scholarly journals Prototype Development of Continuous Remote Monitoring of ICU Patients at Home

2021 ◽  
Vol 20 (2) ◽  
pp. 79-84
Author(s):  
Veerabhadrappa S. Thippeswamy ◽  
Puranik M. Shivakumaraswamy ◽  
Suguna G. Chickaramanna ◽  
Venkatesha M. Iyengar ◽  
Anuroop P. Das ◽  
...  
Keyword(s):  
Human Body ◽  
Physiological State ◽  
Vital Signs ◽  
Cost Effective ◽  
Medical Emergency ◽  
Health State ◽  
Icu Patients ◽  
Prototype Development ◽  
Body Parameter ◽  
Timely Treatment

Vital signs are a group of essential body parameter, which provides the overall health state of a human body. They often play a pivotal role in accessing the overall physiological state of the human body. For patients requiring intense and continuous monitoring, especially those in an Intensive Care Unit, the essentiality to assess their vital signs regularly. Monitoring the health status of ICU patients becomes quite cost-effective when the same can be monitored within the comfort zone of their own house. The technique elaborated herein revolves around the fundamental idea of implementing a vital sign monitoring system that continuously assesses a patient and regularly updates the same to a centralized server system. In an event of a medical emergency, the relevant data is conveyed to the doctor via an efficient alert system, thereby ensuring safe and timely treatment to the patients. Also, as suggested the proposed design is characterized by IoT capability that allows real-time monitoring of the subject, thereby allowing, minimizing the human involvement in its operation.

scholarly journals Exploiting the Interdependence of Electrocardiography (ECG) with other Physiological Parameters of Human Body in Remote Monitoring System

2019 ◽  
Vol 8 (10) ◽  
pp. 1057-1062
Keyword(s):  
Human Body ◽  
Health Monitoring ◽  
Vital Signs ◽  
Physiological Parameters ◽  
World Health ◽  
Health State ◽  
State Monitoring ◽  
Remote Monitoring System ◽  
Cardio Vascular ◽  
Health Organization

Human body holds physiological parameters like heart rate (HR), respiration rate (RR), temperature, blood glucose level and blood pressure (BP) that indicates the health state. Monitoring these vital signs detect early signs of significant diseases like cardio-vascular and pulmonary which increase the death ratio as 70% of global death and in India it was attributed to 61% as per World Health Organization (WHO) report. With advancement in modern technologies health monitoring is achievable without affecting their regular activities and by making people to be at anywhere, not to be in hospital for long stay. In this paper the relevance between electrocardiography (ECG) and remaining other physiological measures is highlighted which will be incorporated in the design of health monitoring device in near future by revealing its complexity and ensures the high comfortability in accessing the device.

scholarly journals Longitudinal remotely mentored self-performed lung ultrasound surveillance of paucisymptomatic Covid-19 patients at risk of disease progression

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Andrew W. Kirkpatrick ◽  
Jessica L. McKee ◽  
John M. Conly
Keyword(s):  
At Risk ◽  
Lung Ultrasound ◽  
Point Of Care ◽  
Human Life ◽  
Vital Signs ◽  
Home Monitoring ◽  
Cost Effective ◽  
Care Providers ◽  
Vital Signs Monitoring ◽  
Ultrasound Probes

AbstractCOVID-19 has impacted human life globally and threatens to overwhelm health-care resources. Infection rates are rapidly rising almost everywhere, and new approaches are required to both prevent transmission, but to also monitor and rescue infected and at-risk patients from severe complications. Point-of-care lung ultrasound has received intense attention as a cost-effective technology that can aid early diagnosis, triage, and longitudinal follow-up of lung health. Detecting pleural abnormalities in previously healthy lungs reveal the beginning of lung inflammation eventually requiring mechanical ventilation with sensitivities superior to chest radiographs or oxygen saturation monitoring. Using a paradigm first developed for space-medicine known as Remotely Telementored Self-Performed Ultrasound (RTSPUS), motivated patients with portable smartphone support ultrasound probes can be guided completely remotely by a remote lung imaging expert to longitudinally follow the health of their own lungs. Ultrasound probes can be couriered or even delivered by drone and can be easily sterilized or dedicated to one or a commonly exposed cohort of individuals. Using medical outreach supported by remote vital signs monitoring and lung ultrasound health surveillance would allow clinicians to follow and virtually lay hands upon many at-risk paucisymptomatic patients. Our initial experiences with such patients are presented, and we believe present a paradigm for an evolution in rich home-monitoring of the many patients expected to become infected and who threaten to overwhelm resources if they must all be assessed in person by at-risk care providers.

