Bionic for Training: Smart Framework Design for Multisensor Mechatronic Platform Validation

Home monitoring supports the continuous improvement of the therapy by sharing data with healthcare professionals. It is required when life-threatening events can still occur after hospital discharge such as neonatal apnea. However, multiple sources of external noise could affect data quality and/or increase the misdetection rate. In this study, we developed a mechatronic platform for sensor characterizations and a framework to manage data in the context of neonatal apnea. The platform can simulate the movement of the abdomen in different plausible newborn positions by merging data acquired simultaneously from three-axis accelerometers and infrared sensors. We simulated nine apnea conditions combining three different linear displacements and body postures in the presence of self-generated external noise, showing how it is possible to reduce errors near to zero in phenomena detection. Finally, the development of a smart 8Ws-based software and a customizable mobile application were proposed to facilitate data management and interpretation, classifying the alerts to guarantee the correct information sharing without specialized skills.

EFFICACY OF A NOVEL DEVICE TO DETECT, ALERT AND RESOLVE NEONATAL APNEA - PILOT STUDY

Objective: To measure the accuracy of a novel device in detecting Bradycardia andDesaturation (B&D) events and to determine its efficacy in resolving apneas innewborns with comparison to standard monitor (which only detects B&D eventsand alerts).Design: This was a prospective observational study.Setting: Sick Newborn Care Unit of a large tertiary referral hospital in Hyderabad,India.Methods: 31 newborns were provided with a novel device, which monitored oxygensaturation and pulse rate and alarmed when values dropped below a set thresholdwhich is referred as an event, henceforth. The novel device also provided footstimulation in response to above-mentioned events. When the monitor alarmed, anurse attended to the baby to confirm whether the baby was breathing and whetherthe event had been resolved by the device. If the event had not resolved, appropriateaction as per the standard-of-care was performed.Results: The novel device “ApneBootTM” positively detected B&D events 94.03% oftimes as compared to the standard reference monitor. 56 of 67 observed B&D eventswere visually confirmed to be apneas, indicating that 83.6% of B&D eventscoincided with apneas. Of the 56 apneic events, 50 were central apneas, of which 35were resolved by the novel device, making the device’s efficacy of apnea resolution70%.Conclusion: The results of the study indicate that this novel device “ApneBootTM”is very effective in detecting and alarming B&D events, which coincides with theapnea, and resolving it by providing foot stimulation.Keywords: Novel Device, Neonatal Apnea, Low Birth Weight, Body Temperature,Kangaroo Mother Care, Community Health,

Does caffeine improve respiratory rate during remifentanil target controlled infusion sedation? A case report in endoscopic sedation

Sedation for endoscopic procedures may be challenging when facing patients with high risk. Traditional techniques, as propofol or meperidine/midazolam administration, cannot ensure an adequate level of safety and efficacy for these patients. Remifentanil infusion is a common alternative, but the incidence of apneic events does not allow achieving safely a good level of analgesia. To overcome with this issue, the authors borrowed suggestions from other medical fields. The clinical practice has recognized a wide utility of methylxanthines (caffeine, theophylline, etc). The positive effect of caffeine on the airways function is known and in the treatment of neonatal apnea, it works as direct stimulant of central respiratory center. Furthermore, preclinical studies suggest that methylxanthines could have a protective role on the opioids inhibition of the bulbar-pontine respiratory center. As described in this report, the authors observed that, also when apnea has been induced by remifentanil, caffeine is able to restore the respiratory rate. The authors present the management of a respiratory impaired patient scheduled for a therapeutic colonoscopy. Our sedation was focused on the match between remifentanil in target controlled infusion and intravenous caffeine, like an “expresso to wake-up” the respiratory drive.