SCH: INT: Smart and Connected Health for Newborn Ventilation

SCH：INT：新生儿通气的智能互联健康

• 批准号: 10021660
• 负责人: Kapil Dandekar
• 金额: $ 26.4万
• 依托单位: DREXEL UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-30 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10021660
• 关键词: Adult; Algorithms; Americas; Area; Breathing; Bronchopulmonary Dysplasia; Caring; Clinical; Custom; Data; Decision Making; Environment; Equilibrium; Feedback; Female; Health; Health Insurance Portability and Accountability Act; Health Personnel; Health Services; Hospitals; Human; Incubators; Infrastructure; Institutes; Instruction; Intelligence; Intermittent Positive-Pressure Ventilation; Laboratories; Life; Manikins; Mechanical ventilation; Medical; Neonatal; Newborn Infant; Nose; Outcome; Outreach Research; Premature Infant; Process; Readiness; Recommendation; Risk; Savings; Sociology; Stress; Students; Survival Rate; System; Techniques; Technology; Textiles; Time; Translating; Tube; Universities; Ventilator; Work; base; commercial application; commercialization; cost; design; endotracheal; feature extraction; field study; improved; infant monitoring; innovation; iterative design; lung injury; new technology; non-invasive monitor; novel; preterm newborn; programs; prototype; recruit; sensor; undergraduate student; underrepresented minority student; ventilation; wearable sensor technology

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

放置气管内导管（ETT）为新生儿提供机械通气可以挽救生命， 有可能造成许多短期和长期的并发症。因为在美国， 随着早产儿的增加，越来越多的人认识到气管内有创机械通气是一种有效的方法。 与婴儿中最常见的慢性肺病的风险增加有关， 支气管肺发育不良（BPD）。BPD的管理对卫生服务造成了相当大的损失， BPD会对成年人的健康产生影响。为了减少BPD，使用非侵入性 早产儿的通气技术被认为是最有效的策略。虽然有 已经利用多种模式的无创通气支持来尝试降低BPD， 最常见的一种是鼻间歇正压通气（NIPPV），它本质上是一种 使用鼻叉提供间歇性指令通气（IMV）的模式。既往研究 NIPPV已经提出了短期的好处，特别是使用同步（SNIPPV）。 我们在此提案中的目标是开发一种智能和互联的健康解决方案， 非侵入性地监测新生儿。该提案的一个关键成果是设计了一个控制回路， 智能地使新生儿呼吸与外部呼吸机同步， 无创通气，如SNIPPV。虽然ETT中的流量传感器可以提供有效的 然而，由于没有同步，它们显著地增加了ETT的尺寸、形状因子，并且因此增加了ETT的成本。相反地， 该方案将使用我们的织物传感器，这将增强非侵入性的诊断援助 降低肺损伤/血压。 相关性（参见说明）： 同步鼻（无创）间歇正压通气（SNIPPV）的使用表明， 有望减少早产儿有创通气引起的肺损伤。目前唯一 美国现有的呼吸机/技术（Servo-i/纳瓦）并未显示出长期改善 临床结果。我们的建议是开发一种新的系统，提供SNIPPV，智能 通过我们独特的织物呼吸，使用外部呼吸机帮助新生儿呼吸 D