Abstract 18150: Prediction of Imminent Deterioration of Children after Stage I Palliation Using Real-Time Processing of Physiological Data

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Craig G Rusin ◽  
Sebastian I Acosta ◽  
Eric L Vu ◽  
Risa B Myers ◽  
Kenneth M Brady ◽  
...  
Keyword(s):  
Early Life ◽  
Physiological State ◽  
Vital Signs ◽  
Clinical Deterioration ◽  
Physiological Data ◽  
Real Time Processing ◽  
Life Saving ◽  
St Segment ◽  
The Hours ◽  
Roc Area

Patients after stage 1 palliation (S1P) for hypoplastic left heart syndrome (HLHS) and related lesions are at risk of life threatening deterioration resulting in shock, cardiac arrest, & hypoxemia. We hypothesize that these sudden deteriorations may be forecast by subtle, previously unidentified changes in cardiorespiratory dynamics. Identification of these precursors may provide an opportunity for early, life-saving intervention. We created complete high-resolution physiological recordings for all patients who had a primary admission of S1P after Jan. 1, 2013. We used the SickbayTM system (Medical Informatics Corp, Houston, TX) to collect high frequency physiological waveforms including EKG, ABP, LAP, SpO2 and Chest Impedance (60Hz - 240Hz), as well as HR, RR, Temp. and ST segment vital signs (0.5 Hz) during the patient’s interstage hospitalization. A logistic regression model was constructed to discriminate between physiological characteristics observed in the hours prior to deterioration from the characteristics observed >24 hours prior to or >96 hours after a clinical deterioration. Model validation was done using a standard bagging approach with a REPtree classifier and 10 fold cross validation. Twenty five patients were included in the study. Of these, 15 (60%) were found to have one or more deterioration events (arrest, CPR, unplanned intubation), with 24 total events observed during the interstage period. Characteristics associated with imminent deterioration were low SpO2 and depressed ST segment. Changes in physiological dynamics could be detected 1-2 hours before overt deterioration occurs (ROC area = 0.89) (Figure 1). This altered physiological state remains for ~96 hours after deterioration. In conclusion, it is possible to identify clinical deterioration in HLHS patients during their interstage period ~1-2 hours before overt deterioration occurs, providing an opportunity for early, life-saving intervention to be administered.

scholarly journals The association between abnormal vital sign groups and undesirable patient outcomes

2018 ◽  
Vol 25 (3) ◽  
pp. 137-145
Author(s):  
Marina Lee ◽  
David McD Taylor ◽  
Antony Ugoni
Keyword(s):  
Emergency Department ◽  
Confidence Interval ◽  
Patient Outcomes ◽  
Vital Sign ◽  
Odds Ratio ◽  
Medical Emergency Team ◽  
Vital Signs ◽  
Medical Emergency ◽  
Emergency Team ◽  
Abnormal Vital Sign

Introduction: To determine the association between both abnormal individual vital signs and abnormal vital sign groups in the emergency department, and undesirable patient outcomes: hospital admission, medical emergency team calls and death. Method: We undertook a prospective cohort study in a tertiary referral emergency department (February–May 2015). Vital signs were collected prospectively in the emergency department and undesirable outcomes from the medical records. The primary outcomes were undesirable outcomes for individual vital signs (multivariate logistic regression) and vital sign groups (univariate analyses). Results: Data from 1438 patients were analysed. Admission was associated with tachycardia, tachypnoea, fever, ≥1 abnormal vital sign on admission to the emergency department, ≥1 abnormal vital sign at any time in the emergency department, a persistently abnormal vital sign, and vital signs consistent with both sepsis (tachycardia/hypotension/abnormal temperature) and pneumonia (tachypnoea/fever) (p < 0.05). Medical emergency team calls were associated with tachycardia, tachypnoea, ≥1 abnormal vital sign on admission (odds ratio: 2.3, 95% confidence interval: 1.4–3.8), ≥2 abnormal vital signs at any time (odds ratio: 2.4, 95% confidence interval: 1.2–4.7), and a persistently abnormal vital sign (odds ratio: 2.7, 95% confidence interval: 1.6–4.6). Death was associated with Glasgow Coma Score ≤13 (odds ratio: 6.3, 95% confidence interval: 2.5–16.0), ≥1 abnormal vital sign on admission (odds ratio: 2.6, 95% confidence interval: 1.2–5.6), ≥2 abnormal vital signs at any time (odds ratio: 6.4, 95% confidence interval: 1.4–29.5), a persistently abnormal vital sign (odds ratio: 4.3, 95% confidence interval: 2.0–9.0), and vital signs consistent with pneumonia (odds ratio: 5.3, 95% confidence interval: 1.9–14.8). Conclusion: Abnormal vital sign groups are generally superior to individual vital signs in predicting undesirable outcomes. They could inform best practice management, emergency department disposition, and communication with the patient and family.

