Clinical Validation of a Wearable Respiratory Rate Device for Neonatal Monitoring
01 Jul 2018-Vol. 2018, pp 1628-1631
TL;DR: Clinical validation of a system for continuous and long term respiratory rate monitoring of neonates, in a wearable form factor with the capability of remote monitoring is presented and results show a high degree of correlation between the respiratory rate measured by the device and reference measurements.
Abstract: Respiratory rate monitoring is of paramount importance in neonatal care. Manual counting of expansions and contractions of the abdomen or diaphragm of the neonate is still the widely accepted measure of respiratory rate in most clinical settings. A practical, affordable, easy-to-use technology to continuously measure respiratory rate in neonates is essential to recognize the signs and symptoms of respiratory disorders. Clinical validation of a system for continuous and long term respiratory rate monitoring of neonates, in a wearable form factor with the capability of remote monitoring is presented in this paper. The respiratory rate monitor was validated in clinical settings on 10 premature babies with various disease conditions and respiratory rates varying from 25 to 90 breaths per minute. Results show a high degree of correlation between the respiratory rate measured by the device and reference measurements. An intelligent algorithm which can remove motion corruption from the accelerometer data and provide reliable results is essential for large-scale adoption of the technology for both clinical as well as home monitoring. The technical details of implementation, results and analysis of the clinical study and observations made during clinical study regarding the feasibility of integrating the device in neonatal care are covered in this paper.
Citations
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TL;DR: An algorithm to explicitly maximize the respiratory signal quality by maximizing the Signal-to-Noise Ratio (SNR) is proposed, which is based on the Generalized Eigen Value Decomposition (GEVD) algorithm and estimates the optimal combination of the temporal color traces to obtain a high-quality rPPG signal.
19 citations
TL;DR: In this article, a review of non-contact breathing rate monitoring in newborn infants is presented, and the advantages, limitations, and clinical applications of these methods are discussed, as well as signal processing, feasibility, and future direction of different noncontact respiratory rate monitoring methods.
14 citations
01 Aug 2021
TL;DR: In this paper, the authors designed an Internet-of-things (IoT) based smart textile chest belt called "Baby-Guard" to monitor respiration rate (RR) and detect critical events such as apnea.
Abstract: A rising number of preterm babies demands innovative solutions to monitor them in the Neonatal Intensive Care Unit (NICU) continuously. NICU monitors various kinds of vital signs. Among them, there is a strong demand for an accurate and sophisticated technology to monitor respiration rate (RR) and detect critical events such as apnea. Existing solutions for RR monitoring either rely on the indirect measurements from thoracic impedance or other invasive techniques posing discomfort and risk of infections to babies. Also, multiple wire loops lying around babies hinder the delivery of parental and clinical care. Motivated by this need, we have designed an Internet-of-Things (IoT) based smart textile chest belt called "Baby-Guard" to monitor RR and detect apnea. The Baby-Guard is a neonatal wearable system consisting of a sensor belt, a wearable embedded system, and an edge computing device. The sensor belt consists of textile-based pressure sensors and an Inertial Measurement Unit (IMU). The wearable system consists of a microcontroller equipped with wireless connectivity and power management. The edge computing device (ECD) connects with the wearable system through an MQTT networking architecture. ECD hosts signal processing and computing services to extract RR and detect apnea. We conducted simulation experiments using a high-fidelity, programmable NICU baby mannequin. We found an average error of 0.89 BrPM in breathing rate and ~97 percent accuracy in apnea detection. Computation and communication latencies were found to be ~66 and 22 ms, respectively. The Baby-Guard showed potential to be a wireless infant monitoring system in the NICU settings.
7 citations
TL;DR: NeoWear as mentioned in this paper is a wearable system consisting of a sensor belt, a wearable embedded system, and an edge computing device for monitoring respiration and events related to the respiration.
6 citations
5 citations
References
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TL;DR: The authors' evidence-based centile charts for children from birth to 18 years should help clinicians to update clinical and resuscitation guidelines and show decline in respiratory rate fromBirth to early adolescence.
947 citations
"Clinical Validation of a Wearable R..." refers background in this paper
...Respiratory rate is of paramount importance in neonatal monitoring [2]....
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TL;DR: Following best-practice strategies is effective in preventing neonatal pneumonia and its complications and on the basis of strong evidence, administration of antenatal corticosteroids and postnatal surfactant decrease respiratory morbidity associated with RDS.
