ISSN 1866-8836
Клеточная терапия и трансплантация

PС-03. Remote nutrition monitoring in patients undergoing allogeneic hematopoietic stem cells transplantation

Natalia M. Nikiforova, Mikhail Yu. Drokov, Vera A. Vasilieva, Ekaterina D. Mikhaltsova, Natalia N. Popova, Daria S. Dubnyak, Anna A. Dmitrova, Olga M. Koroleva, Zoya V. Konova, Mobil I. Akhmedov, Maria V. Dovydenko, Olga S. Starikova, Ulyana V. Maslikova, Feruza A. Omarova, Elmira I. Kolgaeva, Larisa A. Kuzmina, Elena N. Parovichnikova, Valery G. Savchenko

National Research Center for Hematology, Moscow, Russian Federation

Contact: Dr. Mikhail Yu. Drokov, phone: +7 (495) 614 9042, e-mail: mdrokov@gmail.com

doi 10.18620/ctt-1866-8836-2020-9-3-1-152

Summary

Introduction

In the course of treatment, patients undergoing allogeneic hematopoietic stem cells transplantation (allo-HSCT) require constant monitoring, control of basic vital functions in order to early detect a different spectrum of complications and evaluate the effectiveness of their therapy. Taking into account the successful practical application of remote monitoring of clinically significant parameters in patients who underwent allo-HSCT by means of the self-monitoring portal (dnevnik.blood.ru) (http://idmz.ru/jurnali/vrach-i-informatsionnye-tekhnologii/2020/1), as well as frequent nutritional problems during allo-HSCT, we also consider that monitoring of patient’s nutritional status during the hospitalization and after discharge from the hospital is vital. Our objective was to evaluate the effectiveness of using remote monitoring to control the sufficiency of essential nutrients in the patients after allo-HSCT.

Materials and methods

Patients undergoing allo-HSCT in National Research Center for Hematology, were offered to use remote nutrition monitoring. Twenty-eight patients with blood diseases were included in the study. Using the electronic application, to which the patients introduced data on their daily food consumption, the indices of the patient’s daily supply of proteins, fats, carbohydrates and the number of calories consumed per day were calculated. The daily amount of calories needed for each patient to maintain their current weight was calculated using the Harris-Benedict equation. The daily requirement for macronutrients was estimated from this calculation: proteins, 1.0 g/kg/day; fats, 1.5 g/kg/day; carbohydrates, 4.0 g/kg/day. Parenteral nutrition, due to the lack of indications, was not administered to the patients, except of 5% glucose solution (up to 1500 ml/day), which was not taken into account upon the calculations. The data is presented as a scatterplot.

Nikiforova-fig01.jpg

Figure 1. Daily intake of calories (A), proteins (B), fats (C) and carbohydrates (D) relative to medians of normal intake

Results

The daily caloric requirement median to maintain the pre-transplant body weight, under the conditions of minimal physical activity, was 1780 kcal/day. As seen from figure 1A, all the patients have a severe calorie deficiency at different terms after allo-HSCT. The values of proteins (Figure 1B), fats (Figure 1C) and carbohydrates (Figure 1D) consumed by patients were also lower than the medians of the calculated normal daily intake (proteins, 69 g/day; fat 103.5 g/day, carbohydrates 276 g/day).

Conclusion

Our work demonstrates that remote monitoring allows the obtaining of objective information about not only clinically important parameters and blood tests performed outside the hospital, but it is also suitable for assessing malnutrition in patients undergoing allo-HSCT. Remote monitoring can be useful for further study of patient nutrition issues, which can further contribute to improvement of current protocols of supportive care for allo-HSCT.

Keywords

Remote monitoring, nutrition monitoring, allogeneic stem cell transplantation.



Volume 9, Number 3
09/30/2020

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doi 10.18620/ctt-1866-8836-2020-9-3-1-152

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