scholarly journals Composite and Wearable Sensor Kit for Location Aware Healthcare Monitoring and Real-Time Trauma Scoring for Survival Prediction.

2018 ◽  
Author(s):  
Amit Walinjkar
Keyword(s):  
Critical Care ◽  
Real Time ◽  
Injury Severity ◽  
Vital Signs ◽  
Physiological Parameters ◽  
Care Team ◽  
Medical Emergency ◽  
Traumatic Experience ◽  
The Individual ◽  
Critical Care Team

With the availability of wearable health monitoring sensor modules like 3-Lead Electrocardiogram (ECG), Pulse Oximeter (SpO2), Galvanic Skin Response (GSR), Hall effect sensor (for measuring Respiratory Rate), Blood Pressure and Temperature measuring and sensing elements, it has now become possible to device a composite health status monitoring kit that can measure vital signs and other physiological parameters pertaining to human health in real time. Traditionally, the physiological parameters along with vital signs related examination was possible only in a hospitalized or ambulatory environment, however due to advances in sensing and embedded system technology and miniaturization of data acquisition and processing elements health monitoring has become possible even when individuals remain engaged in their day to day activities at the convenience of space and location. The patients or individuals subject to monitoring may suffer from a traumatic experience due to their medical condition and may need emergent incidence response and the critical care team may have to prepare for the treatment only after the patient arrives, which often is too late, as in case of cardiac arrests or severe injuries. The research focused on real-time health status monitoring and trauma scoring using standard physiological parameters along with standard telemetry protocols to make the critical care team aware of an emergent situation and prepare for a medical emergency. Vital signs and physiological parameters (heart rate, temperature, respiratory rate, and blood pressure, SpO2) were measured in real time from human subjects non-invasively. In order to enable monitoring of the patients engaged in day to day activities, errors due to the motion were removed using stationary wavelet transform correction (correlation coefficient of 0.9 after correction) and signals from various sensors were denoised, filtered and were encoded in a format suitable for further data analysis. A composite sensor kit capable of monitoring vital signs and physiological parameters can be very useful in incident response when an individual undergoes a traumatic experience related to stroke, cardiac arrest, fits or even injury, as along with monitoring information the kit can calculate scores related to trauma like the Injury Severity Score (ISS), National Early Warning Signs (NEWS), Revised Trauma Score (RTS). Trauma Injury Severity Score (TRISS), Probability of Survival (Ps) score. An open access database of vital signs and physiological parameters from Physionet, MIMIC 2 Numerics (mimicdb/numerics) database was used to calculate NEWS and RTS and to generate correlation and regression models using the vital signs/physiological parameters for a clinical class of patients with respiratory failure and admitted to Intensive Care Unit (ICU). NEWS and RTS scores showed no significant correlation (r = 0.25, p&lt;0.001) amongst themselves, however together NEWS and RTS showed significant correlation with Ps (blunt) (r = 0.70, p&lt;0.001). RTS and Ps (blunt) scores showed some correlation (r = 0.63, p&lt;0.001) and NEWS score showed significant correlation (r = 0.79, p&lt;0.001) with Ps (blunt) scores. Furthermore, since individuals have to be monitored regardless of location, these kits have to have a built-in capability to locate the individual so that the incident response team can locate the individual based on Global Positioning System coordinates (GPS). A Quantum GIS (Geographical Information System) application using real-time GPS coordinates (OpenStreetMap coordinates) was used to calculate the shortest path using QGIS Network Analysis tool to demonstrate the calculation of shortest path and direction to locate the nearest service provider in shortest time. Along with locating the nearest healthcare service provider, it would help if the critical care team could be made aware of the physiological parameters and trauma scores using standard protocols accepted across the globe. The physiological parameters from the sensors along with the calculated trauma scores were encoded according to a standard Systematized Nomenclature of Medicine-Clinical Terms (SNOMED-CT) coding system and International Code of Diseases (ICD) codes and the trauma information was logged to Electronic Health Records (EHR) using Fast Health Interoperability Resources (FHIR) servers. FHIR servers provided interoperable web services to log the event information in real time. It could be concluded that analytical models trained on existing datasets can help in analyzing a traumatic experience or an injury and the information can be logged using a standard telemetry protocol as a telemedicine initiative. These scores enable the healthcare service providers to estimate the extent of trauma and prepare for medical emergency procedures and find applications in general and military healthcare.

