scholarly journals Continuous recording of vital signs with a wearable device in pediatric patients undergoing chemotherapy for cancer—an operational feasibility study

2021 ◽  
Author(s):  
Christa Koenig ◽  
Roland A. Ammann ◽  
Claudia E. Kuehni ◽  
Jochen Roessler ◽  
Eva Brack
Keyword(s):  
Heart Rate ◽  
Pediatric Patients ◽  
Clinical Symptoms ◽  
Vital Signs ◽  
Wearable Device ◽  
Continuous Recording ◽  
Patient Specific ◽  
Specific Goal ◽  
Severe Infections ◽  
Age Range

Abstract Purpose Pediatric patients with cancer are at high risk for severe infections. Infections can trigger changes of vital signs long before clinical symptoms arise. Continuous recording may detect such changes earlier than discrete measurements. We aimed to assess the feasibility of continuous recording of vital signs by a wearable device (WD) in pediatric patients undergoing chemotherapy for cancer. Methods In this prospective, observational single-center study, pediatric patients under chemotherapy wore the Everion® WD for 14 days. The predefined patient-specific goal was heart rate recorded in good quality during ≥18/24 h per day, on ≥7 consecutive days. The predefined criterion to claim feasibility was ≥15/20 patients fulfilling this patient-specific goal. Results Twenty patients were included (median age, 6 years; range, 2–16). Six patients aged 3–16 years fulfilled the patient-specific goal. Quality of heart rate recording was good during 3992 of 6576 (61%) hours studied and poor during 300 (5%) hours, and no data was recorded during 2284 (35%) hours. Eighteen of 20 participants indicated that this WD is acceptable to measure vital signs in children under chemotherapy. Conclusion The predefined feasibility criterion was not fulfilled. This was mainly due to important compliance problems and independent of the WD itself. However, continuous recording of vital signs was possible across a very wide age range in pediatric patients undergoing chemotherapy for cancer. We recommend to study feasibility in the Everion® again, plus in further WDs, applying measures to enhance compliance. Trial registration ClinicalTrials.gov (NCT04134429) on October 22, 2019.

scholarly journals Continuous Recording of Vital Signs With a Wearable Device in Pediatric Patients Undergoing Chemotherapy for Cancer – an Operational Feasibility Study

2021 ◽  
Author(s):  
Christa Koenig ◽  
Roland A Ammann ◽  
Claudia E Kuehni ◽  
Jochen Roessler ◽  
Eva Brack
Keyword(s):  
Heart Rate ◽  
Pediatric Patients ◽  
Clinical Symptoms ◽  
Vital Signs ◽  
Wearable Device ◽  
Continuous Recording ◽  
Patient Specific ◽  
Patients With Cancer ◽  
Severe Infections ◽  
Age Range

Abstract PurposePediatric patients with cancer are at high risk for severe infections. Infections can trigger changes of vital signs long before clinical symptoms arise. Continuous recording may detect such changes earlier than discrete measurements. We aimed to assess the feasibility of continuous recording of vital sings by a wearable device (WD) in pediatric patients undergoing chemotherapy for cancer.MethodsIn this prospective, observational single-center study pediatric patients undergoing chemotherapy for cancer wore the Everion® WD for 14 days.ResultsTwenty patients were included (median age, 6 years; range, 2-16). Six patients (predefined feasibility criterion, ≥15 patients) aged 3-16 years fulfilled the patient specific goal, defined as heart rate recorded with good quality during ≥18 hours/day on ≥7 consecutive days. The quality of heart rate recording was good during 3992 of 6576 (61%) hours studied, poor during 300 (5%) hours, and no data was recorded during 2284 (35%) hours. Eighteen of 20 participants indicated that this WD is acceptable to measure vital sings in children undergoing chemotherapy for cancer. ConclusionWe found that continuous recording of vital signs is feasible across a very wide age range in pediatric patients undergoing chemotherapy for cancer. In the configuration studied, however, the predefined feasibility criterion was not fulfilled. This was mainly due to important compliance problems and independent of the WD itself. These results will influence the design of future WD-studies including those aiming to identify patterns predicting fever or infection. This study was registered at ClinicalTrials.gov (NCT04134429) the 22th of October, 2019.

