Continuous remote monitoring of COPD patients—justification and explanation of the requirements and a survey of the available technologies

• Published in: Medical & biological engineering & computing Vol. 56; no. 4; pp. 547 - 569
• Main Authors: Tomasic, Ivan, Tomasic, Nikica, Trobec, Roman, Krpan, Miroslav, Kelava, Tomislav
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.04.2018; Springer Nature B.V
• Subjects: Annan medicinteknik; Biomedical and Life Sciences; Biomedical Engineering and Bioengineering; Biomedicine; Blood pressure; Carbon dioxide; Chronic obstructive pulmonary disease; Computer Applications; COPD; Decision support in healthcare; eHealth; Electrocardiography - methods; Engineering and Technology; Human Physiology; Humans; Imaging; Lung diseases; Medical Engineering; Medical research; Medicinteknik; Monitoring; Monitoring, Physiologic; Motivation; Obstructive lung disease; Other Medical Engineering; Parameters; Partial pressure; Patch ECG; Patients; Physiology; Pulmonary Disease, Chronic Obstructive - diagnosis; Radiology; Remote monitoring; Remote patient monitoring; Review; Review Article; Teknik; Telehealth; Telehealthcare; Telemedicine; Transcutaneous measurement; Telehealthcare; Patch ECG; Telemedicine; Telehealth; Decision support in healthcare; Chronic obstructive pulmonary disease; Transcutaneous measurement; Remote patient monitoring; eHealth; COPD
• ISSN: 0140-0118; 1741-0444; 1741-0444
• DOI: 10.1007/s11517-018-1798-z

Remote patient monitoring should reduce mortality rates, improve care, and reduce costs. We present an overview of the available technologies for the remote monitoring of chronic obstructive pulmonary disease (COPD) patients, together with the most important medical information regarding COPD in a language that is adapted for engineers. Our aim is to bridge the gap between the technical and medical worlds and to facilitate and motivate future research in the field. We also present a justification, motivation, and explanation of how to monitor the most important parameters for COPD patients, together with pointers for the challenges that remain. Additionally, we propose and justify the importance of electrocardiograms (ECGs) and the arterial carbon dioxide partial pressure (PaCO 2 ) as two crucial physiological parameters that have not been used so far to any great extent in the monitoring of COPD patients. We cover four possibilities for the remote monitoring of COPD patients: continuous monitoring during normal daily activities for the prediction and early detection of exacerbations and life-threatening events, monitoring during the home treatment of mild exacerbations, monitoring oxygen therapy applications, and monitoring exercise. We also present and discuss the current approaches to decision support at remote locations and list the normal and pathological values/ranges for all the relevant physiological parameters. The paper concludes with our insights into the future developments and remaining challenges for improvements to continuous remote monitoring systems. Graphical abstract ᅟ