scholarly journals IOT Based Health Monitoring System

2021 ◽  
Vol 9 (8) ◽  
pp. 1176-1178
Author(s):  
Sowmya G
Keyword(s):  
Monitoring System ◽  
Health Monitoring ◽  
Social Insurance ◽  
Vital Signs ◽  
Smart Phone ◽  
Smart Devices ◽  
The Internet ◽  
Health State ◽  
Health Monitoring System ◽  
Vital Parameters

Abstract: The increased use of smart phones and smart devices in the health zone has brought on extraordinary effect on the world’s critical care. The Internet of things is progressively permitting to coordinate sensors fit for associating with the Internet and give data on the health condition of patients. These technologies create an amazing change in medicinal services during pandemics. Likewise, many users are beneficiaries of the M-Health (Mobile Health) applications and E-Health (social insurance upheld by ICT) to enhance, help and assist continuously to specialists who help. The main aim of this ‘IOT Health Monitoring System’ is to build up a system fit for observing vital body signs such as body temperature, heart rate, pulse oximetry etc. The System is additionally equipped measuring Room Temperature and Humidity and Atmosphere CO level. To accomplish this, the system involves many sensors to display vital signs that can be interfaced to the doctor’s smart phone as well as caretakers’ smartphone. This prototype will upload the readings from the sensor to a server remotely and the information gathered will be accessible for analysis progressively. It has the capacity of reading and transmitting vital parameters measured to the cloud server and then to any Smartphone configured with Blynk App. These readings can be utilized to recognize the health state of the patient and necessary actions can be taken if the vital parameters are not in prescribed limits for a longer period. Keywords: IOT Health Monitoring System, Vital parameters, Blynk App

scholarly journals Metabolomics pilot study identifies circadian desynchronization and distinct intra-patient variability patterns in critical illness

2019 ◽  
Author(s):  
Elizabeth R. Lusczek ◽  
Lee Parsons ◽  
Jesse Elder ◽  
Stephen B. Harvey ◽  
Mariya Skube ◽  
...  
Keyword(s):  
Pilot Study ◽  
Circadian Rhythms ◽  
Vital Signs ◽  
Principal Component ◽  
Underlying Disease ◽  
Plasma Metabolites ◽  
Metabolic Profiles ◽  
Healthy Controls ◽  
Icu Patients ◽  
Sound Levels

AbstractBackgroundSynchronized circadian rhythms play a key role in coordinating physiologic health. Desynchronized circadian rhythms may predispose individuals to disease or be indicative of underlying disease. Intensive care unit (ICU) patients likely experience desynchronized circadian rhythms due to disruptive environmental conditions in the ICU and underlying pathophysiology. This observational pilot study was undertaken to determine if circadian rhythms are altered in ICU patients relative to healthy controls by profiling circadian rhythms in vital signs and plasma metabolites.MethodsWe monitored circadian rhythms in 5 healthy controls and 5 ICU patients for 24 hours. Heart rate and blood pressure were measured every 30 minutes, temperature was measured every hour, and blood was sampled for mass spectrometry-based plasma metabolomics every 4 hours. Bedside sound levels were measured every minute. Circadian rhythms were evaluated in vitals and plasma metabolites individually and in each group using the cosinor method.ResultsICU patient rooms were significantly louder than healthy controls’ rooms and average noise levels were above EPA recommendations. Healthy controls generally had significant circadian rhythms individually and as a group. While a few ICU patients had significant circadian rhythms in isolated variables, no significant rhythms were identified in ICU patients as a group, except in cortisol. This indicates a lack of coherence in circadian phases and amplitudes among ICU patients. Finally, principal component analysis of metabolic profiles showed surprising patterns in plasma sample clustering. Each ICU patient’s samples were clearly discernable in individual clusters, separate from a single cluster of healthy controls.ConclusionsICU patients’ circadian rhythms show significant desynchronization compared to healthy controls. Clustering of plasma metabolic profiles suggests that metabolomics could be used to track individual patients’ clinical courses longitudinally. Our results show global disordering of metabolism and the circadian system in ICU patients which should be characterized further in order to determine implications for patient care.

