Internet-based Home Monitoring of Pulmonary Function after Lung Transplantation
- 1 March 2002
- journal article
- Published by American Thoracic Society in American Journal of Respiratory and Critical Care Medicine
- Vol. 165 (5), 694-697
- https://doi.org/10.1164/ajrccm.165.5.2107059
Abstract
Home monitoring of spirometry has been advocated in lung transplant recipients for the early detection of acute infection and rejection of the allograft. We have developed a user-friendly, Internet-based telemonitoring system providing direct transmission of home spirometry to the hospital. In this prospective study, we assessed patient adherence with the monitoring, agreement between home and hospital spirometry, intrasubject coefficient of variation (CV) for FEV(1) and FEF(25-75), and sensitivity of these variables for the detection of acute complications. Twenty-two bilateral-lung and heart-lung transplant recipients were followed for a median of 473 d (range, 60-822), during which 13,833 measurements were obtained. Patient compliance was 55% for two measurements a day and 84% for one measurement a day. Agreement between home and hospital spirometry was within 4% for FEV(1) and 6% for FEF(25-75). Mean CV was 3.2% for FEV(1) and 7.5% for FEF(25-75). Using transbronchial lung biopsy and/or bronchoalveolar lavage as gold standards, the sensitivity of home spirometry was 63%, and 23% of true positives were detected by changes in FEF(25-75) alone. We conclude that home monitoring of pulmonary function in lung transplant recipients via the Internet is feasible and provides very reproducible data; yet it has only a mild sensitivity for the detection of acute allograft dysfunction.Journal ArticleResearch Support, Non-U.S. Gov'tinfo:eu-repo/semantics/publisheKeywords
This publication has 16 references indexed in Scilit:
- Detection of Obliterative Bronchiolitis after Lung Transplantation by Indexes of Ventilation DistributionAmerican Journal of Respiratory and Critical Care Medicine, 2000
- Bronchial Hyperreactivity after Lung Transplantation Predicts Early Bronchiolitis ObliteransAmerican Journal of Respiratory and Critical Care Medicine, 1999
- Spirometry values in stable lung transplant recipients.American Journal of Respiratory and Critical Care Medicine, 1997
- Monitoring progress after lung transplantation from home-patient adherenceJournal of Medical Engineering & Technology, 1996
- Inert gas single-breath washout after heart-lung transplantation.American Journal of Respiratory and Critical Care Medicine, 1995
- Limitations of spirometry in detecting rejection after single-lung transplantation.American Journal of Respiratory and Critical Care Medicine, 1994
- Lung Function Associated with Histologically Diagnosed Acute Lung Rejection and Pulmonary Infection in Heart-Lung Transplant PatientsAmerican Review of Respiratory Disease, 1990
- The Use of Home Spirometry in Detecting Acute Lung Rejection and Infection Following Heart-Lung TransplantationSocial psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 1990
- STATISTICAL METHODS FOR ASSESSING AGREEMENT BETWEEN TWO METHODS OF CLINICAL MEASUREMENTThe Lancet, 1986
- Changes in Measured Spirometric IndicesSocial psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 1981