Abstract: Respiratory distress presents as tachypnea, nasal flaring, retractions, and grunting and may progress to respiratory failure if not readily recognized and managed. Causes of respiratory distress vary and may not lie within the lung. A thorough history, physical examination, and radiographic and laboratory findings will aid in the differential diagnosis. Common causes include transient tachypnea of the newborn, neonatal pneumonia, respiratory distress syndrome (RDS), and meconium aspiration syndrome (MAS). Strong evidence reveals an inverse relationship between gestational age and respiratory morbidity. (1)(2)(9)(25)(26) Expert opinion recommends careful consideration about elective delivery without labor at less than 39 weeks’ gestation. Extensive evidence, including randomized control trials, cohort studies, and expert opinion, supports maternal group B streptococcus screening, intrapartum antibiotic prophylaxis, and appropriate followup of high-risk newborns according to guidelines established by the Centers for Disease Control and Prevention. (4)(29)(31)(32)(34) Following these best-practice strategies is effective in preventing neonatal pneumonia and its complications. (31)(32)(34). On the basis of strong evidence, including randomized control trials and Cochrane Reviews, administration of antenatal corticosteroids (5) and postnatal surfactant (6) decrease respiratory morbidity associated with RDS. Trends in perinatal management strategies to prevent MAS have changed. There is strong evidence that amnioinfusion, (49) oropharyngeal and nasopharyngeal suctioning at the perineum, (45) or intubation and endotracheal suctioning of vigorous infants (46)(47) do not decrease MAS or its complications. Some research and expert opinion supports endotracheal suctioning of nonvigorous meconium-stained infants (8) and induction of labor at 41 weeks’ gestation (7) to prevent MAS.
182 citations
"Clinical Validation of a Wearable R..." refers background in this paper
...Hence, it is imperative that pediatricians can readily recognize the signs and symptoms of respiratory distress, differentiate various causes, and initiate management strategies to prevent complications [5]....
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07 Jun 2010
TL;DR: A method based on tri-axial accelerometer data from a wireless sensor device, which tracks the axis of rotation and obtains angular rates of breathing motion is demonstrated, which is validated against gyroscope measurements and shows high correlation to flow rate measurements using a nasal cannula.
Abstract: There is a strong medical need for continuous, unobstrusive respiratory monitoring, and many shortcomings to existing methods. Previous work shows that MEMS accelerometers worn on the torso can measure inclination changes due to breathing, from which a respiratory rate can be obtained. There has been limited validation of these methods. The problem of practical continuous monitoring, in which patient movement disrupts the measurements and the axis of interest changes, has also not been addressed. We demonstrate a method based on tri-axial accelerometer data from a wireless sensor device, which tracks the axis of rotation and obtains angular rates of breathing motion. The resulting rates are validated against gyroscope measurements and show high correlation to flow rate measurements using a nasal cannula. We use a movement detection method to classify periods in which the patient is static and breathing signals can be observed accurately. Within these periods we obtain a close match to cannula measurements, for both the flow rate waveform and derived respiratory rates, over multi-hour datasets obtained from wireless sensor devices on hospital patients. We discuss future directions for improvement and potential methods for estimating absolute airflow rate and tidal volume.
126 citations
"Clinical Validation of a Wearable R..." refers background in this paper
...Other non-contact methods like use of imaging-based solutions are not affordable and requires proper line of sight for reliable monitoring [6]....
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03 Jun 2009
TL;DR: The first version of the neonatal jacket that enables ECG measurement by textile electrodes is presented, and a new solution for skin-contact challenges that textile electrodes pose is explored.
Abstract: Critically ill new born babies admitted at the Neonatal Intensive Care Unit (NICU) are extremely tiny and vulnerable to external disturbance. Smart Jacket proposed in this paper is the vision of a wearable unobtrusive continuous monitoring system realized by body sensor networks (BSN) and wireless communication. The smart jacket aims for providing reliable health monitoring as well as a comfortable clinical environment for neonatal care and parent-child interaction. We present the first version of the neonatal jacket that enables ECG measurement by textile electrodes. We also explore a new solution for skin-contact challenges that textile electrodes pose. The jacket is expandable with new wearable technologies and has aesthetics that appeal to parents and medical staff. An iterative design process in close contact with the users and experts lead to a balanced integration of technology, user focus and aesthetics. We demonstrate the prototype and the experimental results obtained in clinical setting.
114 citations
"Clinical Validation of a Wearable R..." refers background in this paper
...Temperature, respiratory rate and blood oxygen saturation level are the three main vital signs for standard clinical assessment of children with acute illness [1]....
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14 May 2008
TL;DR: A method to detect the respiratory waveform from an accelerometer strapped onto the chest is proposed, suitable for automatic identification of some respiratory malfunction, for example during the obstructive apnea.
Abstract: The cardiorespiratory signal is a fundamental vital sign to assess a person's health. Additionally, the cardio-respiratory signal gives a great deal of information to healthcare providers wishing to monitor healthy individuals. This paper proposes a method to detect the respiratory waveform from an accelerometer strapped onto the chest. A system was designed and several experiments were conducted on volunteers. The acquisition is performed in different status: normal, apnea, deep breathing and also in different postures: vertical (sitting, standing) or horizontal (lying down). This method could therefore be suitable for automatic identification of some respiratory malfunction, for example during the obstructive apnea.
106 citations
"Clinical Validation of a Wearable R..." refers background in this paper
...Respiratory conditions are the most common reason for admission to a neonatal unit in both term and preterm infants [4]....
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