Parenteral nutrition weaning in pediatric intestinal failure patients enrolled in remote patient monitoring: A descriptive study.

Abstract

Background: Remote patient monitoring (RPM) enhances patient surveillance. This study describes our initial experience with RPM in pediatric intestinal failure patients and its preliminary impact on parenteral nutrition (PN) reduction in an outpatient setting.

Methods: We performed a descriptive cohort study on pediatric patients with intestinal failure receiving home PN and enrolled in an RPM program managed by our intestinal rehabilitation team. Initiated in March 2021, the study compared PN energy and volume reduction rates before and after RPM implementation. We calculated the rate of PN decrease per day and the time to achieve a 20% reduction in PN volume. Paired t tests were used for comparisons. Statistical significance was set at P < 0.05. The study received institutional review board approval.

Results: Seventeen patients were included (52% male; mean age: 44 months). The most common etiology of short bowel syndrome was necrotizing enterocolitis (NEC), with a mean residual small bowel length of 15.5% ± 12.5%. Post-RPM, there was a greater reduction in PN energy and volume (0.22 ± 0.28 and 0.17 ± 0.24) compared with pre-RPM (0.08 ± 0.10 and 0.07 ± 0.08), though not statistically significant (P = 0.11 and P = 0.17). Time to achieve a 20% reduction in PN was shorter post RPM but not statistically significant (P = 0.06 and P = 0.20 for energy and volume, respectively).

Conclusion: Remote patient monitoring appears safe for pediatric intestinal failure patients, with potential for higher PN reduction and shorter time to achieve it. Further research is needed to fully assess RPM's impact on this population.