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Chung HU, Rwei AY, Hourlier-Fargette A, Xu S, Lee K, Dunne EC, Xie Z, Liu C, Carlini A, Kim DH, Ryu D, Kulikova E, Cao J, Odland IC, Fields KB, Hopkins B, Banks A, Ogle C, Grande D, Park JB, Kim J, Irie M, Jang H, Lee J, Park Y, Kim J, Jo HH, Hahm H, Avila R, Xu Y, Namkoong M, Kwak JW, Suen E, Paulus MA, Kim RJ, Parsons BV, Human KA, Kim SS, Patel M, Reuther W, Kim HS, Lee SH, Leedle JD, Yun Y, Rigali S, Son T, Jung I, Arafa H, Soundararajan VR, Ollech A, Shukla A, Bradley A, Schau M, Rand CM, Marsillio LE, Harris ZL, Huang Y, Hamvas A, Paller AS, Weese-Mayer DE, Lee JY, Rogers JA. Skin-interfaced biosensors for advanced wireless physiological monitoring in neonatal and pediatric intensive-care units. Nat Med 2020; 26:418-429. [PMID: 32161411 PMCID: PMC7315772 DOI: 10.1038/s41591-020-0792-9] [Citation(s) in RCA: 148] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Accepted: 02/05/2020] [Indexed: 11/29/2022]
Abstract
Standard of care management in neonatal and pediatric intensive care units (NICUs and PICUs) involve continuous monitoring of vital signs with hard-wired devices that adhere to the skin and, in certain instances, include catheter-loaded pressure sensors that insert into the arteries. These protocols involve risks for complications and impediments to clinical care and skin-to-skin contact between parent and child. Here we present a wireless, non-invasive technology that not only offers measurement equivalency to these management standards but also supports a range of important additional features (without limitations or shortcomings of existing approaches), supported by data from pilot clinical studies in the neonatal intensive care unit (NICU) and pediatric ICU (PICU). The combined capabilities of these platforms extend beyond clinical quality measurements of vital signs (heart rate, respiration rate, temperature and blood oxygenation) to include novel modalities for (1) tracking movements and changes in body orientation, (2) quantifying the physiological benefits of skin-to-skin care (e.g. Kangaroo care) for neonates, (3) capturing acoustic signatures of cardiac activity by directly measuring mechanical vibrations generated through the skin on the chest, (4) recording vocal biomarkers associated with tonality and temporal characteristics of crying impervious to confounding ambient noise, and (5) monitoring a reliable surrogate for systolic blood pressure. The results have potential to significantly enhance the quality of neonatal and pediatric critical care.
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Affiliation(s)
- Ha Uk Chung
- Simpson Querrey Institute, Northwestern University, Chicago, IL, USA.,Department of Electrical and Computer Engineering, Northwestern University, Evanston, IL, USA.,Center for Bio-integrated Electronics, Northwestern University, Evanston, IL, USA
| | - Alina Y Rwei
- Simpson Querrey Institute, Northwestern University, Chicago, IL, USA.,Center for Bio-integrated Electronics, Northwestern University, Evanston, IL, USA
| | - Aurélie Hourlier-Fargette
- Simpson Querrey Institute, Northwestern University, Chicago, IL, USA.,Center for Bio-integrated Electronics, Northwestern University, Evanston, IL, USA
| | - Shuai Xu
- Simpson Querrey Institute, Northwestern University, Chicago, IL, USA.,Center for Bio-integrated Electronics, Northwestern University, Evanston, IL, USA.,Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - KunHyuck Lee
- Simpson Querrey Institute, Northwestern University, Chicago, IL, USA.,Center for Bio-integrated Electronics, Northwestern University, Evanston, IL, USA.,Department of Materials Science and Engineering, Northwestern University, Evanston, IL, USA
| | - Emma C Dunne
- Division of Pediatric Autonomic Medicine, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Zhaoqian Xie
- State Key Laboratory of Structural Analysis for Industrial Equipment, Department of Engineering Mechanics, Dalian University of Technology, Dalian, China
| | - Claire Liu
- Simpson Querrey Institute, Northwestern University, Chicago, IL, USA.,Center for Bio-integrated Electronics, Northwestern University, Evanston, IL, USA.,Department of Biomedical Engineering, Northwestern University, Evanston, IL, USA
| | - Andrea Carlini
