Binodal, wireless epidermal electronic systems with in-sensor analytics for neonatal intensive care

By Ha Uk Chung, Bong Hoon Kim, Jong Yoon Lee, Jungyup Lee, Zhaoqian Xie, Erin M Ibler, KunHyuck Lee, Anthony R. Banks, J. Jeong, Jongwon Kim and 35 more. Science, 2019

696 citations recorded by the source corpus.

Sensitive sensing Neonatal care, particularly for premature babies, is complicated by the infants' fragility and by the need for a large number of tethered sensors to be attached to their tiny bodies. Chung et al. developed a pair of sensors that only require water to adhere to the skin and allow for untethered monitoring of key vital signs (see the Perspective by Guinsburg). On-board data processing allowed for efficient wireless near-field communication using standard protocols. The absence of cables makes it easier to handle the infants and allows for skin-to-skin contact between the babies and their parents or caregivers. Science, this issue p. eaau0780; see also p. 924 Battery-free, skin-like sensors enable wireless, high-fidelity measurement of vital signs in fragile infants. INTRODUCTION In neonatal intensive care units (NICUs), continuous monitoring of vital signs is essential, particularly in cases of severe prematurity. Current monitoring platforms require multiple hard-wired, rigid interfaces to a neonate’s fragile, underdeveloped skin and, in some cases, invasive lines inserted into their delicate arteries. These platforms and their wired interfaces pose risks for iatrogenic skin injury, create physical barriers for skin-to-skin parental/neonate bonding, and frustrate even basic clinical tasks. Technologies that bypass these limitations and provide additional, advanced physiological monitoring capabilities would directly address an unmet clinical need for a highly vulnerable population. RATIONALE It is now possible to fabricate wireless, battery-free vital signs monitoring systems based on ultrathin, “skin-like” measurement modules. These devices can gently and noninvasively interface onto the skin of neonates with gestational ages down to the edge of viability. 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. The resulting systems can be much smaller in size, lighter in weight, and less traumatic to the skin than any existing alternative. RESULTS We report the realization of this class of NICU monitoring technology, embodied as a pair of devices that, when used in a time-synchronized fashion, can reconstruct full vital signs information with clinical-grade precision. One device mounts on the chest to capture electrocardiograms (ECGs); the other rests on the base of the foot to simultaneously record photoplethysmograms (PPGs). This binodal system captures and continuously transmits ECG, PPG, and (from each device) skin temperature data, yielding measurements of heart rate, heart rate variability, respiration rate, blood oxygenation, and pulse arrival time as a surrogate of systolic blood pressure. Successful tests on neonates with gestational ages ranging from 28 weeks to full term demonstrate the full range of functions in two level III NICUs. The thin, lightweight, low-modulus characteristics of these wireless devices allow for interfaces to the skin mediated by forces that are nearly an order of magnitude smaller than those associated with adhesives used for conventional hardware in the NICU. This reduction greatly lowers the potential for iatrogenic injuries. CONCLUSION The advances outlined here serve as the basis for a skin-like technology that not only reproduces capabilities currently provided by invasive, wired systems as the standard of care, but also offers multipoint sensing of temperature and continuous tracking of blood pressure, all with substantially safer device-skin interfaces and compatibility with medical imaging. By eliminating wired connections, these platforms also facilitate therapeutic skin-to-skin contact between neonates and parents, which is known to stabilize vital signs, reduce morbidity, and promote parental bonding. Beyond use in advanced hospital settings, these systems also offer cost-effective capabilities with potential relevance to global health. Wireless, skin-like systems for vital signs monitoring in neonatal intensive care. (A) Images and finite-element modeling results for ECG and PPG devices bent around glass cylinders. (B) A neonate with an ECG device on the chest. (C and D) A mother holding her infant with a PPG device on the foot and an ECG device on the chest (C) and on the back (D). Existing vital sign monitoring systems in the neonatal intensive care unit (NICU) require multiple wires connected to rigid sensors with strongly adherent interfaces to the skin. We introduce a pair of ultrathin, soft, skin-like electronic devices whose coordinated, wireless operation reproduces the functionality of these traditional technologies but bypasses their intrinsic limitations. The enabling advances in engineering science include designs that support wireless, battery-free operation; real-time, in-sensor data analytics; time-synchronized, continuous data streaming; soft mechanics and gentle adhesive interfaces to the skin; and compatibility with visual inspection and with medical imaging techniques used in the NICU. Preliminary studies on neonates admitted to operating NICUs demonstrate performance comparable to the most advanced clinical-standard monitoring systems.

Subfields: Biomedical Engineering, Electrical and Electronic Engineering

View Paper: https://www.semanticscholar.org/paper/b0511afac0cc252946aa8f08a078b12e48030581

How researchers see this paper

The researchers whose trusted networks rank it highest, strongest advocate first. Every researcher gets a different order.

In Biomedical Engineering

  1. Chengkuo Lee
  2. Xinge Guo
  3. Long Liu
  4. Tianyiyi He
  5. Feng Wen
  6. Zixuan Zhang
  7. Zhongda Sun
  8. Qiongfeng Shi

In Electrical and Electronic Engineering

  1. Xinge Guo
  2. Long Liu
  3. Qiongfeng Shi
  4. Chengkuo Lee

Citations in the corpus