A wireless, skin-interfaced biosensor for cerebral hemodynamic monitoring in pediatric care.
A wireless, skin-interfaced biosensor for cerebral hemodynamic monitoring in pediatric care.
复制标题
DOI：
10.1073/pnas.2019786117
复制
发表时间：
2020-12-15
影响因子：
11.1
通讯作者：
Rogers JA
中科院分区：
文献类型：
--
作者：
Rwei AY;Lu W;Wu C;Human K;Suen E;Franklin D;Fabiani M;Gratton G;Xie Z;Deng Y;Kwak SS;Li L;Gu C;Liu A;Rand CM;Stewart TM;Huang Y;Weese-Mayer DE;Rogers JA
持续监测脑血流动力学对保障儿科患者神经发育的健康至关重要。本文介绍了一种柔软、灵活、小型化的无线系统，用于实时、连续地监测全身和脑血流动力学。对年龄在0.2岁到15岁之间和具有不同种族背景的儿科受试者的临床研究证实了在医院手术环境中实际使用的机会。这一平台可以显著提高儿科患者的护理质量，特别是那些在发达国家和发展中国家面临大脑和神经发育障碍风险的患者。许多儿科和新生儿神经重症监护病房的临床护理标准包括使用硬连线设备持续监测脑血流动力学，这些设备物理上附着在皮肤上，并连接到通常安装在相邻墙壁或支架上的基站。将这些系统粘合到皮肤上的粘合剂以及患者和/或医疗保健专业人员与电线的纠缠可能会阻碍对儿科患者的护理、发展和康复至关重要的临床程序和自然运动，从而导致医源性皮肤损伤的风险。本文介绍了一种无线、小型化、机械柔软、灵活的设备，它支持与现有临床标准相当的定量测量。该系统具有多光电二极管阵列和一对发光二极管，用于同时监测全身和大脑血流动力学，通过利用多波长反射模式光体积描记和功能性近红外光谱，能够测量脑氧合、心率、外周氧合，以及潜在的脑脉压和血管张力。蒙特卡罗光学模拟使用具有代表性的儿科患者头部的磁共振图像来定义相关几何形状，从而定义这些系统的源-探测器距离和工作波长的组织探测深度。对患有和不患有先天性中枢性低通气综合征的儿科受试者的临床研究证实了在运营医院中使用该系统的可行性，并确定了其相对于现有技术的优势。这一平台有可能大幅提高各种条件和使用方案的儿科护理质量，不仅是在先进的医院环境中，而且在低收入和中等收入国家的诊所也是如此。
Continuous monitoring of cerebral hemodynamics is critical for safeguarding the healthy neurodevelopment of pediatric patients. This paper introduces a soft, flexible, miniaturized wireless system for real-time, continuous monitoring of systemic and cerebral hemodynamics for such purposes. Clinical studies on pediatric subjects with ages between 0.2 and 15 y and with various racial backgrounds validate opportunities for practical use in operating hospital environments. This platform may significantly enhance the quality of care of pediatric patients, particularly those at risk for cerebral and neurodevelopmental impairments in developed and developing world settings alike. The standard of clinical care in many pediatric and neonatal neurocritical care units involves continuous monitoring of cerebral hemodynamics using hard-wired devices that physically adhere to the skin and connect to base stations that commonly mount on an adjacent wall or stand. Risks of iatrogenic skin injuries associated with adhesives that bond such systems to the skin and entanglements of the patients and/or the healthcare professionals with the wires can impede clinical procedures and natural movements that are critical to the care, development, and recovery of pediatric patients. This paper presents a wireless, miniaturized, and mechanically soft, flexible device that supports measurements quantitatively comparable to existing clinical standards. The system features a multiphotodiode array and pair of light-emitting diodes for simultaneous monitoring of systemic and cerebral hemodynamics, with ability to measure cerebral oxygenation, heart rate, peripheral oxygenation, and potentially cerebral pulse pressure and vascular tone, through the utilization of multiwavelength reflectance-mode photoplethysmography and functional near-infrared spectroscopy. Monte Carlo optical simulations define the tissue-probing depths for source–detector distances and operating wavelengths of these systems using magnetic resonance images of the head of a representative pediatric patient to define the relevant geometries. Clinical studies on pediatric subjects with and without congenital central hypoventilation syndrome validate the feasibility for using this system in operating hospitals and define its advantages relative to established technologies. This platform has the potential to substantially enhance the quality of pediatric care across a wide range of conditions and use scenarios, not only in advanced hospital settings but also in clinics of lower- and middle-income countries.
登录
查看更多内容
影响因子：
--
作者：
Dehghani, Hamid;Eames, Matthew E.;Yalavarthy, Phaneendra K.;Davis, Scott C.;Srinivasan, Subhadra;Carpenter, Colin M.;Pogue, Brian W.;Paulsen, Keith D.
通讯作者：
Paulsen, Keith D.
影响因子：
5.1
作者：
Alderliesten, Thomas;van Bel, Frank;Lemmers, Petra
通讯作者：
Lemmers, Petra
影响因子：
4.1
作者：
Ben Sivarajan, V.;Bohn, Desmond
通讯作者：
Bohn, Desmond
影响因子：
2.9
作者：
Kim, Yoo Hwan;Paik, Seung-ho;Kim, Beop-Min
通讯作者：
Kim, Beop-Min
DOI：
10.1177/1089253208316444
发表时间：
2008-03-01
影响因子：
1.4
作者：
Chakravarti, Sujata;Srivastava, Shubhika;Mittnacht, Alexander J. C.
通讯作者：
Mittnacht, Alexander J. C.