- Simpson Querrey Institute, Northwestern University, Chicago, IL, USA.,Center for Bio-integrated Electronics, Northwestern University, Evanston, IL, USA.,Department of Materials Science and Engineering, Northwestern University, Evanston, IL, USA
| | - Dong Hyun Kim
- Center for Bio-integrated Electronics, Northwestern University, Evanston, IL, USA.,Department of Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Dennis Ryu
- Center for Bio-integrated Electronics, Northwestern University, Evanston, IL, USA.,Sibel Inc, Evanston, IL, USA
| | | | | | - Ian C Odland
- Center for Bio-integrated Electronics, Northwestern University, Evanston, IL, USA
| | - Kelsey B Fields
- Center for Bio-integrated Electronics, Northwestern University, Evanston, IL, USA.,Department of Materials Science and Engineering, Northwestern University, Evanston, IL, USA
| | - Brad Hopkins
- Division of Pediatric Autonomic Medicine, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Anthony Banks
- Simpson Querrey Institute, Northwestern University, Chicago, IL, USA.,Center for Bio-integrated Electronics, Northwestern University, Evanston, IL, USA
| | - Christopher Ogle
- Center for Bio-integrated Electronics, Northwestern University, Evanston, IL, USA
| | - Dominic Grande
- Center for Bio-integrated Electronics, Northwestern University, Evanston, IL, USA
| | - Jun Bin Park
- Center for Bio-integrated Electronics, Northwestern University, Evanston, IL, USA
| | - Jongwon Kim
- Photo-Electronic Hybrids Research Center, Korea Institute of Science and Technology (KIST), Seoul, South Korea.,Department of Mechanical Engineering, Kyung Hee University, Yongin, Republic of Korea
| | - Masahiro Irie
- Simpson Querrey Institute, Northwestern University, Chicago, IL, USA.,Department of Electrical and Computer Engineering, Northwestern University, Evanston, IL, USA.,Center for Bio-integrated Electronics, Northwestern University, Evanston, IL, USA
| | - Hokyung Jang
- Center for Bio-integrated Electronics, Northwestern University, Evanston, IL, USA.,Frederick Seitz Materials Research Laboratory, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | | | - Yerim Park
- Department of Computer Science, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Jungwoo Kim
- Department of Computer Science, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Han Heul Jo
- Department of Computer Science, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Hyoungjo Hahm
- Department of Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Raudel Avila
- Center for Bio-integrated Electronics, Northwestern University, Evanston, IL, USA.,Department of Materials Science and Engineering, Northwestern University, Evanston, IL, USA.,Department of Mechanical Engineering, Northwestern University, Evanston, IL, USA.,Department of Civil and Environmental Engineering, Northwestern University, Evanston, IL, USA
| | - Yeshou Xu
- Center for Bio-integrated Electronics, Northwestern University, Evanston, IL, USA.,Department of Materials Science and Engineering, Northwestern University, Evanston, IL, USA.,Department of Mechanical Engineering, Northwestern University, Evanston, IL, USA.,Department of Civil and Environmental Engineering, Northwestern University, Evanston, IL, USA.,Key Laboratory of C&PC Structures of the Ministry of Education, Southeast University, Nanjing, China
| | - Myeong Namkoong
- Simpson Querrey Institute, Northwestern University, Chicago, IL, USA.,Department of Biomedical Engineering, Northwestern University, Evanston, IL, USA
| | - Jean Won Kwak
- Simpson Querrey Institute, Northwestern University, Chicago, IL, USA.,Center for Bio-integrated Electronics, Northwestern University, Evanston, IL, USA.,Department of Mechanical Engineering, Northwestern University, Evanston, IL, USA
| | - Emily Suen
- Department of Neurobiology, Northwestern University, Evanston, IL, USA
| | - Max A Paulus
- Department of Biology, Northwestern University, Evanston, IL, USA
| | - Robin J Kim
- Center for Bio-integrated Electronics, Northwestern University, Evanston, IL, USA
| | - Blake V Parsons
- Center for Bio-integrated Electronics, Northwestern University, Evanston, IL, USA
| | - Kelia A Human
- Department of Biomedical Engineering, Northwestern University, Evanston, IL, USA
| | - Seung Sik Kim
- Department of Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Manish Patel
