title: Feasibility of a remote monitoring system for home-based non-invasive positive pressure ventilation of children and infants.
abstract: OBJECTIVE
  We examined the safety, efficacy, and caregiver satisfaction of a remote monitoring system for home-based non-invasive positive pressure ventilation of children and infants with upper airway obstruction.
  
  
  METHODS
  Fourteen pediatric patients (age 50 days to 12 years) treated in our ENT unit from March 2009 to July 2011 and requiring home-based non-invasive positive pressure ventilation were enrolled in this feasibility study; one patient underwent CPAP and the other 13 patients underwent Bi-PAP. User satisfaction with the monitoring system was assessed by questionnaires given at regular intervals to parents and attending physicians. Compliance was determined by the number of days that parents uploaded data to the central server. In addition, the feasibility of the system was analyzed by comparing costs and time expenditures with traditional clinic visits.
  
  
  RESULTS
  The patients' parents (primary caregivers) uploaded data via the system on 93.3% of trial days, indicating good compliance. No system or device failures occurred. Both parents and physicians considered the system convenient and ease to use according to >80% of the returned questionnaires, indicating high user satisfaction. The mean distance between the patients' homes and the hospital was 113 ± 71 km, and parents required 371 ± 182 min to reach the hospital for a follow-up visit. In contrast, it took only 5.7 ± 3.1 min per day to transmit data (P<0.05 compared to hospital travel time). As of August 2011, average cost per patient was 632 Chinese yuan (¥), which was ¥924 (59.4%) lower than the cost of clinic visits (¥1556).
  
  
  CONCLUSIONS
  The remote monitoring system was safe, reliable, easy to use, cost effective, and widely acceptable to both parents and physicians. This system may allow for safe and effective home-based non-invasive positive pressure ventilation for children with upper airway obstructions in developing countries with limited health care budgets or for patients from remote regions.
authors.affiliation: Guangzhou Women and Children's Medical Center, Affiliated Women and Children's Medical Center of Guangzhou Medical University, Guangzhou, Guangdong, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Zhou
authors.forename: Da-Bo
authors.initials: DB
authors.lastname: Liu
authors.forename: Jian-Wen
authors.initials: JW
authors.lastname: Zhong
authors.forename: Zhen-Yun
authors.initials: ZY
authors.lastname: Huang
authors.forename: Shu-Yao
authors.initials: SY
authors.lastname: Qiu
authors.forename: Yu-Ping
authors.initials: YP
authors.lastname: Zhou
authors.forename: Xin-Hua
authors.initials: XH
authors.lastname: Yi
mesh_terms: D000402:Airway Obstruction / Q000503:physiopathology / Q000628:therapy*; D017028:Caregivers; D002648:Child; D002675:Child, Preschool; D002681:China; D003266:Continuity of Patient Care; D003362:Cost-Benefit Analysis; D005240:Feasibility Studies; D005260:Female; D006699:Home Care Services; D006801:Humans; D007223:Infant; D008297:Male; D008991:Monitoring, Physiologic / Q000191:economics / Q000295:instrumentation* / Q000379:methods; D010351:Patient Discharge; D061214:Patient Safety; D011175:Positive-Pressure Respiration / Q000379:methods*; D011446:Prospective Studies; D013686:Telemetry / Q000191:economics / Q000295:instrumentation*; D016896:Treatment Outcome