Skin-interfaced biosensors for advanced wireless physiological monitoring in neonatal and pediatric intensive-care units

Abstract

Standard of care management in neonatal and pediatric intensive care units (NICUs and PICUs) involve continuous monitoring of vital signs with hard-wired devices that adhere to the skin and, in certain instances, include catheter-loaded pressure sensors that insert into the arteries. These protocols involve risks for complications and impediments to clinical care and skin-to-skin contact between parent and child. Here we present a wireless, non-invasive technology that not only offers measurement equivalency to these management standards but also supports a range of important additional features (without limitations or shortcomings of existing approaches), supported by data from pilot clinical studies in the neonatal intensive care unit (NICU) and pediatric ICU (PICU). The combined capabilities of these platforms extend beyond clinical quality measurements of vital signs (heart rate, respiration rate, temperature and blood oxygenation) to include novel modalities for (1) tracking movements and changes in body orientation, (2) quantifying the physiological benefits of skin-to-skin care (e.g. Kangaroo care) for neonates, (3) capturing acoustic signatures of cardiac activity by directly measuring mechanical vibrations generated through the skin on the chest, (4) recording vocal biomarkers associated with tonality and temporal characteristics of crying impervious to confounding ambient noise, and (5) monitoring a reliable surrogate for systolic blood pressure. The results have potential to significantly enhance the quality of neonatal and pediatric critical care.In the United States, over 480,000 critically-ill infants and children enter intensive care units (ICUs) each year. Those less than one year of age suffer from the highest morbidity and mortality rates and therefore require the most intensive care 1,2 . These fragile patients include

A wireless, skin-interfaced biosensor for cerebral hemodynamic monitoring in pediatric care

“…Pilot studies in operating hospital environments indicate no negative skin effects during device operation. The skin-interfacing adhesives and the device encapsulation materials are similar to those tested on over 100 neonatal and pediatric subjects, including premature babies born as young as 24-wk gestational age, for up to 24 h at 8 wk of postnatal life without any negative skin effects on their fragile premature skin (23). These results further support the clinical safety and feasibility of the systems reported here.…”

Improvements in Patient Monitoring in the Intensive Care Unit: Survey Study

“…In many cases, technical requirement analysis (eg, Bluetooth connectivity and interference with other medical devices) was conducted more than a decade ago [ 26 , 27 ]. However, implementation into intensive care routines is still in its infancy [ 28 ]. Reasons for this may be the costs associated with developing novel wireless sensors for a high-reliability environment such as the ICU, and technical challenges associated with the need to recharge sensors regularly.…”

Continuous on-body sensing for the COVID-19 pandemic: Gaps and opportunities

“…Figure 1 shows the device and some representative data collected from a patient with COVID-19. These systems, as well as a related platform developed by Sibel Health for wireless ICU-grade monitoring of complete vital signs, including pulse oximetry, are currently deployed at scale on patients, physicians, nurses, and respiratory rehabilitation specialists at the Shirley Ryan AbilityLab and Northwestern Memorial Hospital in Chicago ( 23 ). Initially, on-going pilot studies on ~50 subjects over the past 2 months reveal many interesting features of the disease and its progression, extracted from several terabytes of raw data, including those collected on patients released to the home.…”