scholarly journals Multichannel esophageal signals to monitor respiratory rate in preterm infants

Author(s):  
Corine Bürgin ◽  
Patrizia Simmen ◽  
Nishant Gupta ◽  
Lilian Suter ◽  
Samuel Kreuzer ◽  
...  

Abstract Background Apnea of prematurity cannot be reliably measured with current monitoring techniques. Instead, indirect parameters such as oxygen desaturation or bradycardia are captured. We propose a Kalman filter-based detection of respiration activity and hence apnea using multichannel esophageal signals in neonatal intensive care unit patients. Methods We performed a single-center observational study with moderately preterm infants. Commercially available nasogastric feeding tubes containing multiple electrodes were used to capture signals with customized software. Multichannel esophageal raw signals were manually annotated, processed using extended Kalman filter, and compared with standard monitoring data including chest impedance to measure respiration activity. Results Out of a total of 405.4 h captured signals in 13 infants, 100 episodes of drop in oxygen saturation or heart rate were examined. Median (interquartile range) difference in respiratory rate was 0.04 (−2.45 to 1.48)/min between esophageal measurements annotated manually and with Kalman filter and −3.51 (−7.05 to −1.33)/min when compared to standard monitoring, suggesting an underestimation of respiratory rate when using the latter. Conclusions Kalman filter-based estimation of respiratory activity using multichannel esophageal signals is safe and feasible and results in respiratory rate closer to visual annotation than that derived from chest impedance of standard monitoring.

2016 ◽  
Vol 103 (6) ◽  
pp. 603-605 ◽  
Author(s):  
Paul Seddon ◽  
Sonia Sobowiec-Kouman ◽  
David Wertheim

Respiratory rate (RR) is a valuable early marker of illness in vulnerable infants, but current monitoring methods are unsuitable for sustained home use. We have demonstrated accurate measurement of RR from brief recordings of pulse oximeter plethysmogram (pleth) trace in full-term neonates in hospital. This study assessed the feasibility of this method in preterm infants during overnight recordings in the home. We collected simultaneous overnight SpO2, pleth and respiratory inductive plethysmography (RIP) on 24 preterm infants in the home. RR from pleth analysis was compared with RR from RIP bands; pleth quality was assessed by the presence of visible artefact. Median (range) RR from RIP and pleth were not significantly different at 42 (25–65) and 42 (25–64) breaths/min. Median (range) % of epochs rejected due to artefact was 20 (8–75) for pleth and 10 (3–53) for RIP. Our results suggest that home RR monitoring by pulse oximeter pleth signal is accurate and feasible.


2019 ◽  
Vol 2 (1) ◽  
Author(s):  
Mauricio Villarroel ◽  
Sitthichok Chaichulee ◽  
João Jorge ◽  
Sara Davis ◽  
Gabrielle Green ◽  
...  

AbstractThe implementation of video-based non-contact technologies to monitor the vital signs of preterm infants in the hospital presents several challenges, such as the detection of the presence or the absence of a patient in the video frame, robustness to changes in lighting conditions, automated identification of suitable time periods and regions of interest from which vital signs can be estimated. We carried out a clinical study to evaluate the accuracy and the proportion of time that heart rate and respiratory rate can be estimated from preterm infants using only a video camera in a clinical environment, without interfering with regular patient care. A total of 426.6 h of video and reference vital signs were recorded for 90 sessions from 30 preterm infants in the Neonatal Intensive Care Unit (NICU) of the John Radcliffe Hospital in Oxford. Each preterm infant was recorded under regular ambient light during daytime for up to four consecutive days. We developed multi-task deep learning algorithms to automatically segment skin areas and to estimate vital signs only when the infant was present in the field of view of the video camera and no clinical interventions were undertaken. We propose signal quality assessment algorithms for both heart rate and respiratory rate to discriminate between clinically acceptable and noisy signals. The mean absolute error between the reference and camera-derived heart rates was 2.3 beats/min for over 76% of the time for which the reference and camera data were valid. The mean absolute error between the reference and camera-derived respiratory rate was 3.5 breaths/min for over 82% of the time. Accurate estimates of heart rate and respiratory rate could be derived for at least 90% of the time, if gaps of up to 30 seconds with no estimates were allowed.


Children ◽  
2020 ◽  
Vol 7 (9) ◽  
pp. 114
Author(s):  
Cheng Ma ◽  
Denisse Broadbent ◽  
Garrett Levin ◽  
Sanjeet Panda ◽  
Devaraj Sambalingam ◽  
...  