scholarly journals Continuous monitoring of health data with a wearable device in pediatric patients undergoing chemotherapy for cancer – a feasibility pilot study

2021 ◽  
Author(s):  
Brack Eva ◽  
Koenig Christa ◽  
Roessler Jochen ◽  
Ammann Roland A.
Keyword(s):  
Pilot Study ◽  
Continuous Monitoring ◽  
Pediatric Patients ◽  
Clinical Symptoms ◽  
Vital Signs ◽  
Ethics Committees ◽  
Health Data ◽  
Wearable Device ◽  
Delayed Treatment ◽  
Patient Will

Abstract Pediatric patients with cancer are at high risk for severe infections and delayed treatment increases mortality. Infections can trigger changes of vital signs long before clinical symptoms arise. Continuous recording may detect such changes earlier than discrete measurements. This is the protocol for an investigator-initiated, single-center observational pilot study on the feasibility of continuous monitoring of health data with a wearable device (WD) in pediatric patients undergoing chemotherapy of cancer. A total of 20 patients will be included, including at least 4 patients <6 years. Each patient will wear the WD for 14 days and we expect study duration of three to four months. The protocol had been registered at www.clinicaltrials.com (NCT04134429) and was approved by the local Ethics Committees (Ethikkommission der Universitätskinderkliniken Bern, “Gesuch 1912”, Kantonale Ethikkommission Bern, BASEC-No.: 2019-01919).

Intranasal dexmedetomidine: the ideal drug for sedation in the pediatric echo lab?

2021 ◽  
pp. 1-5
Author(s):  
David E Saudek ◽  
Deborah Walbergh ◽  
Peter Bartz ◽  
Sara Shreve ◽  
Amy Schaal ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Disease ◽  
Chart Review ◽  
Chloral Hydrate ◽  
Vital Signs ◽  
Cyanotic Heart Disease ◽  
Historical Cohort ◽  
Safety And Efficacy ◽  
Attractive Option ◽  
The Ideal

Abstract Background: Intranasal dexmedetomidine is an attractive option for procedural sedation in pediatrics due to ease of administration and its relatively short half-life. This study sought to compare the safety and efficacy of intranasal dexmedetomidine to a historical cohort of pediatric patients sedated using chloral hydrate in a pediatric echo lab. Methods: Chart review was performed to compare patients sedated between September, 2017 and October, 2019 using chloral hydrate and intranasal dexmedetomidine. Vital signs, time to sedation, duration of sedation, need for second dose of medication, rate of failed sedation, and impact on vital signs were compared between groups. Subgroup analysis was performed for those with complex and cyanotic heart disease. Results: Chloral hydrate was used in 356 patients and intranasal dexmedetomidine in 376. Patient age, complexity of heart disease, and duration of sedation were similar. Rates of failed sedation were very low and similar. Average heart rate and minimum heart rate were lower for those receiving intranasal dexmedetomidine than chloral hydrate. Impact on vital signs was similar for those with complex and cyanotic heart disease. No adverse events occurred in either group. Conclusions: Sedation with intranasal dexmedetomidine is comparable to chloral hydrate in regards to safety and efficacy for children requiring echocardiography. Consistent with the mechanism of action, patients receiving intranasal dexmedetomidine have a lower heart rate without morbidity.

scholarly journals FRI0618-HPR EFFECTS OF MUSIC THERAPY ON PAIN, ANXIETY, AND VITAL SIGNS IN CHRONIC INFLAMMATORY RHEUMATIC DISEASES PATIENTS DURING BIOLOGICAL DRUGS INFUSION

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 914.2-914
Author(s):  
S. Boussaid ◽  
M. Ben Majdouba ◽  
S. Jriri ◽  
M. Abbes ◽  
S. Jammali ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Music Therapy ◽  
Systolic Blood Pressure ◽  
Respiratory Rate ◽  
Vital Signs ◽  
Biological Therapies ◽  
Biological Drugs ◽  
Pain Anxiety ◽  
The Mean

