Effects of Remote Patient Monitoring on Neonatal Intensive Care Unit Patients Discharged with Nasogastric Tube Feeding.

Abstract

To examine whether discharge with remote patient monitoring (RPM) is associated with improved outcomes among infants discharged from the neonatal intensive care unit with a nasogastric tube (NGT). This was a retrospective cohort study of infants discharged with an NGT from the Cincinnati Children's Hospital Medical Center neonatal intensive care unit from 2015 to 2022. Infants were divided into pre-RPM and RPM cohorts. Differences in clinical characteristics, weight at follow-up, and unplanned health care utilization were evaluated using multivariable generalized linear regression models. There were 385 eligible patients (n = 139 pre-RPM, n = 246 RPM). Infants discharged with RPM had higher rates of prematurity. The RPM group was discharged at an earlier postmenstrual age (43.00 vs 44.12 weeks, P = .0102) and had more favorable change in weight z-score at follow-up (0.21 [0.03, 0.4] at 3 months, 0.34 [0.09, 0.58)] at 6 months). The risk of unplanned admissions or emergency department visits was 53% lower in the RPM group than in the pre-RPM group (risk ratio = 0.47 [0.28, 0.79]). Patients discharged with an NGT plus RPM were discharged at earlier postmenstrual age, had more favorable growth trajectory, and had fewer unplanned health care encounters, indicating that discharge with NGT feeds with RPM appears to be safer and more effective than discharge with NGT feeds without RPM.