Feb 28, 2019

Scientists try to monitor preterm babies' vitals wirelessly

Weighing as much as a raindrop, the chest sensor can wirelessly monitor heart rate, breathing rate, and temperature. Photo: Northwestern University

Researchers say they have developed a new way to monitor preterm babies using cordless, wafer-thin integrated technology and soft mechanics with little to no adhesive, according to a study published in Science on Thursday.

Why it matters: While the technology is in early stages of testing, this could offer an "innovative approach" to give doctors and nurses better access and monitoring abilities, allowing the baby to move more freely, and offering parents a better bonding experience, which is particularly important for underdeveloped babies.

"The technology is fascinating and an exciting example of applied engineering being formulated and utilized to assist the care of some of our littlest, most fragile infants."
— Lawrence Eichenfield, who was not part of this study, tells Axios

Background: Current technology, first developed in the 1960s, uses rigid electrodes with strong adhesives on the baby connected to giant computing systems that monitor the heart rate and oxygen saturation of healthy preterm babies.

  • For those born with critical issues, more monitors are often added, such as those to check the levels of carbon dioxide breathed out, monitor other breathing parameters and watch electric brain wave activity.
  • The adhesives can damage and even scar the underdeveloped skin of neonates, says co-author Steve Xu of Northwestern University.
  • The wires can make it difficult for doctors or nurses to access the baby quickly and for parents to hold the baby, skin-to-skin as therapeutically recommended, or even to breastfeed, co-author Amy S. Paller of Northwestern University tells Axios.
"The most exciting thing for me is for the parents," Paller says. "I've seen the faces of the parents. They're sitting in the [NICU] room, sometimes trying to hold their little hands, but the babies are absolutely tethered."

What they did: Researchers worked on both developing soft mechanics and adhesives that wouldn't damage the baby's skin and creating the lightest technology that wouldn't need wires or batteries but could still monitor and integrate vital signs, Xu tells Axios.

  • The outside of the sensor uses advances in materials science and biomedical engineering to create a skin-like silicone material encasing the technology.
  • Using near-field communication (similar to Apple Pay), the sensors collect vital signs data at high sampling frequencies and use a bluetooth chip to transmit the data to a mobile device.
  • The device is powered wirelessly through radio frequency energy. "The absence of the battery allows the device to be ultra-thin and low profile. It also allows the device to be easily cleaned ... and compatible with medical imaging," Xu says.
  • They tested this on 21 neonates (while simultaneously using the traditional monitoring system) for the published study and conducted further testing on about 60 more babies with the same results, Paller says.

What they found:

  • Paller says they're "thrilled" at the accuracy of the sensors, the fact that they work well when wet, and are compatible with advanced medical imaging techniques like MRI and CT scans. None of the babies have experienced any negative side effects, she adds.
  • Ruth Guinsburg of Escola Paulista de Medicina–Universidade Federal de São Paulo writes in a Science perspective piece that it's an "innovative approach."
  • "The integrated monitoring brings efficiency and integration, which will allow integrated assessment of vitals and other parameters to assess the health status of infants. It is also exciting to make the baby more accessible to parents (and staff), without the tangle of leads that is now standard," says Eichenfield, who's a professor of dermatology and pediatrics at UC San Diego.

Developing countries may also benefit from this, since it would require less technology, the authors say.

  • "We leverage smartphones and tablets to transmit and display data. This eliminates the need for expensive legacy equipment. The cost of the devices are low at high-scale manufacturing facilitating deployment in poorer countries. If you can apply a bandaid, you can use the technology," Xu says.
  • "This technology may improve the care of very preterm infants in developed-world settings, but also has great potential impact on monitoring practices all over the world and may give many neonates a more equitable opportunity to survive," per Guinsburg. 

Yes, but: Eichenfield says more research is needed on a larger cohort of preterm babies. Paller says that's the plan, and adds that while other research has shown the benefit of skin-to-skin contact, they were unable to evaluate that particular benefit in this study because the babies were required to wear the traditional monitors.

What's next: Paller says the team is planning to start a large trial in Zambia, India and Pakistan later this year and will continue research in the U.S. If all continues well, she says they hope to have FDA approval in 5 years.

Watch more via Northwestern's video.

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