Background:Music therapy is based on ancient cross-cultural beliefs that music can have a “healing” effect on mind and body. Research determined that listening to music can increase comfort and relaxation, relieve pain, lower distress, reduce anxiety, improve positive emotions and mood, and decrease psychological symptoms. Music therapy has been used greatly in various medical procedures to reduce associated anxiety and pain. Patients have a high level of anxiety when they are in the hospital, this is the case of patients with rheumatic diseases who consult regularly to have intravenous infusion of biological therapies.Objectives:The purpose of this study was to examine the effectiveness of music therapy on pain, anxiety, and vital signs among patients with chronic inflammatory rheumatic diseases during intravenous infusion of biological drugs.Methods:Fifty patients were divided into two groups: The experimental group G1 (n=25) received drug infusion while lestening to soft music (30 minutes); and the control group G2 (n=25) received only drug infusion. Measures include pain, anxiety, vital signs (blood pressure, heart rate and respiratory rate). The pain was measured using visual analogic scale (VAS). The state-trait anxiety inventory (STAI) was used for measuring anxiety, low anxiety ranges from 20 to 39, the moderate anxiety ranges from 40 to 59, and high anxiety ranges from 60 to 80. Vital signs (systolic blood pressure [SBP], diastolic blood pressure [DBP], heart rate [HR], and respiratory rate [RR]) were measured before, during and immediately after the infusion.Statistical package for social sciences (SPSS) was used for analysis.Results:The mean age in G1 was 44.45 years (26-72) with a sex ratio (M/F) of 0.8. Including the 25 patients, 12 had rheumatoid arthritis, 10 had ankylosing spondylitis and 3 had psoriatic arthritis. The mean disease duration was 8 years. In G2, the mean age was 46 years (25-70) with a sex ratio (M/F) of 0.75, 12 had rheumatoid arthritis, 11 had ankylosing spondylitis and 2 had psoriatic arthritis. The mean disease duration was 7.5 years. The biological drugs used were: Infliximab in 30 cases, Tocilizumab in 12 cases and Rituximab in 8 cases.Before the infusion, the patients of experimental group had a mean VAS of 5/10±3, a mean STAI of 50.62±6.01, a mean SBP of 13.6 cmHg±1.4, a mean DBP of 8.6 cmHg±1, a mean HR of 85±10 and a mean RR of 18±3. While in control group the mean VAS was 5.5±2, the mean STAI was 50.89±5.5, the mean SBP was 13.4±1.2, the mean DBP was 8.8±1.1, the mean HR was 82±8 and the mean RR was 19±2.During the infusion and after music intervention in G1, the mean STAI became 38.35±5 in G1 versus 46.7±5.2 in G2 (p value=0.022), the mean SBP became 12.1±0.5 in G1 versus 13±1 in G2 (p=0.035), the mean DBP became 8.1±0.8 in G1 versus 8.4±0.9 in G2 (p=0.4), the mean HR became 76±9 in G1 versus 78±7 in G2 (p=0.04) and the mean RR became 17.3±2.1 in G1 versus 18.2±1.7 in G2 (p=0.39).This study found a statistically significant decrease in anxiety, systolic blood pressure and heart rate in patients receiving music interventions during biological therapies infusion, but no significant difference were identified in diastolic blood pressure and respiratory rate.Conclusion:The findings provide further evidence to support the use of music therapy to reduce anxiety, and lower systolic blood pressure and heart rate in patients with rheumatic disease during biological therapies infusion.References:[1] Lin, C., Hwang, S., Jiang, P., & Hsiung, N. (2019).Effect of Music Therapy on Pain After Orthopedic Surgery -A Systematic review and Meta-Analysis. Pain Practice.Disclosure of Interests:None declared

scholarly journals Predictive Value of Subacute Heart Rate Variability for Determining Outcome Following Adolescent Concussion

2021 ◽  
Vol 10 (1) ◽  
pp. 161
Author(s):  
Colt A. Coffman ◽  
Jacob J. M. Kay ◽  
Kat M. Saba ◽  
Adam T. Harrison ◽  
Jeffrey P. Holloway ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Cognitive Performance ◽  
Predictive Value ◽  
System Integration ◽  
Sports Medicine ◽  
Clinical Symptoms ◽  
Physiological Stress ◽  
Neurological Dysfunction ◽  
Neurobehavioral Function

