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Bernasconi S, Angelucci A, De Cesari A, Masotti A, Pandocchi M, Vacca F, Zhao X, Paganelli C, Aliverti A. Recent Technologies for Transcutaneous Oxygen and Carbon Dioxide Monitoring. Diagnostics (Basel) 2024; 14:785. [PMID: 38667431 PMCID: PMC11049249 DOI: 10.3390/diagnostics14080785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 03/27/2024] [Accepted: 04/07/2024] [Indexed: 04/28/2024] Open
Abstract
The measurement of partial pressures of oxygen (O2) and carbon dioxide (CO2) is fundamental for evaluating a patient's conditions in clinical practice. There are many ways to retrieve O2/CO2 partial pressures and concentrations. Arterial blood gas (ABG) analysis is the gold standard technique for such a purpose, but it is invasive, intermittent, and potentially painful. Among all the alternative methods for gas monitoring, non-invasive transcutaneous O2 and CO2 monitoring has been emerging since the 1970s, being able to overcome the main drawbacks of ABG analysis. Clark and Severinghaus electrodes enabled the breakthrough for transcutaneous O2 and CO2 monitoring, respectively, and in the last twenty years, many innovations have been introduced as alternatives to overcome their limitations. This review reports the most recent solutions for transcutaneous O2 and CO2 monitoring, with a particular consideration for wearable measurement systems. Luminescence-based electronic paramagnetic resonance and photoacoustic sensors are investigated. Optical sensors appear to be the most promising, giving fast and accurate measurements without the need for frequent calibrations and being suitable for integration into wearable measurement systems.
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Vitazkova D, Foltan E, Kosnacova H, Micjan M, Donoval M, Kuzma A, Kopani M, Vavrinsky E. Advances in Respiratory Monitoring: A Comprehensive Review of Wearable and Remote Technologies. BIOSENSORS 2024; 14:90. [PMID: 38392009 PMCID: PMC10886711 DOI: 10.3390/bios14020090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 01/28/2024] [Accepted: 02/03/2024] [Indexed: 02/24/2024]
Abstract
This article explores the importance of wearable and remote technologies in healthcare. The focus highlights its potential in continuous monitoring, examines the specificity of the issue, and offers a view of proactive healthcare. Our research describes a wide range of device types and scientific methodologies, starting from traditional chest belts to their modern alternatives and cutting-edge bioamplifiers that distinguish breathing from chest impedance variations. We also investigated innovative technologies such as the monitoring of thorax micromovements based on the principles of seismocardiography, ballistocardiography, remote camera recordings, deployment of integrated optical fibers, or extraction of respiration from cardiovascular variables. Our review is extended to include acoustic methods and breath and blood gas analysis, providing a comprehensive overview of different approaches to respiratory monitoring. The topic of monitoring respiration with wearable and remote electronics is currently the center of attention of researchers, which is also reflected by the growing number of publications. In our manuscript, we offer an overview of the most interesting ones.
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Affiliation(s)
- Diana Vitazkova
- Institute of Electronics and Photonics, Faculty of Electrical Engineering and Information Technology, Slovak University of Technology, Ilkovicova 3, 81219 Bratislava, Slovakia; (E.F.); (H.K.); (M.M.); (M.D.); (A.K.)
| | - Erik Foltan
- Institute of Electronics and Photonics, Faculty of Electrical Engineering and Information Technology, Slovak University of Technology, Ilkovicova 3, 81219 Bratislava, Slovakia; (E.F.); (H.K.); (M.M.); (M.D.); (A.K.)
| | - Helena Kosnacova
- Institute of Electronics and Photonics, Faculty of Electrical Engineering and Information Technology, Slovak University of Technology, Ilkovicova 3, 81219 Bratislava, Slovakia; (E.F.); (H.K.); (M.M.); (M.D.); (A.K.)