scholarly journals Micro RNAs: an arguable appraisal in medicine

2016 ◽  
Vol 50 (2) ◽  
pp. 106-124 ◽  
Author(s):  
K. Voglova ◽  
J. Bezakova ◽  
Iveta Herichova
Keyword(s):  
Clinical Trials ◽  
Human Body ◽  
Physiological State ◽  
Intercellular Signaling ◽  
Circulating Mirnas ◽  
Intracellular Space ◽  
Double Stranded Rna ◽  
Micro Rnas ◽  
Neural Diseases

AbstractMicro RNAs (miRNAs) represent a newly discovered class of regulatory molecules in the human body. miRNA is a short double stranded RNA sequence interfering with mRNA, causing in most cases, inhibition of translation. Synthesis of miRNAs shows an increasing developmental pattern and postnatally miRNAs are synthesized in all cells possessing transcriptional machinery. miRNAs usually target several mRNAs and therefore conclusive evidences proving their functions are not always ease to be acquired. In spite of this difficulty, functions of miRNAs were firmly established in the development, the cardiovascular and neural diseases, and cancer. Many miRNAs have been reported to be associated with physiological state of cells and/or tissues. This finding becomes fundamental, especially when consider that these miRNAs can be released from cell into intracellular space or circulation. Correlation between miRNA production in tissues and its contribution to multisource miRNA pool in the circulation is in a focus of biomarker-oriented researchers. Recently, circulating miRNAs have been suggested to be applicable as biomarkers in several types of cancer, cardiovascular injury, and diabetes. Role of miRNAs in the organism intercellular signaling is still under the broad investigation. Several miRNA mimics, intended for treatment of disease, are being currently tested in the clinical trials.

scholarly journals Blood Lactate Is a Useful Indicator for the Medical Emergency Team

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Maria Schollin-Borg ◽  
Pär Nordin ◽  
Henrik Zetterström ◽  
Joakim Johansson
Keyword(s):  
Blood Lactate ◽  
Medical Emergency Team ◽  
Lactate Concentration ◽  
Vital Signs ◽  
Blood Lactate Level ◽  
Medical Emergency ◽  
Emergency Team ◽  
Arterial Blood ◽  
Arterial Blood Lactate ◽  
Secondary Referral Hospital

Lactate has been thoroughly studied and found useful for stratification of patients with sepsis, in the Intensive Care Unit, and trauma care. However, little is known about lactate as a risk-stratification marker in the Medical Emergency Team- (MET-) call setting. We aimed to determine whether the arterial blood lactate level at the time of a MET-call is associated with increased 30-day mortality. This is an observational study on a prospectively gathered cohort at a regional secondary referral hospital. All MET-calls during the two-year study period were eligible. Beside blood lactate, age and vital signs were registered at the call. Among the 211 calls included, there were 64 deaths (30.3%). Median lactate concentration at the time of the MET-call was 1.82 mmol/L (IQR 1.16–2.7). We found differences between survivors and nonsurvivors for lactate and oxygen saturation, a trend for age, but no significant correlations between mortality and systolic blood pressure, respiratory rate, and heart rate. As compared to normal lactate (<2.44 mmol/L), OR for 30-day mortality was 3.54 (p<0.0006) for lactate 2.44–5.0 mmol/L and 4.45 (p<0.0016) for lactate > 5.0 mmol/L. The present results support that immediate measurement of blood lactate in MET call patients is a useful tool in the judgment of illness severity.

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