Stevens Guylian, Van De Velde Stijn, Larmuseau Michiel, Poelaert Jan, Van Damme Annelies, Verdonck Pascal
Departement of electronics and information systems-IBiTech, Ghent University, Korneel Heymanslaan, Gent, 9000, East-Flanders, Belgium.
H3CareSolutions, Henegouwestraat 41, Gent, 9000, East-Flanders, Belgium.
J Clin Monit Comput. 2025 Feb;39(1):157-167. doi: 10.1007/s10877-024-01222-6. Epub 2024 Sep 21.
Measuring spontaneous swallowing frequencies (SSF), coughing frequencies (CF), and the temporal relationships between swallowing and coughing in patients could provide valuable clinical insights into swallowing function, dysphagia, and the risk of pneumonia development. Medical technology with these capabilities has potential applications in hospital settings. In the management of intensive care unit (ICU) patients, monitoring SSF and CF could contribute to predictive models for successful weaning from ventilatory support, extubation, or tracheal decannulation. Furthermore, the early prediction of pneumonia in hospitalized patients or home care residents could offer additional diagnostic value over current practices. However, existing technologies for measuring SSF and CF, such as electromyography and acoustic sensors, are often complex and challenging to implement in real-world settings. Therefore, there is a need for a simple, flexible, and robust method for these measurements. The primary objective of this study was to develop a system that is both low in complexity and sufficiently flexible to allow for wide clinical applicability. To construct this model, we recruited forty healthy volunteers. Each participant was equipped with two medical-grade sensors (Movesense MD), one attached to the cricoid cartilage and the other positioned in the epigastric region. Both sensors recorded tri-axial accelerometry and gyroscopic movements. Participants were instructed to perform various conscious actions on cue, including swallowing, talking, throat clearing, and coughing. The recorded signals were then processed to create a model capable of accurately identifying conscious swallowing and coughing, while effectively discriminating against other confounding actions. Training of the algorithm resulted in a model with a sensitivity of 70% (14/20), a specificity of 71% (20/28), and a precision of 66.7% (14/21) for the detection of swallowing and, a sensitivity of 100% (20/20), a specificity of 83.3% (25/30), and a precision of 80% (20/25) for the detection of coughing. SSF, CF and the temporal relationship between swallowing and coughing are parameters that could have value as predictive tools for diagnosis and therapeutic guidance. Based on 2 tri-axial accelerometry and gyroscopic sensors, a model was developed with an acceptable sensitivity and precision for the detection of swallowing and coughing movements. Also due to simplicity and robustness of the set-up, the model is promising for further scientific research in a wide range of clinical indications.
测量患者的自发吞咽频率(SSF)、咳嗽频率(CF)以及吞咽和咳嗽之间的时间关系,可为吞咽功能、吞咽困难和肺炎发生风险提供有价值的临床见解。具备这些功能的医疗技术在医院环境中有潜在应用。在重症监护病房(ICU)患者的管理中,监测SSF和CF有助于建立预测模型,以成功撤机、拔管或气管造口脱管。此外,对住院患者或居家护理居民的肺炎进行早期预测,相较于当前的做法可能具有额外的诊断价值。然而,现有的测量SSF和CF的技术,如肌电图和声学传感器,在实际应用中往往复杂且具有挑战性。因此,需要一种简单、灵活且可靠的测量方法。本研究的主要目标是开发一种复杂度低且足够灵活、具有广泛临床适用性的系统。为构建此模型,我们招募了40名健康志愿者。每位参与者配备两个医用级传感器(Movesense MD),一个附着在环状软骨上,另一个放置在上腹部区域。两个传感器均记录三轴加速度和陀螺仪运动。参与者被指示根据提示执行各种有意识的动作,包括吞咽、说话、清嗓和咳嗽。然后对记录的信号进行处理,以创建一个能够准确识别有意识吞咽和咳嗽,同时有效区分其他混淆动作的模型。算法训练得到的模型在检测吞咽时,灵敏度为70%(14/20),特异性为71%(20/28),精确度为66.7%(14/21);在检测咳嗽时,灵敏度为100%(20/20),特异性为83.3%(25/30),精确度为80%(20/25)。SSF、CF以及吞咽和咳嗽之间的时间关系作为诊断和治疗指导的预测工具可能具有价值。基于两个三轴加速度和陀螺仪传感器,开发了一个对吞咽和咳嗽运动检测具有可接受灵敏度和精确度的模型。此外,由于设置的简单性和稳健性,该模型在广泛的临床适应症中进行进一步科学研究具有前景。