TY - JOUR
T1 - Feasibility of wireless cardiorespiratory monitoring with dry electrodes incorporated in a belt in preterm infants
AU - Scholten, Anouk W. J.
AU - van Leuteren, Ruud W.
AU - de Waal, Cornelia G.
AU - de Jongh, Frans H.
AU - van Kaam, Anton H.
AU - Hutten, G. Jeroen
N1 - Publisher Copyright: © 2022 Institute of Physics and Engineering in Medicine.
PY - 2022/5/31
Y1 - 2022/5/31
N2 - Objective.Monitoring heart rate (HR) and respiratory rate (RR) is essential in preterm infants and is currently measured with ECG and chest impedance (CI), respectively. However, in current clinical practice these techniques use wired adhesive electrodes which can cause skin damage and hinder parent-infant interaction. Moreover, CI is not always reliable. We assessed the feasibility of a wireless dry electrode belt to measure HR and RR via transcutaneous diaphragmatic electromyography (dEMG).Approach.In this prospective, observational study, infants were monitored up to 72 h with the belt and standard CI. Feasibility of the belt was expressed by its ability to retrieve a respiratory waveform from dEMG, determining the percentage of time with stable respiration data without signal errors ('lead-off' and Bluetooth Loss Error, 'BLE'), skin-friendliness of the belt (skin score) and by exploring the ability to monitor trends in HR and RR with the belt.Main results.In all 19 included infants (median gestational age 27.3 weeks) a respiratory waveform could be obtained. The amount of signal errors was low (lead-off 0.5% (IQR 0.1-1.6) and BLE 0.3% (IQR 0.1-0.9)) and 76.5% (IQR 69.3-80.0) of the respiration measurement was stable. No adverse skin effects were observed (median skin score of 3(3-4)). A similar HR and RR trend between the belt and CI was observed.Significance.Dry electrodes incorporated in a non-adhesive belt can measure dEMG in preterm infants. The belt provided a HR and RR trend similar to CI. Future studies are required to investigate the non-inferiority of the belt as a cardiorespiratory monitor compared to CI.
AB - Objective.Monitoring heart rate (HR) and respiratory rate (RR) is essential in preterm infants and is currently measured with ECG and chest impedance (CI), respectively. However, in current clinical practice these techniques use wired adhesive electrodes which can cause skin damage and hinder parent-infant interaction. Moreover, CI is not always reliable. We assessed the feasibility of a wireless dry electrode belt to measure HR and RR via transcutaneous diaphragmatic electromyography (dEMG).Approach.In this prospective, observational study, infants were monitored up to 72 h with the belt and standard CI. Feasibility of the belt was expressed by its ability to retrieve a respiratory waveform from dEMG, determining the percentage of time with stable respiration data without signal errors ('lead-off' and Bluetooth Loss Error, 'BLE'), skin-friendliness of the belt (skin score) and by exploring the ability to monitor trends in HR and RR with the belt.Main results.In all 19 included infants (median gestational age 27.3 weeks) a respiratory waveform could be obtained. The amount of signal errors was low (lead-off 0.5% (IQR 0.1-1.6) and BLE 0.3% (IQR 0.1-0.9)) and 76.5% (IQR 69.3-80.0) of the respiration measurement was stable. No adverse skin effects were observed (median skin score of 3(3-4)). A similar HR and RR trend between the belt and CI was observed.Significance.Dry electrodes incorporated in a non-adhesive belt can measure dEMG in preterm infants. The belt provided a HR and RR trend similar to CI. Future studies are required to investigate the non-inferiority of the belt as a cardiorespiratory monitor compared to CI.
KW - diaphragm activity
KW - dry electrodes
KW - electromyography
KW - preterm infants
KW - wireless cardiorespiratory monitoring
UR - http://www.scopus.com/inward/record.url?scp=85131107293&partnerID=8YFLogxK
U2 - https://doi.org/10.1088/1361-6579/ac69a9
DO - https://doi.org/10.1088/1361-6579/ac69a9
M3 - Article
C2 - 35453135
SN - 0967-3334
VL - 43
JO - Physiological measurement
JF - Physiological measurement
IS - 5
M1 - 055003
ER -