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Yoo JY, Oh S, Shalish W, Maeng WY, Cerier E, Jeanne E, Chung MK, Lv S, Wu Y, Yoo S, Tzavelis A, Trueb J, Park M, Jeong H, Okunzuwa E, Smilkova S, Kim G, Kim J, Chung G, Park Y, Banks A, Xu S, Sant'Anna GM, Weese-Mayer DE, Bharat A, Rogers JA. Wireless broadband acousto-mechanical sensing system for continuous physiological monitoring. Nat Med 2023; 29:3137-3148. [PMID: 37973946 DOI: 10.1038/s41591-023-02637-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 10/06/2023] [Indexed: 11/19/2023]
Abstract
The human body generates various forms of subtle, broadband acousto-mechanical signals that contain information on cardiorespiratory and gastrointestinal health with potential application for continuous physiological monitoring. Existing device options, ranging from digital stethoscopes to inertial measurement units, offer useful capabilities but have disadvantages such as restricted measurement locations that prevent continuous, longitudinal tracking and that constrain their use to controlled environments. Here we present a wireless, broadband acousto-mechanical sensing network that circumvents these limitations and provides information on processes including slow movements within the body, digestive activity, respiratory sounds and cardiac cycles, all with clinical grade accuracy and independent of artifacts from ambient sounds. This system can also perform spatiotemporal mapping of the dynamics of gastrointestinal processes and airflow into and out of the lungs. To demonstrate the capabilities of this system we used it to monitor constrained respiratory airflow and intestinal motility in neonates in the neonatal intensive care unit (n = 15), and to assess regional lung function in patients undergoing thoracic surgery (n = 55). This broadband acousto-mechanical sensing system holds the potential to help mitigate cardiorespiratory instability and manage disease progression in patients through continuous monitoring of physiological signals, in both the clinical and nonclinical setting.
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Affiliation(s)
- Jae-Young Yoo
- Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL, USA
| | - Seyong Oh
- Division of Electrical Engineering, Hanyang University ERICA, Ansan, Republic of Korea
| | - Wissam Shalish
- Neonatal Division, Department of Pediatrics, McGill University Health Center, Montreal, Quebec, Canada
| | - Woo-Youl Maeng
- Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL, USA
| | - Emily Cerier
- Division of Thoracic Surgery, Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Emily Jeanne
- Neonatal Division, Department of Pediatrics, McGill University Health Center, Montreal, Quebec, Canada
| | - Myung-Kun Chung
- School of Electrical Engineering, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea
| | - Shasha Lv
- Neonatal Division, Department of Pediatrics, McGill University Health Center, Montreal, Quebec, Canada
| | - Yunyun Wu
- Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL, USA
| | - Seonggwang Yoo
- Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL, USA
| | - Andreas Tzavelis
- Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL, USA
| | - Jacob Trueb
- Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL, USA
| | - Minsu Park
- Department of Polymer Science and Engineering, Dankook University, Yongin, Republic of Korea
| | - Hyoyoung Jeong
- Department of Electrical and Computer Engineering, University of California, Davis, CA, USA
| | - Efe Okunzuwa
- Division of Thoracic Surgery, Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Slobodanka Smilkova
- Department of Electrical and Computer Engineering, Northwestern University, Evanston, IL, USA
| | - Gyeongwu Kim
- Adlai E. Stevenson High School, Lincolnshire, IL, USA
| | - Junha Kim
- Department of Advanced Materials Engineering for Information and Electronics, Kyung Hee University, Gyeonggi-do, Republic of Korea
| | - Gooyoon Chung
- Department of Advanced Materials Engineering for Information and Electronics, Kyung Hee University, Gyeonggi-do, Republic of Korea
| | - Yoonseok Park
- Department of Advanced Materials Engineering for Information and Electronics, Kyung Hee University, Gyeonggi-do, Republic of Korea
| | - Anthony Banks
- Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL, USA
| | - Shuai Xu
- Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL, USA
- Sibel Health, Niles, IL, USA
| | - Guilherme M Sant'Anna
- Neonatal Division, Department of Pediatrics, McGill University Health Center, Montreal, Quebec, Canada
| | - Debra E Weese-Mayer
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Division of Autonomic Medicine, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
- Stanley Manne Children's Research Institute, Chicago, IL, USA
| | - Ankit Bharat
- Division of Thoracic Surgery, Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
| | - John A Rogers
- Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL, USA.
