SCH: INT: Smart and Connected Health for Newborn Ventilation

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Placing an endotracheal tube {ETT) to provide mechanical ventilation for a newborn is life-saving but comes with the potential to create many short- and long-term complications. As the survival rate in preterm infants rises, it is increasingly recognized that endotracheal invasive mechanical ventilation is associated with an increased risk of developing the most common chronic lung disease in infants, bronchopulmonary dysplasia (BPD). Management of BPD takes a considerable toll on health services, and BPD can have health ramifications reaching into adulthood. To decrease BPD, the use of noninvasive ventilation techniques in preterm infants is recognized as the most effective strategy. While there are multiple modes of noninvasive ventilation support that have been utilized in an attempt to decrease BPD, the most common one is nasal intermittent positive pressure ventilation (NIPPV), which is essentially a mode of providing intermittent mandatory ventilation (IMV) using nasal prongs. Prior studies done with NIPPV have suggested short-term benefits, especially with the use of synchronization (SNIPPV). Our objective in this proposal is to develop a smart and connected health solution to unobtrusively and non-invasively monitor newborns. A key outcome of this proposal is the design of a control loop to intelligently synchronize newborn breathing with an external ventilator to provide invasive as well as non-invasive ventilation, such as SNIPPV. While flow sensors in the ETT can provide effective synchronization, they significantly increase the size, form-factor, and hence, the cost of the ETT. Instead, this proposal will use our fabric-based sensors, which will enhance non-invasive ventilatory assistance and decrease lung injury/BP. RELEVANCE (See instructions): Use of synchronized nasal (noninvasive) intermittent positive pressure ventilation (SNIPPV) has shown promise to decrease invasive ventilation-induced lung injury to premature newborns. The only currently available ventilator/technique (Servo-i/NAVA) in the USA to do so has not shown improved long-term clinical outcomes. Our proposal is to develop a novel system to provide SNIPPV that intelligently synchronizes newborn breathing with an external ventilator with our unique fabric-based breathing D