Non-Invasive Wearable Patch Utilizing Seismocardiography for Peri-Operative Use in Surgical Patients.
Non-Invasive Wearable Patch Utilizing Seismocardiography for Peri-Operative Use in Surgical Patients.
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DOI：
10.1109/jbhi.2020.3032938
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发表时间：
2021-05
影响因子：
7.7
通讯作者：
Inan OT
中科院分区：
文献类型：
--
作者：
Semiz B;Carek AM;Johnson JC;Ahmad S;Heller JA;Vicente FG;Caron S;Hogue CW;Etemadi M;Inan OT
优化围手术期液体管理已被证明可改善患者结局，并且使用每搏输出量（SV）测量已成为指导液体治疗的公认工具。经食管多普勒（TED）是一种经确认的微创器械，可用于SV的临床评估。不幸的是，TED的使用仅限于麻醉患者的术中设置，并且需要持续的监督和定期调整以获得准确的信号质量。然而，术后液体管理对于改善结果也至关重要。目前，在临床上没有常规使用的设备可以在手术期间和手术后连续且无创地跟踪患者的SV。在本文中，我们建议使用安装在胸骨中段的可穿戴贴片，其连续捕获心震图（SCG）和心电图（ECG）信号，以预测接受大手术的患者的SV。在一项12名患者的研究中，使用TED和可穿戴贴片同时记录血液动力学数据。使用信号处理和回归技术从可穿戴贴片捕获的信号（SCG和ECG）中导出SV，并将其与TED获得的值进行比较。结果表明，SCG和ECG的组合包含大量关于SV的信息，导致预测和参考SV值之间的相关性和绝对误差中位数分别为0.81和7.56 mL。这项工作表明，所提出的基于可穿戴设备的方法有望用作TED的替代方案，用于连续的患者监测和指导围手术期液体管理。
Optimizing peri-operative fluid management has been shown to improve patient outcomes and the use of stroke volume (SV) measurement has become an accepted tool to guide fluid therapy. The Transesophageal Doppler (TED) is a validated, minimally invasive device that allows clinical assessment of SV. Unfortunately, the use of the TED is restricted to the intra-operative setting in anesthetized patients and requires constant supervision and periodic adjustment for accurate signal quality. However, post-operative fluid management is also vital for improved outcomes. Currently, there is no device regularly used in clinics that can track patient’s SV continuously and non-invasively both during and after surgery. In this paper, we propose the use of a wearable patch mounted on the mid-sternum, which captures the seismocardiogram (SCG) and electrocardiogram (ECG) signals continuously to predict SV in patients undergoing major surgery. In a study of 12 patients, hemodynamic data was recorded simultaneously using the TED and wearable patch. Signal processing and regression techniques were used to derive SV from the signals (SCG and ECG) captured by the wearable patch and compare it to values obtained by the TED. The results showed that the combination of SCG and ECG contains substantial information regarding SV, resulting in a correlation and median absolute error between the predicted and reference SV values of 0.81 and 7.56 mL, respectively. This work shows promise for the proposed wearable-based methodology to be used as an alternative to TED for continuous patient monitoring and guiding peri-operative fluid management.