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Hu H, Hu C, Guo W, Zhu B, Wang S. Wearable ultrasound devices: An emerging era for biomedicine and clinical translation. ULTRASONICS 2024; 142:107401. [PMID: 39004039 DOI: 10.1016/j.ultras.2024.107401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 07/08/2024] [Accepted: 07/09/2024] [Indexed: 07/16/2024]
Abstract
In recent years, personalized diagnosis and treatment have gained significant recognition and rapid development in the biomedicine and healthcare. Due to the flexibility, portability and excellent compatibility, wearable ultrasound (WUS) devices have become emerging personalized medical devices with great potential for development. Currently, with the development of the ongoing advancements in materials and structural design of the ultrasound transducers, WUS devices have improved performance and are increasingly applied in the medical field. In this review, we provide an overview of the design and structure of WUS devices, focusing on their application for diagnosis and treatment of various diseases from a clinical application perspective, and then explore the issues that need to be addressed before clinical translation. Finally, we summarize the progress made in the development of WUS devices, and discuss the current challenges and the future direction of their development. In conclusion, WUS devices usher an emerging era for biomedicine with great clinical promise.
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Affiliation(s)
- Haoyuan Hu
- Department of Cardiology, Renmin Hospital of Wuhan University, China; Cardiac Autonomic Nervous System Research Center of Wuhan University, China; Cardiovascular Research Institute, Wuhan University, China; Hubei Key Laboratory of Cardiology, China
| | - Changhao Hu
- Department of Cardiology, Renmin Hospital of Wuhan University, China; Cardiac Autonomic Nervous System Research Center of Wuhan University, China; Cardiovascular Research Institute, Wuhan University, China; Hubei Key Laboratory of Cardiology, China
| | - Wei Guo
- Department of Cardiology, Renmin Hospital of Wuhan University, China; Cardiac Autonomic Nervous System Research Center of Wuhan University, China; Cardiovascular Research Institute, Wuhan University, China; Hubei Key Laboratory of Cardiology, China
| | - Benpeng Zhu
- School of Optical and Electronic Information, Huazhong University of Science and Technology, China.
| | - Songyun Wang
- Department of Cardiology, Renmin Hospital of Wuhan University, China; Cardiac Autonomic Nervous System Research Center of Wuhan University, China; Cardiovascular Research Institute, Wuhan University, China; Hubei Key Laboratory of Cardiology, China.
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Williams GJ, Al-Baraikan A, Rademakers FE, Ciravegna F, van de Vosse FN, Lawrie A, Rothman A, Ashley EA, Wilkins MR, Lawford PV, Omholt SW, Wisløff U, Hose DR, Chico TJA, Gunn JP, Morris PD. Wearable technology and the cardiovascular system: the future of patient assessment. Lancet Digit Health 2023; 5:e467-e476. [PMID: 37391266 DOI: 10.1016/s2589-7500(23)00087-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 02/26/2023] [Accepted: 04/19/2023] [Indexed: 07/02/2023]
Abstract
The past decade has seen a dramatic rise in consumer technologies able to monitor a variety of cardiovascular parameters. Such devices initially recorded markers of exercise, but now include physiological and health-care focused measurements. The public are keen to adopt these devices in the belief that they are useful to identify and monitor cardiovascular disease. Clinicians are therefore often presented with health app data accompanied by a diverse range of concerns and queries. Herein, we assess whether these devices are accurate, their outputs validated, and whether they are suitable for professionals to make management decisions. We review underpinning methods and technologies and explore the evidence supporting the use of these devices as diagnostic and monitoring tools in hypertension, arrhythmia, heart failure, coronary artery disease, pulmonary hypertension, and valvular heart disease. Used correctly, they might improve health care and support research.
