Recent advances in materials science and biomedical engineering serve as the basis for devices that have a skin-like form factor.
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Although textile-based sensors are of interest, these technologies retain wired connections across the body, and their inability to support an intimate connection to the skin precludes reliable operation at clinical-grade levels of accuracy, particularly with motion ( 5– 7).
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Moreover, the adhesives that couple these wired electrodes to the fragile skin of the neonates are a frequent cause of iatrogenic injuries and subsequent scarring ( 2– 4).Ī fully wireless alternative that eliminates mechanical stresses and potentially reduces injury risk, and that deploys effectively on the full range of gestational ages encountered in the NICU, would represent a substantial advance over the existing standard of care.
This hardware also interferes with emergency clinical interventions and radiological studies, and impedes therapeutic skin-to-skin contact (colloquially known as kangaroo mother care) between parents and their infant. Although such technologies are essential to clinical care, the associated web of wires complicates even the most basic bedside tasks, such as turning a neonate from prone to supine. Existing monitoring systems for the NICU require multiple electrode/sensor interfaces to the skin, with hard-wired connections to separately located base units that may be stand-alone or wall-mounted, for heart rate (HR), respiratory rate (RR), temperature, blood oxygenation (SpO 2), and blood pressure (BP). Each year in the United States, approximately 300,000 neonates, including a large fraction with exceptionally fragile health due to severe prematurity and very low birth weight (<1500 g), are admitted to neonatal intensive care units (NICUs) ( 1). RESULTSĬontinuous recording and real-time graphical display of vital signs are essential for critical care. The resulting systems can be much smaller in size, lighter in weight, and less traumatic to the skin than any existing alternative. Four essential advances in engineering science serve as the foundations for this technology: (i) schemes for wireless power transfer, low-noise sensing, and high-speed data communications via a single radio-frequency link with negligible absorption in biological tissues (ii) efficient algorithms for real-time data analytics, signal processing, and dynamic baseline modulation implemented on the sensor platforms themselves (iii) strategies for time-synchronized streaming of wireless data from two separate devices and (iv) designs that enable visual inspection of the skin interface while also allowing magnetic resonance imaging and x-ray imaging of the neonate.
These devices can gently and noninvasively interface onto the skin of neonates with gestational ages down to the edge of viability. It is now possible to fabricate wireless, battery-free vital signs monitoring systems based on ultrathin, “skin-like” measurement modules.
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