Objective assessments of concussion recovery are crucial for facilitating effective clinical management. However, predictive tools for determining adolescent concussion outcomes are currently limited. Research suggests that heart rate variability (HRV) represents an indirect and objective marker of central and peripheral nervous system integration. Therefore, it may effectively identify underlying deficits and reliably predict the symptomology following concussion. Thus, the present study sought to evaluate the relationship between HRV and adolescent concussion outcomes. Furthermore, we sought to examine its predictive value for assessing outcomes. Fifty-five concussed adolescents (12–17 years old) recruited from a local sports medicine clinic were assessed during the initial subacute evaluation (within 15 days postinjury) and instructed to follow up for a post-acute evaluation. Self-reported clinical and depressive symptoms, neurobehavioral function, and cognitive performance were collected at each timepoint. Short-term HRV metrics via photoplethysmography were obtained under resting conditions and physiological stress. Regression analyses demonstrated significant associations between HRV metrics, clinical symptoms, neurobehavioral function, and cognitive performance at the subacute evaluation. Importantly, the analyses illustrated that subacute HRV metrics significantly predicted diminished post-acute neurobehavioral function and cognitive performance. These findings indicate that subacute HRV metrics may serve as a viable predictive biomarker for identifying underlying neurological dysfunction following concussion and predict late cognitive outcomes.

Safety and efficacy of therapeutic early onset granulocyte transfusions in pediatric patients with neutropenia and severe infections

Transfusion ◽  
2006 ◽  
Vol 46 (11) ◽  
pp. 1909-1914 ◽  
Author(s):  
Ulrich J.H. Sachs ◽  
Alfred Reiter ◽  
Tobias Walter ◽  
Gregor Bein ◽  
Wilhelm Woessmann
Keyword(s):  
Early Onset ◽  
Pediatric Patients ◽  
Safety And Efficacy ◽  
Severe Infections

PNEUMATOSIS INTESTINALIS

PEDIATRICS ◽  
1951 ◽  
Vol 7 (4) ◽  
pp. 537-549
Author(s):  
ELLEN P. MACKENZIE
Keyword(s):  
Respiratory Disease ◽  
Clinical Diagnosis ◽  
General Condition ◽  
Clinical Picture ◽  
Pediatric Patients ◽  
Pneumatosis Intestinalis ◽  
Pediatric Age ◽  
Infantile Diarrhea ◽  
Age Range

Thirteen cases of pneumatosis intestinalis are reported, 12 of them in infants between 12 days and 12 months of age, one in a boy of 6 years. Review of these cases and of 32 reported cases falling within the pediatric age range discloses that the disease occurs most frequently in patients whose general condition is poor, that it is very often associated with congenital or acquired disease of the intestine, and that respiratory disease, usually infectious, frequently co-exists. The presence of pneumatosis in pediatric patients has so far been discovered only at autopsy, but clinical diagnosis, with the aid of the typical roentgenologic findings, is feasible and may be accomplished when the disease is more widely known. The clinical picture and roentgenographic findings in adults are reviewed. The most acceptable theories concerning the pathogenesis are discussed, with their possible relation to infantile diarrhea.

Abstract 222: Nerve Conduction Study in Postural Orthostatic Tachycardia Syndrome

2016 ◽  
Vol 9 (suppl_2) ◽  
Author(s):  
Chandralekha Ashangari ◽  
Samreen F Asghar ◽  
Sadaf Syed ◽  
Amna A Butt ◽  
Amer Suleman
Keyword(s):  
Heart Rate ◽  
Nerve Conduction Study ◽  
Nerve Conduction ◽  
Clinical Symptoms ◽  
Orthostatic Intolerance ◽  
Tibial Nerve ◽  
Sensory Nerves ◽  
Exercise Intolerance ◽  
Postural Orthostatic Tachycardia Syndrome ◽  
Medical Diagnostic