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Affiliation(s)
- Gareth J Williams
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Abdulaziz Al-Baraikan
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Frank E Rademakers
- Faculty of Medicine, Department of Cardiology, KU Leuven, Leuven, Belgium
| | - Fabio Ciravegna
- Dipartimento di Informatica, Universitàdi Torino, Turin, Italy
| | - Frans N van de Vosse
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
| | - Allan Lawrie
- National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, UK
| | - Alexander Rothman
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK; Academic Directorate of Cardiothoracic Services, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Euan A Ashley
- Department of Medicine, Stanford University, Stanford, CA, US
| | - Martin R Wilkins
- National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, UK
| | - Patricia V Lawford
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK; Insigneo Institute for In Silico Medicine, University of Sheffield, Sheffield, UK
| | - Stig W Omholt
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ulrik Wisløff
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway; School of Human Movement & Nutrition Sciences, University of Queensland, QLD, Australia
| | - D Rodney Hose
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK; Insigneo Institute for In Silico Medicine, University of Sheffield, Sheffield, UK
| | - Timothy J A Chico
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK; Insigneo Institute for In Silico Medicine, University of Sheffield, Sheffield, UK; Academic Directorate of Cardiothoracic Services, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK; BHF Data Centre, Health Data Research UK, London, UK
| | - Julian P Gunn
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK; Insigneo Institute for In Silico Medicine, University of Sheffield, Sheffield, UK; Academic Directorate of Cardiothoracic Services, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Paul D Morris
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK; Insigneo Institute for In Silico Medicine, University of Sheffield, Sheffield, UK; Academic Directorate of Cardiothoracic Services, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
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Munding CE, Kenny JÉS, Yang Z, Clarke G, Elfarnawany M, Eibl AM, Eibl JK, Nalla B, Atoui R. Detecting the Change in Total Circulatory Flow with a Wireless, Wearable Doppler Ultrasound Patch: A Pilot Study. Crit Care Explor 2023; 5:e0914. [PMID: 37168690 PMCID: PMC10166367 DOI: 10.1097/cce.0000000000000914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023] Open
Abstract
Measuring fluid responsiveness is important in the management of critically ill patients, with a 10-15% change in cardiac output typically being used to indicate "fluid responsiveness." Ideally, these changes would be measured noninvasively and peripherally. The aim of this study was to determine how the common carotid artery (CCA) maximum velocity changes with total circulatory flow when confounding factors are mitigated and determine a value for CCA maximum velocity corresponding to a 10% change in total circulatory flow. DESIGN Prospective observational pilot study. SETTING Patients undergoing elective, on-pump coronary artery bypass grafting (CABG) surgery. PATIENTS Fourteen patients were referred for elective coronary artery bypass grafting surgery. INTERVENTIONS Cardiopulmonary bypass (CPB) pump flow changes during surgery, as chosen by the perfusionist. MEASUREMENTS A hands-free, wearable Doppler patch was used for CCA velocity measurements with the aim of preventing user errors in ultrasound measurements. Maximum CCA velocity was determined from the spectrogram acquired by the Doppler patch. CPB flow rates were recorded as displayed on the CPB console, and further measured from the peristaltic pulsation frequency visible on the recorded Doppler spectrograms. MAIN RESULTS Changes in CCA maximum velocity tracked well with changes in CPB flow. On average, a 13.6% change in CCA maximum velocity was found to correspond to a 10% change in CPB flow rate. CONCLUSIONS Changes in CCA velocity may be a useful surrogate for determining fluid responsiveness when user error can be mitigated.
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Affiliation(s)
| | - Jon-Émile S Kenny
- Flosonics Medical, Sudbury, ON, Canada
- Health Sciences North Research Institute, Sudbury ON, Canada
| | - Zhen Yang
- Flosonics Medical, Sudbury, ON, Canada
| | - Geoffrey Clarke
- Flosonics Medical, Sudbury, ON, Canada
- Health Sciences North Research Institute, Sudbury ON, Canada
| | | | - Andrew M Eibl
- Flosonics Medical, Sudbury, ON, Canada
- Health Sciences North Research Institute, Sudbury ON, Canada
| | - Joseph K Eibl
- Flosonics Medical, Sudbury, ON, Canada
- Health Sciences North Research Institute, Sudbury ON, Canada
- Northern Ontario School of Medicine, Sudbury ON, Canada
| | - Bhanu Nalla
- Health Sciences North Research Institute, Sudbury ON, Canada
- Northern Ontario School of Medicine, Sudbury ON, Canada
| | - Rony Atoui
- Health Sciences North Research Institute, Sudbury ON, Canada
- Northern Ontario School of Medicine, Sudbury ON, Canada
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Assessing Fluid Intolerance with Doppler Ultrasonography: A Physiological Framework. Med Sci (Basel) 2022; 10:medsci10010012. [PMID: 35225945 PMCID: PMC8883898 DOI: 10.3390/medsci10010012] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 02/04/2022] [Accepted: 02/07/2022] [Indexed: 12/11/2022] Open
Abstract
Ultrasonography is becoming the favored hemodynamic monitoring utensil of emergentologists, anesthesiologists and intensivists. While the roles of ultrasound grow and evolve, many clinical applications of ultrasound stem from qualitative, image-based protocols, especially for diagnosing and managing circulatory failure. Often, these algorithms imply or suggest treatment. For example, intravenous fluids are opted for or against based upon ultrasonographic signs of preload and estimation of the left ventricular ejection fraction. Though appealing, image-based algorithms skirt some foundational tenets of cardiac physiology; namely, (1) the relationship between cardiac filling and stroke volume varies considerably in the critically ill, (2) the correlation between cardiac filling and total vascular volume is poor and (3) the ejection fraction is not purely an appraisal of cardiac function but rather a measure of coupling between the ventricle and the arterial load. Therefore, management decisions could be enhanced by quantitative approaches, enabled by Doppler ultrasonography. Both fluid ‘responsiveness’ and ‘tolerance’ are evaluated by Doppler ultrasound, but the physiological relationship between these constructs is nebulous. Accordingly, it is argued that the link between them is founded upon the Frank–Starling–Sarnoff relationship and that this framework helps direct future ultrasound protocols, explains seemingly discordant findings and steers new routes of enquiry.
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