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A novel system that continuously visualizes and analyzes respiratory sounds to promptly evaluate upper airway abnormalities: a pilot study. J Clin Monit Comput 2021; 36:221-226. [PMID: 33459947 DOI: 10.1007/s10877-020-00641-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 12/22/2020] [Indexed: 10/22/2022]
Abstract
Although respiratory sounds are useful indicators for evaluating abnormalities of the upper airway and lungs, the accuracy of their evaluation may be limited. The continuous evaluation and visualization of respiratory sounds has so far been impossible. To resolve these problems, we developed a novel continuous visualization system for assessing respiratory sounds. Our novel system was used to evaluate respiratory abnormalities in two patients. The results were not known until later. The first patient was a 23-year-old man with chronic granulomatous disease and persistent anorexia. During his hospital stay, he exhibited a consciousness disorder, bradypnea, and hypercapnia requiring tracheal intubation. After the administration of muscle relaxant, he suddenly developed acute airway stenosis. Because we could not intubate and ventilate, we performed cricothyroidotomy. Subsequent review of our novel system revealed mild stridor before the onset of acute airway stenosis, which had not been recognized clinically. The second patient was a 74-year-old woman who had been intubated several days earlier for tracheal burn injury, and was extubated after alleviation of her laryngeal edema. After extubation, she gradually developed inspiratory stridor. We re-intubated her after diagnosing post-extubation laryngeal edema. Subsequent review of our novel system revealed serially increased stridor after the extubation, at an earlier time than was recognized by healthcare providers. This unique continuous monitoring and visualization system for respiratory sounds could be an objective tool for improving patient safety regarding airway complications.
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Deng M, Tu M, Liu Y, Hu X, Zhang T, Wu J, Wang Y. Comparing two airway management strategies for moderately sedated patients undergoing awake craniotomy: A single-blinded randomized controlled trial. Acta Anaesthesiol Scand 2020; 64:1414-1421. [PMID: 32659854 DOI: 10.1111/aas.13667] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 07/03/2020] [Accepted: 07/05/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND In the monitored anesthesia care (MAC) setting for awake craniotomy (AC), maintaining airway patency in sedated patients remains challenging. This randomized controlled trial aimed to compare the validity of the below-epiglottis transnasal tube insertion (the tip of the tube placed between the epiglottis and vocal cords) and the nasopharyngeal airway (simulated by the above-epiglottis transnasal tube with the tip of the tube placed between the epiglottis and the free edge of the soft palate) with respect to maintaining upper airway patency for moderately sedated patients undergoing AC. METHODS Sixty patients scheduled for elective AC were randomized to receive below-epiglottis (n = 30) or above-epiglottis (n = 30) transnasal tube insertion before surgery. Moderate sedation was maintained in the pre- and post-awake phases. The primary outcome was the upper airway obstruction (UAO) remission rate (relieved obstructions after tube insertion/the total number of obstructions before tube insertion). RESULTS The UAO remission rate was higher in the below-epiglottis group [100% (12/12) vs 45% (5/11); P = .005]. The tidal volume values monitored through the tube were greater in the below-epiglottis group during the pre-awake phase (P < .001). End-tidal carbon dioxide (EtCO2 ) monitored through the tube was higher in the below-epiglottis group at bone flap removal (P < .001). During the awake phase, patients' ability to speak was not impeded. No patient had serious complications related to the tube. CONCLUSION The below-epiglottis tube insertion is a more effective method to maintain upper airway patency than the nasopharyngeal airway for moderately sedated patients undergoing AC.
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Affiliation(s)
- Meng Deng
- Department of Anesthesiology Huashan Hospital of Fudan University Shanghai China
| | - Meng‐Yun Tu
- Department of Anesthesiology Huashan Hospital of Fudan University Shanghai China
| | - Yi‐Heng Liu
- Department of Anesthesiology Huashan Hospital of Fudan University Shanghai China
| | - Xiao‐Bing Hu
- Department of Anesthesiology Huashan Hospital of Fudan University Shanghai China
| | - Tao Zhang
- Department of Epidemiology, School of Public Health Fudan University Shanghai China
| | - Jin‐Song Wu
- Department of Neurosurgery Huashan Hospital of Fudan University Shanghai China
| | - Ying‐Wei Wang
- Department of Anesthesiology Huashan Hospital of Fudan University Shanghai China
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