Background: Postural orthostatic tachycardia syndrome (POTS) is an autonomic disturbance characterized by the clinical symptoms of orthostatic intolerance, mainly light headedness, fatigue, sweating, tremor, anxiety, palpitation, exercise intolerance and near syncope on upright posture. These are relieved on lying down. Patients also have a heart rate >120 beats/min (bpm) on standing or increase their heart rate by 30 bpm from a resting heart rate after standing for 10 min. A nerve conduction study (NCS) is a medical diagnostic test commonly used to evaluate the function, especially the ability of electrical conduction, of the motor and sensory nerves of the human body. The aim of this study is to demonstrate median, ulnar, peroneal, tibial nerve conduction results POTS patients. Methods: 177 patients were selected randomly from our clinic with POTS. Nerve conduction results of median, ulnar, peroneal, tibial nerves were reviewed from electronic medical records. Results: Out of 177 patients, 151 patients are females (85%, n=151, age 32.07±11.10), 26 patients are males (15%, n=26, age 29.08±17.40).Median nerve conduction results are 57.83 m/sec ±7.58 m/sec, Ulnar nerve conduction results are 56.62 m/sec ±6.85 m/sec, Peroneal nerve conduction results are 49.96 m/sec ±6.85 m/sec, Tibial nerve conduction results are 50.70 m/sec ±6.86 m/sec. Conclusion: The nerve conduction velocities tend to be within normal range in Postural Orthostatic Tachycardia Syndrome (POTS) patients.

Continuous Auscultation of Heart and Bilateral Breath Sounds

PEDIATRICS ◽  
1988 ◽  
Vol 81 (5) ◽  
pp. 745-746
Author(s):  
NATHAN SCHWARTZ ◽  
JAMES B. EISENKRAFT
Keyword(s):  
Heart Rate ◽  
Critically Ill ◽  
Vital Signs ◽  
Sleep Pattern ◽  
Monitoring Device ◽  
Challenging Problem ◽  
Breath Sounds ◽  
Increased Risk ◽  
Risk Of Exposure

To the Editor.— The frequent determination of vital signs, such as heart rate and bilateral breath sounds, is a mainstay in the care of critically ill infants. Unfortunately, the routine determination of such vital signs involves the manipulation and disturbance of the infant, unnecessary risk of exposure to cold, increased risk of apnea, and infection.1,2 In addition, the frequent disruption of the infant's sleep pattern may take an unaccountable physiologic and psychologic toll. To deal with this common and challenging problem we have devised a simple and inexpensive monitoring device, using readily available supplies, which facilitates the continuous or intermittent evaluation of heart rate and bilateral breath sounds.

IoT Based Pulse Oximeter

2021 ◽  
Vol 9 (8) ◽  
pp. 2946-2951
Author(s):  
G Sidhartha
Keyword(s):  
Heart Rate ◽  
Signal Processing ◽  
Oxygen Saturation ◽  
Data Transmission ◽  
Pulse Oximeter ◽  
Mobile Application ◽  
Preventive Measures ◽  
Vital Signs ◽  
Home Treatment ◽  
Portable Devices

Abstract: In recent times, we have realized the importance of vital signs such as Oxygen saturation and heart rate i.e beats per minute (BPM) due to the covid-19 situation worldwide. SpO2 and BPM are being used as preliminary indicators for testing a person’s health, the drop in the oxygen saturation is perceived as one of the symptoms of a person suffering from coronavirus. Oximeters are portable devices that are used to measure the SpO2 and BPM of a person. Timely measurements of oxygen saturation can aid in taking preventive measures. This paper discusses the construction and development of an IoT-based pulse oximeter that is capable of transmitting the reading obtained to any remote location wirelessly. The proposed system uses Arduino as the microcontroller which is used for signal processing and Esp-01 as the Wifi platform to enable remote data transmission. The data is communicated remotely through Blynk mobile application. This project is aimed at reducing the manual effort undergone in regularly updating the oxygen saturation to the doctor, in the case of a person undergoing home treatment. Though an oximeter is not a screening te st, it is a primary indicator of a person’s health. Keywords: Heart rate, SpO2, IoT, Arduino, BLYNK server, Red, IR.

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