Background: Electrocardiogram (ECG) and impedance pneumography (IPG), the most widely used techniques for cardiorespiratory monitoring in the neonatal intensive care unit (NICU), have the disadvantage of causing skin damage when used for very premature newborn infants. To prevent skin damage, we designed a new piezoelectric transducer (PZT) sensor. Objective: To assess the potential of the PZT sensor for cardiorespiratory monitoring in the NICU. Methods: The PZT sensor was placed under a folded towel under a neonate to detect an acoustic cardiorespiratory signal, from which heart rate (HR) and breathing rate (BR) were calculated, together with simultaneous ECG/IPG recording for 1–9 days for long and brief (1-min) assessment. Results: The brief assessment showed average correlation coefficients of 0.92 ± 0.12 and 0.95 ± 0.02 between instantaneous HRs/BRs detected by the PZT sensor and ECG/IPG in 27 and 11 neonates examined. During the long assessment, the HR detection rate by the PZT sensor was ∼10% lower than that by ECG (82.6 ± 12.9 vs. 91.8 ± 4.1%; p = 0.001, n = 27), although comparable (90.3 ± 4.1 vs. 92.5 ± 3.4%, p = 0.081) in ∼70% (18/27) of neonates examined; BR detection rate was comparable between the PZT sensor and IPG during relatively stable signal conditions (95.9 ± 4.0 vs. 95.3 ± 3.5%; p = 0.38, n = 11). The PZT sensor caused neither skin damage nor body movement increase in all neonates examined. Conclusion: The PZT sensor is noninvasive and does not cause skin irritation, and we believe it does provide a reliable, accurate cardiorespiratory monitoring tool for use in the NICU, although the issue of mechanical-ventilation noise remains to be solved.

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