Non-invasive home lung impedance monitoring in early post-acute heart failure discharge: Three case reports

摘要

cqvip:BACKGROUND Patients discharged after hospitalization for acute heart failure(AHF) are frequently readmitted due to an incomplete decongestion, which is difficult to assess clinically. Recently, it has been shown that the use of a highly sensitive,non-invasive device measuring lung impedance(LI) reduces hospitalizations for heart failure(HF); it has also been shown that this device reduces the cardiovascular and all-cause mortality of stable HF patients when used in longterm out-patient follow-ups. The aim of these case series is to demonstrate the potential additive role of non-invasive home LI monitoring in the early postdischarge period.CASE SUMMARY We present a case series of three patients who had performed daily LI measurements at home using the edema guard monitor(EGM) during 30 d after an episode of AHF. All patients had a history of chronic ischemic HF with a reduced ejection fraction and were hospitalized for 6–17 d. LI measurements were successfully made at home by patients with the help of their caregivers. The patients were carefully followed up by HF specialists who reacted to the values of LI measurements, blood pressure, heart rate and clinical symptoms. LI reduction was a more frequent trigger to medication adjustments compared to changes in symptoms or vital signs. Besides, LI dynamics closely tracked the use and dose of diuretics.CONCLUSION Our case series suggests non-invasive home LI monitoring with EGM to be a reliable and potentially useful tool for the early detection of congestion or dehydration and thus for the further successful stabilization of a HF patient after a worsening episode.