- Department of Simulation and Virtual Medical Education, Faculty of Medicine, Comenius University, Sasinkova 4, 81272 Bratislava, Slovakia
| | - Michal Micjan
- Institute of Electronics and Photonics, Faculty of Electrical Engineering and Information Technology, Slovak University of Technology, Ilkovicova 3, 81219 Bratislava, Slovakia; (E.F.); (H.K.); (M.M.); (M.D.); (A.K.)
| | - Martin Donoval
- Institute of Electronics and Photonics, Faculty of Electrical Engineering and Information Technology, Slovak University of Technology, Ilkovicova 3, 81219 Bratislava, Slovakia; (E.F.); (H.K.); (M.M.); (M.D.); (A.K.)
| | - Anton Kuzma
- Institute of Electronics and Photonics, Faculty of Electrical Engineering and Information Technology, Slovak University of Technology, Ilkovicova 3, 81219 Bratislava, Slovakia; (E.F.); (H.K.); (M.M.); (M.D.); (A.K.)
| | - Martin Kopani
- Institute of Medical Physics, Biophysics, Informatics and Telemedicine, Faculty of Medicine, Comenius University, Sasinkova 2, 81272 Bratislava, Slovakia;
| | - Erik Vavrinsky
- Institute of Electronics and Photonics, Faculty of Electrical Engineering and Information Technology, Slovak University of Technology, Ilkovicova 3, 81219 Bratislava, Slovakia; (E.F.); (H.K.); (M.M.); (M.D.); (A.K.)
- Institute of Medical Physics, Biophysics, Informatics and Telemedicine, Faculty of Medicine, Comenius University, Sasinkova 2, 81272 Bratislava, Slovakia;
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Dervieux E, Guerrero F, Uhring W, Giroux-Metgès MA, Théron M. Skin temperature influence on transcutaneous carbon dioxide (CO 2) conductivity and skin blood flow in healthy human subjects at the arm and wrist. Front Physiol 2024; 14:1293752. [PMID: 38321986 PMCID: PMC10846589 DOI: 10.3389/fphys.2023.1293752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 12/05/2023] [Indexed: 02/08/2024] Open
Abstract
Objective: present transcutaneous carbon dioxide (CO2)-tcpCO2-monitors suffer from limitations which hamper their widespread use, and call for a new tcpCO2 measurement technique. However, the progress in this area is hindered by the lack of knowledge in transcutaneous CO2 diffusion. To address this knowledge gap, this study focuses on investigating the influence of skin temperature on two key skin properties: CO2 permeability and skin blood flow. Methods: a monocentric prospective exploratory study including 40 healthy adults was undertaken. Each subject experienced a 90 min visit split into five 18 min sessions at different skin temperatures-Non-Heated (NH), 35, 38, 41, and 44°C. At each temperature, custom sensors measured transcutaneous CO2 conductivity and exhalation rate at the arm and wrist, while Laser Doppler Flowmetry (LDF) assessed skin blood flow at the arm. Results: the three studied metrics sharply increased with rising skin temperature. Mean values increased from the NH situation up to 44°C from 4.03 up to 8.88 and from 2.94 up to 8.11 m·s-1 for skin conductivity, and from 80.4 up to 177.5 and from 58.7 up to 162.3 cm3·m-2·h-1 for exhalation rate at the arm and wrist, respectively. Likewise, skin blood flow increased elevenfold for the same temperature increase. Of note, all metrics already augmented significantly in the 35-38°C skin temperature range, which may be reached without active heating-i.e. only using a warm clothing. Conclusion: these results are extremely encouraging for the development of next-generation tcpCO2 sensors. Indeed, the moderate increase (× 2) in skin conductivity from NH to 44°C tends to indicate that heating the skin is not critical from a response time point of view, i.e. little to no skin heating would only result in a doubled sensor response time in the worst case, compared to a maximal heating at 44°C. Crucially, a skin temperature within the 35-38°C range already sharply increases the skin blood flow, suggesting that tcpCO2 correlates well with the arterial paCO2 even at such low skin temperatures. These two conclusions further strengthen the viability of non-heated tcpCO2 sensors, thereby paving the way for the development of wearable transcutaneous capnometers.
