Wireless, Skin‐Interfaced Devices for Pediatric Critical Care: Application to Continuous, Noninvasive Blood Pressure Monitoring

Abstract

Indwelling arterial lines, the clinical gold standard for continuous blood pressure (BP) monitoring in the pediatric intensive care unit (PICU), have significant drawbacks due to their invasive nature, ischemic risk, and impediment to natural body movement. A noninvasive, wireless, and accurate alternative would greatly improve the quality of patient care. Recently introduced classes of wireless, skin‐interfaced devices offer capabilities in continuous, precise monitoring of physiologic waveforms and vital signs in pediatric and neonatal patients, but have not yet been employed for continuous tracking of systolic and diastolic BP—critical for guiding clinical decision‐making in the PICU. The results presented here focus on materials and mechanics that optimize the system‐level properties of these devices to enhance their reliable use in this context, achieving full compatibility with the range of body sizes, skin types, and sterilization schemes typically encountered in the PICU. Systematic analysis of the data from these devices on 23 pediatric patients, yields derived, noninvasive BP values that can be quantitatively validated against direct recordings from arterial lines. The results from this diverse cohort, including those under pharmacological protocols, suggest that wireless, skin‐interfaced devices can, in certain circumstances of practical utility, accurately and continuously monitor BP in the PICU patient population.

Soft shape-programmable surfaces by fast electromagnetic actuation of liquid metal networks

“…7c ). The programmable surfaces were uniformly coated with black dots (~200–500 μm) using a spray-painting technique 72 . The 3D imaging acquisition hardware and the programmable surface system were externally synchronized to allow rapid, automated collection of data for thousands of different shapes.…”

Recent Advances in Materials and Flexible Sensors for Arrhythmia Detection

“…For example, the general impedance challenges of sweat buildup on electrodes have been addressed by integrating hydrophilic poly(urethane-acrylate) into Ag electrodes to increase conductivity during sweating and increasing the breathability of the substrate, as shown in Figure 2c,d [37][38][39][40][41]. All-in-one systems featuring wireless charging, wireless data communication, and onboard data analysis have been developed, as in Figure 2e [42][43][44][45].…”

Skin‐Integrated Devices with Soft, Holey Architectures for Wireless Physiological Monitoring, With Applications in the Neonatal Intensive Care Unit

“…[23][24][25] The hydrogel adhesive is based on 2-acrylamido-2-methylpropane sulfonic acid/ acrylic acid (AMPS/AA) copolymer. [16] Water reduces the adhesion by hydrating and decomposing the hydrogel network. [40] After immersion for 24 h, the hydrogel is fully decomposed (Figure S23, Supporting Information).…”

“…[3] Soft, wireless electronic devices can overcome these and other drawbacks of traditional monitoring equipment, to enable safe and effective care for vulnerable patients. [7][8][9][10][11][12][13][14][15][16] Soft, flexible, and biocompatible hydrogels are options in skin-interfaces for integrated circuit systems designed for health monitoring. [17] Two such types of technologies have been demonstrated with patients in NICU and PICU facilities.…”