Zhou Ping, Lu Meiling, Chen Ping, Wang Danlei, Jin Zhenchao, Zhang Lian
Department of Neonatology, Baoan Women's and Children's Hospital, Shenzhen, China.
Research and Development Department, Linkwah Integrated Circuit Institute, Nanjing, China.
Front Pediatr. 2022 Nov 3;10:1000395. doi: 10.3389/fped.2022.1000395. eCollection 2022.
Bowel dysfunction continues to be a serious issue in neonates. Traditional auscultation of bowel sounds as a diagnostic tool in neonatal gastrointestinal problems is limited by skill and inability to document and reassess. Consequently, in order to objectively and noninvasively examine the viability of continuous assessment of bowel sounds, we utilized an acoustic recording and analysis system to capture bowel sounds and extract acoustic features in term neonates.
From May 1, 2020 to September 30, 2020, 82 neonates who were hospitalized because of hyperbilirubinemia were included. For 20 h, a convolutional neural network-based acoustic recorder that offers real-time, wireless, continuous auscultation was employed to track the bowel sounds of these neonates.
(1) Usable data on five acoustic parameters of bowel sound was recorded for 68 neonates, and the median values were as follows: The rate was 25.80 times/min [interquartile range (IQR): 15.63-36.20]; the duration was 8.00 s/min (IQR: 4.2-13.20); the amplitude was 0.46 (IQR: 0.27-0.68); the frequency was 944.05 Hz (IQR: 848.78-1,034.90); and the interval time was 2.12 s (IQR: 1.3-3.5). (2) In comparison to the parameters of the bowel sounds recorded from the right lower abdomen in 68 infants, the acoustic parameters of the 10 out of 68 infants from chest controls and blank controls were considerably different. (3) The 50%-75% breast milk intake group had the highest rate, the longest duration, and the highest amplitude of bowel sounds, while the >75% breast milk intake group had the highest frequency of bowel sounds. (4) Compared with neonates without hyperbilirubinemia, there was no significant difference in the five parameters of bowel sounds in hyperbilirubinemia infants; nor was there a significant effect of phototherapy and non-phototherapy status on the parameters of bowel sounds during bowel sound monitoring in hyperbilirubinemia patients. (5) A mild transient skin rash appeared on the skin of three infants. No other adverse events occurred.
The acoustic recording and analysis system appears useful for monitoring bowel sounds using a continuous, invasive, and real-time approach. Neonatal bowel sounds are affected by various feeding types rather than hyperbilirubinemia and phototherapy. Potential influencing factors and the significance of their application in neonatal intestinal-related disorders require further research.
肠功能障碍仍是新生儿的一个严重问题。传统的听诊肠鸣音作为新生儿胃肠道问题的诊断工具,受到技术水平的限制,且无法记录和重新评估。因此,为了客观、无创地检查持续评估肠鸣音的可行性,我们利用声学记录和分析系统来捕捉足月儿的肠鸣音并提取声学特征。
纳入2020年5月1日至2020年9月30日因高胆红素血症住院的82例新生儿。使用基于卷积神经网络的声学记录仪,该记录仪可进行实时、无线、连续听诊,对这些新生儿的肠鸣音进行20小时的跟踪。
(1) 记录了68例新生儿肠鸣音五个声学参数的可用数据,中位数如下:频率为25.80次/分钟 [四分位间距 (IQR):15.63 - 36.20];持续时间为8.00秒/分钟 (IQR:4.2 - 13.20);振幅为0.46 (IQR:0.27 - 0.68);频率为944.05赫兹 (IQR:848.78 - 1034.90);间隔时间为2.12秒 (IQR:1.3 - 3.5)。(2) 与68例婴儿右下腹记录的肠鸣音参数相比,68例中10例胸部对照组和空白对照组婴儿的声学参数有显著差异。(3) 母乳摄入量为50% - 75%组的肠鸣音频率最高、持续时间最长、振幅最大,而母乳摄入量>75%组的肠鸣音频率最高。(4) 与无高胆红素血症的新生儿相比,高胆红素血症婴儿肠鸣音的五个参数无显著差异;在高胆红素血症患者肠鸣音监测期间,光疗和非光疗状态对肠鸣音参数也无显著影响。(5) 3例婴儿皮肤出现轻度短暂皮疹。未发生其他不良事件。
声学记录和分析系统似乎有助于采用连续、无创和实时的方法监测肠鸣音。新生儿肠鸣音受多种喂养方式影响而非高胆红素血症和光疗。潜在影响因素及其在新生儿肠道相关疾病中的应用意义有待进一步研究。