷和心力衰竭症状。预测哪些女性的能力 发展这些并发症，并在先进之前对利尿进行更积极的治疗 医院出院或产后第一周有限。这条线的总体目标 研究是开发和实施便利的拥塞预测设备，以供家庭使用 结合与家庭血压监测后，产后人群的血压监测 怀孕的高血压障碍。在此应用中，目标是开发和测试 基于智能手机的设备可以预测子痫前期患者的流体超负荷 具体目的：1）构建多个基于智能手机的设备以通过A评估音量状态 产后妇女的拥塞预测指数 使用设备培训数据，优化其评估数量状态的准确性，并确定 并创建最终的实时设备和3）为响应验证最终设备 在新的产后女性患有先兆子痫的新队列中已知的液体变化。这 在本应用中提出的研究对基于证据的新颖适应性是创新的 心力衰竭患者的液体评估方法 发病率明显的人口，使用智能手机外形和设计以及 建议对多个设备进行测试，以优化有效性和便利性。该提议是 意义重大，因为它将提供一个开发和评估智能手机的可行性的机会 - 基于子痫前期女性中基于液体状况的评估。有效的 改善产后高血压护理的干预措施以及创新的遥控器 策略对改善孕产妇的发病率和降低差异具有广泛的影响 关心。我们的发现将提供一个宝贵的框架，以告知未来的随机试验 产后的远程评估和管理流体状况。成功的 这一研究的完成将代表产后管理的转变 先兆子痫的妇女的直接影响，以改善高血压和 心血管相关的孕产妇发病率和死亡率。