Background: Apnea of prematurity (AOP) affects preterm neonates. AOP, combined with intermittent hypoxemic (IH) events frequently prolongs the length of stay. Caffeine is the preferred medication to treat AOP and may help improve IH events. There is lack of information on the safety of discharging preterm neonates home on caffeine for AOP in the literature. Our objective was to assess safety and benefits, if any, of discharging preterm infants home on caffeine. Methods: After IRB approval, preterm infants discharged home from the neonatal intensive care unit (NICU) on caffeine were compared with those without a discharge prescription for the period of January 2013 to December 2017. Results: A total of 297 infants were started on caffeine, and of those, 87 infants were discharged home on caffeine. There was no difference in length of stay between two groups. Duration of caffeine at home was 31 (28–42) days. The average cost of apnea monitor and caffeine at home per 30 days was USD 1326 and USD 50. There was no difference in number or reasons for emergency department (ED) visits or hospitalizations between two groups. Conclusion: AOP affects almost all preterm infants and along with intermittent hypoxemic events, and is one of the most common reasons for prolonged hospital stay. Discharging stable preterm infants home on caffeine may be safe, especially in those who are otherwise ready to be discharged and are only awaiting complete resolution of AOP/IH events.


2019 ◽  
Vol 10 (4) ◽  
pp. 2800-2804 ◽  
Author(s):  
Alice Jeba J ◽  
Senthil Kumar S ◽  
Shivaprakash sosale

Preterm infants are babies who are delivered before the completion of 37 weeks gestation period. They are born with immature functioning of the brain. In  Neonatal Intensive Care Unit (NICU), these infants receives many environmental stimuli, and their comfort will be disturbed. These various sensory stimulus received in NICU influence the functional and neurodevelopmental outcome of these infants and also their quality of life. So this study was intended to evaluate the axillary temperature, heart rate, respiratory rate and oxygen saturation level of these infants prior to nesting and after nesting at the 60th minute. Forty preterm infants who fulfilled the criteria of selection were included in the study by simple random sampling and segregated into case and control groups by blocked randomization. Data was collected and recorded. The temperature was recorded by a digital thermometer, respiratory rate was counted by the number of times the infants' chest rises, heart rate and oxygen saturation readings from the pulse oximeter. The result of the study showed that there was statistically significant effect of nesting at 60th minute, temperature (t=5.03966,p<0.05), respiratory rate(t= -2.13,p<0.05) and heart rate (t=-2.59766,p<0.05). But the effect was not significant on oxygen saturation level (t=1.2,p=0.238).  Hence this study result supports the use of nesting in NICU.


PEDIATRICS ◽  
2007 ◽  
Vol 119 (2) ◽  
pp. 314-319 ◽  
Author(s):  
J. Profit ◽  
M. C. McCormick ◽  
G. J. Escobar ◽  
D. K. Richardson ◽  
Z. Zheng ◽  
...  

2020 ◽  
Vol 68 (1) ◽  
Author(s):  
Reem M. Soliman ◽  
Fatma Alzahraah Mostafa ◽  
Antoine Abdelmassih ◽  
Elham Sultan ◽  
Dalia Mosallam

Abstract Background Patent ductus arteriosus poses diagnostic and therapeutic dilemma for clinicians, diagnosis of persistent PDA, and determination of its clinical and hemodynamic significance are challenging. The aim of this study is to determine the prevalence of PDA in preterm infants admitted to our NICU, to report cardiac and respiratory complications of PDA, and to study the management strategies and their subsequent outcomes. Result Echocardiography was done for 152 preterm babies admitted to neonatal intensive care unit (NICU) on day 3 of life. Eighty-seven (57.2%) preterms had PDA; 54 (62.1%) non-hemodynamically significant PDA (non-hsPDA), and 33 (37.9%) hemodynamically significant PDA. Hemodynamically significant PDA received medical treatment (paracetamol 15 mg/kg/6 h IV for 3 days). Follow-up echocadiography was done on day 7 of life. Four babies died before echo was done on day 7. Twenty babies (68.9%) achieved closure after 1st paracetamol course. Nine babies received 2nd course paracetamol. Follow-up echo done on day 11 of life showed 4 (13.7%) babies achieved successful medical closure after 2nd paracetamol course; 5 babies failed closure and were assigned for surgical ligation. The group of non-hsPDA showed spontaneous closure after conservative treatment. Pulmonary hemorrhage was significantly higher in hsPDA group. Mortality was higher in hsPDA group than non-hsPDA group. Conclusion Echocardiographic evaluation should be done for all preterms suspected clinically of having PDA. We should not expose vulnerable population of preterm infants to medication with known side effects unnecessarily; we should limit medical closure of PDA to hsPDA. Paracetamol offers several important therapeutic advantages options being well tolerated and having more favorable side effects profile.


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