Simpson Querrey Institute, Northwestern University, Chicago, IL, USA.
Department of Electrical and Computer Engineering, Northwestern University, Evanston, IL, USA.
Nat Med. 2020 Mar;26(3):418-429. doi: 10.1038/s41591-020-0792-9. Epub 2020 Mar 11.
Standard clinical care in neonatal and pediatric intensive-care units (NICUs and PICUs, respectively) involves continuous monitoring of vital signs with hard-wired devices that adhere to the skin and, in certain instances, can involve catheter-based pressure sensors inserted into the arteries. These systems entail risks of causing iatrogenic skin injuries, complicating clinical care and impeding skin-to-skin contact between parent and child. Here we present a wireless, non-invasive technology that not only offers measurement equivalency to existing clinical standards for heart rate, respiration rate, temperature and blood oxygenation, but also provides a range of important additional features, as supported by data from pilot clinical studies in both the NICU and PICU. These new modalities include tracking movements and body orientation, quantifying the physiological benefits of skin-to-skin care, capturing acoustic signatures of cardiac activity, recording vocal biomarkers associated with tonality and temporal characteristics of crying and monitoring a reliable surrogate for systolic blood pressure. These platforms have the potential to substantially enhance the quality of neonatal and pediatric critical care.
标准的新生儿和儿科重症监护病房(NICU 和 PICU)临床护理包括使用硬连线设备对生命体征进行连续监测,这些设备紧贴皮肤,在某些情况下,还可以使用插入动脉的基于导管的压力传感器。这些系统存在造成医源性皮肤损伤的风险,使临床护理变得复杂,并阻碍了父母与孩子之间的皮肤接触。在这里,我们展示了一种无线、非侵入性的技术,它不仅提供了与现有临床心率、呼吸频率、温度和血氧标准等效的测量方法,而且还提供了一系列重要的附加功能,这些功能得到了 NICU 和 PICU 试点临床研究数据的支持。这些新方法包括跟踪运动和身体方向、量化皮肤接触的生理益处、捕捉心脏活动的声学特征、记录与哭声的音调和时间特征相关的生物标志物以及监测收缩压的可靠替代指标。这些平台有可能极大地提高新生儿和儿科重症监护的质量。