- Simpson Querrey Institute, Northwestern University, Chicago, IL, USA.,Center for Bio-integrated Electronics, Northwestern University, Evanston, IL, USA.,Department of Materials Science and Engineering, Northwestern University, Evanston, IL, USA.,Sibel Inc, Evanston, IL, USA.,University of Illinois College of Medicine at Chicago, Chicago, IL, USA
| | - William Reuther
- Department of Graphic Design and Industrial Design at North Carolina State University, Raleigh, NC, USA
| | - Hyun Soo Kim
- Department of Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, Urbana, IL, USA.,Frederick Seitz Materials Research Laboratory, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Sung Hoon Lee
- Department of Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | | | - Yeojeong Yun
- Frederick Seitz Materials Research Laboratory, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | | | - Taeyoung Son
- Frederick Seitz Materials Research Laboratory, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Inhwa Jung
- Department of Mechanical Engineering, Kyung Hee University, Yongin, Republic of Korea
| | - Hany Arafa
- Simpson Querrey Institute, Northwestern University, Chicago, IL, USA.,Center for Bio-integrated Electronics, Northwestern University, Evanston, IL, USA.,Department of Biomedical Engineering, Northwestern University, Evanston, IL, USA
| | - Vinaya R Soundararajan
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Ayelet Ollech
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Avani Shukla
- Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Allison Bradley
- Division of Pediatric Autonomic Medicine, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Molly Schau
- Division of Neonatology, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Casey M Rand
- Division of Pediatric Autonomic Medicine, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.,Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Lauren E Marsillio
- Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.,Division of Pediatric Critical Care Medicine, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Zena L Harris
- Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.,Division of Pediatric Critical Care Medicine, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Yonggang Huang
- Center for Bio-integrated Electronics, Northwestern University, Evanston, IL, USA.,Department of Materials Science and Engineering, Northwestern University, Evanston, IL, USA.,Department of Mechanical Engineering, Northwestern University, Evanston, IL, USA.,Department of Civil and Environmental Engineering, Northwestern University, Evanston, IL, USA
| | - Aaron Hamvas
- Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.,Division of Neonatology, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.,Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Amy S Paller
- Center for Bio-integrated Electronics, Northwestern University, Evanston, IL, USA.,Department of Materials Science and Engineering, Northwestern University, Evanston, IL, USA.,Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Debra E Weese-Mayer
- Division of Pediatric Autonomic Medicine, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA. .,Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA. .,Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.
| | - Jong Yoon Lee
- Simpson Querrey Institute, Northwestern University, Chicago, IL, USA. .,Center for Bio-integrated Electronics, Northwestern University, Evanston, IL, USA. .,Department of Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, Urbana, IL, USA. .,Sibel Inc, Evanston, IL, USA.
| | - John A Rogers
- Simpson Querrey Institute, Northwestern University, Chicago, IL, USA. .,Center for Bio-integrated Electronics, Northwestern University, Evanston, IL, USA. .,Department of Materials Science and Engineering, Northwestern University, Evanston, IL, USA. .,Department of Biomedical Engineering, Northwestern University, Evanston, IL, USA. .,Frederick Seitz Materials Research Laboratory, University of Illinois at Urbana-Champaign, Urbana, IL, USA. .,Department of Mechanical Engineering, Northwestern University, Evanston, IL, USA. .,Department of Chemistry, Northwestern University, Evanston, IL, USA. .,Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
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