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Affiliation(s)
- Emmanuel Dervieux
- Biosency, Cesson-Sévigné, France
- EA4324-ORPHY, Univ Brest, Brest, France
- ICube, University of Strasbourg and CNRS, Strasbourg, France
| | | | - Wilfried Uhring
- ICube, University of Strasbourg and CNRS, Strasbourg, France
| | - Marie-Agnès Giroux-Metgès
- EA4324-ORPHY, Univ Brest, Brest, France
- Explorations Fonctionnelles Respiratoires, Centre Hospitalier Régional et Universitaire de Brest, Brest, France
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El-Safoury M, Weber C, Yassine H, Wöllenstein J, Schmitt K. Towards a Miniaturized Photoacoustic Sensor for Transcutaneous CO 2 Monitoring. SENSORS (BASEL, SWITZERLAND) 2024; 24:457. [PMID: 38257550 PMCID: PMC10820682 DOI: 10.3390/s24020457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 01/08/2024] [Accepted: 01/09/2024] [Indexed: 01/24/2024]
Abstract
A photoacoustic sensor system (PAS) intended for carbon dioxide (CO2) blood gas detection is presented. The development focuses on a photoacoustic (PA) sensor based on the so-called two-chamber principle, i.e., comprising a measuring cell and a detection chamber. The aim is the reliable continuous monitoring of transcutaneous CO2 values, which is very important, for example, in intensive care unit patient monitoring. An infrared light-emitting diode (LED) with an emission peak wavelength at 4.3 µm was used as a light source. A micro-electro-mechanical system (MEMS) microphone and the target gas CO2 are inside a hermetically sealed detection chamber for selective target gas detection. Based on conducted simulations and measurement results in a laboratory setup, a miniaturized PA CO2 sensor with an absorption path length of 2.0 mm and a diameter of 3.0 mm was developed for the investigation of cross-sensitivities, detection limit, and signal stability and was compared to a commercial infrared CO2 sensor with a similar measurement range. The achieved detection limit of the presented PA CO2 sensor during laboratory tests is 1 vol. % CO2. Compared to the commercial sensor, our PA sensor showed less influences of humidity and oxygen on the detected signal and a faster response and recovery time. Finally, the developed sensor system was fixed to the skin of a test person, and an arterialization time of 181 min could be determined.
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Affiliation(s)
- Mahmoud El-Safoury
- Fraunhofer Institute for Physical Measurement Techniques IPM, 79110 Freiburg im Breisgau, Germany; (C.W.); (J.W.); (K.S.)
| | - Christian Weber
- Fraunhofer Institute for Physical Measurement Techniques IPM, 79110 Freiburg im Breisgau, Germany; (C.W.); (J.W.); (K.S.)
- Department of Microsystems Engineering–Institut für Mikrosystemtechnik (IMTEK), University of Freiburg, 79110 Freiburg im Breisgau, Germany;
| | - Hassan Yassine
- Department of Microsystems Engineering–Institut für Mikrosystemtechnik (IMTEK), University of Freiburg, 79110 Freiburg im Breisgau, Germany;
| | - Jürgen Wöllenstein
- Fraunhofer Institute for Physical Measurement Techniques IPM, 79110 Freiburg im Breisgau, Germany; (C.W.); (J.W.); (K.S.)
- Department of Microsystems Engineering–Institut für Mikrosystemtechnik (IMTEK), University of Freiburg, 79110 Freiburg im Breisgau, Germany;
| | - Katrin Schmitt
- Fraunhofer Institute for Physical Measurement Techniques IPM, 79110 Freiburg im Breisgau, Germany; (C.W.); (J.W.); (K.S.)
- Department of Microsystems Engineering–Institut für Mikrosystemtechnik (IMTEK), University of Freiburg, 79110 Freiburg im Breisgau, Germany;
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Xian X. Frontiers of Wearable Biosensors for Human Health Monitoring. BIOSENSORS 2023; 13:964. [PMID: 37998139 PMCID: PMC10669529 DOI: 10.3390/bios13110964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 10/30/2023] [Indexed: 11/25/2023]
Abstract
Wearable biosensors offer noninvasive, real-time, and continuous monitoring of diverse human health data, making them invaluable for remote patient tracking, early diagnosis, and personalized medicine [...].
