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一种用于儿科护理的无线、皮肤界面脑血流动力学监测生物传感器。

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

机构信息

Querrey Simpson Institute for Bioelectronics, Northwestern University, Chicago, IL 60208;

Department of Chemical Engineering, Delft University of Technology, 2629 HZ Delft, The Netherlands.

出版信息

Proc Natl Acad Sci U S A. 2020 Dec 15;117(50):31674-31684. doi: 10.1073/pnas.2019786117. Epub 2020 Nov 30.

Abstract

The standard of clinical care in many pediatric and neonatal neurocritical care units involves continuous monitoring of cerebral hemodynamics using hard-wired devices that physically adhere to the skin and connect to base stations that commonly mount on an adjacent wall or stand. Risks of iatrogenic skin injuries associated with adhesives that bond such systems to the skin and entanglements of the patients and/or the healthcare professionals with the wires can impede clinical procedures and natural movements that are critical to the care, development, and recovery of pediatric patients. This paper presents a wireless, miniaturized, and mechanically soft, flexible device that supports measurements quantitatively comparable to existing clinical standards. The system features a multiphotodiode array and pair of light-emitting diodes for simultaneous monitoring of systemic and cerebral hemodynamics, with ability to measure cerebral oxygenation, heart rate, peripheral oxygenation, and potentially cerebral pulse pressure and vascular tone, through the utilization of multiwavelength reflectance-mode photoplethysmography and functional near-infrared spectroscopy. Monte Carlo optical simulations define the tissue-probing depths for source-detector distances and operating wavelengths of these systems using magnetic resonance images of the head of a representative pediatric patient to define the relevant geometries. Clinical studies on pediatric subjects with and without congenital central hypoventilation syndrome validate the feasibility for using this system in operating hospitals and define its advantages relative to established technologies. This platform has the potential to substantially enhance the quality of pediatric care across a wide range of conditions and use scenarios, not only in advanced hospital settings but also in clinics of lower- and middle-income countries.

摘要

许多儿科和新生儿神经重症监护病房的临床护理标准都涉及使用硬连线设备对脑血流动力学进行连续监测,这些设备物理上附着在皮肤上,并连接到通常安装在相邻墙壁或支架上的基站。与将这些系统粘接到皮肤上的粘合剂相关的医源性皮肤损伤以及患者和/或医护人员与电线的缠绕的风险可能会妨碍临床程序和对儿科患者的护理、发育和康复至关重要的自然运动。本文介绍了一种无线、微型化、机械柔软、灵活的设备,该设备支持与现有临床标准定量可比的测量。该系统具有多光电二极管阵列和一对发光二极管,可同时监测全身和脑血流动力学,通过使用多波长反射模式光体积描记法和功能近红外光谱法,具有测量脑氧合、心率、外周氧合以及潜在的脑脉搏压和血管张力的能力。蒙特卡罗光学模拟使用代表性儿科患者头部的磁共振图像定义这些系统的源-探测器距离和工作波长的组织探测深度,以定义相关的几何形状。对患有和不患有先天性中枢性低通气综合征的儿科患者的临床研究验证了在运营医院使用该系统的可行性,并定义了其相对于现有技术的优势。该平台有可能在广泛的条件和使用场景中显著提高儿科护理的质量,不仅在先进的医院环境中,而且在中低收入国家的诊所中也是如此。

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