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Affiliation(s)
- Xiaojun Xian
- The Department of Electrical Engineering and Computer Science, Jerome J. Lohr College of Engineering, South Dakota State University, Brookings, SD 57007, USA
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Cascales JP, Draghici AE, Keshishian H, Taylor JA, Evans CL. Calculation of Tissue Oxygenation via an Inverse Boundary Problem for Transcutaneous Oxygenation Wearable Applications. ACS MEASUREMENT SCIENCE AU 2023; 3:269-276. [PMID: 37600461 PMCID: PMC10436371 DOI: 10.1021/acsmeasuresciau.3c00013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 04/19/2023] [Accepted: 04/19/2023] [Indexed: 08/22/2023]
Abstract
In this article, we present a toolset to fully leverage a previously developed transcutaneous oxygenation monitor (TCOM) wearable technology to accurately measure skin oxygenation values. We describe numerical models and experimental characterization techniques that allow for the extraction of precise tissue oxygenation measurements. The numerical model is based on an inverse boundary problem of the parabolic equation with Dirichlet boundary conditions. To validate this model and characterize the diffusion of oxygen through the oxygen sensing materials, we designed a series of control/calibration experiments modeled after the device's clinical application using oxygenation values in the physiological range expected for healthy tissue. Our results demonstrate that it is possible to obtain accurate tissue pO2 measurements without the need for long equilibration times with a small wearable device.
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Affiliation(s)
- Juan Pedro Cascales
- Wellman
Center for Photomedicine, Massachusetts General Hospital, Harvard
Medical School, Charlestown, Massachusetts 02129, United States
- Departamento
de Química en Ciencias Farmacéuticas, Facultad de Farmacia, Universidad Complutense de Madrid, Plaza Ramón y Cajal S/N, Madrid 28040, Spain
| | - Adina E. Draghici
- Cardiovascular
Research Lab, Spaulding Rehabilitation Hospital,
Harvard Medical School, Cambridge, Massachusetts 02138, United States
| | - Helen Keshishian
- Wellman
Center for Photomedicine, Massachusetts General Hospital, Harvard
Medical School, Charlestown, Massachusetts 02129, United States
| | - J. Andrew Taylor
- Cardiovascular
Research Lab, Spaulding Rehabilitation Hospital,
Harvard Medical School, Cambridge, Massachusetts 02138, United States
| | - Conor L. Evans
- Wellman
Center for Photomedicine, Massachusetts General Hospital, Harvard
Medical School, Charlestown, Massachusetts 02129, United States
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Tufan TB, Guler U. A Transcutaneous Carbon Dioxide Monitor Based on Time-Domain Dual Lifetime Referencing. IEEE TRANSACTIONS ON BIOMEDICAL CIRCUITS AND SYSTEMS 2023; 17:795-807. [PMID: 37195846 DOI: 10.1109/tbcas.2023.3277398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
The partial pressure of arterial carbon dioxide plays a critical role in assessing the acid-base and respiratory status of the human body. Typically, this measurement is invasive and can only be taken momentarily when an arterial blood sample is drawn. Transcutaneous monitoring is a noninvasive surrogate method that provides a continuous measure of arterial carbon dioxide. Unfortunately, current technology is limited to bedside instruments mainly used in intensive care units. We developed a first-of-its-kind miniaturized transcutaneous carbon dioxide monitor that utilizes a luminescence sensing film and a time-domain dual lifetime referencing method. Gas cell experiments confirmed the monitor's ability to accurately identify changes in the partial pressure of carbon dioxide within the clinically significant range. Compared to the luminescence intensity-based technique, the time-domain dual lifetime referencing method is less prone to measurement errors caused by changes in excitation strength, reducing the maximum error from ∼ 40% to ∼ 3% and resulting in more reliable readings. Additionally, we analyzed the sensing film by investigating its behavior under various confounding factors and its susceptibility to measurement drift. Finally, a human subject test demonstrated the effectiveness of the applied method in detecting even slight changes in transcutaneous carbon dioxide, as small as ∼ 0.7%, during hyperventilation. The prototype, which consumes 30.1 mW of power, is a wearable wristband with compact dimensions of 37 mm× 32 mm.
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