Embedded neonatal respiration monitoring

Current neonatal monitoring methods are not very comfortable for the neonate. The sticky electrodes used to measure the heart and breathing rate, can cause skin irritations and skin lesions when being pulled off. Furthermore, all the wires create a barrier for parents to touch and interact with their child.
The E-Nemo (Embedded Neonatal Monitoring) project intends to change the way in which (premature) neonates are monitored in the neonatal intensive care unit (NICU).
The aim of E-Nemo is to create a patient support system that assures comfort for the neonate and provides a more friendly environment for parental bonding, whilst keeping the current quality of vital sign monitoring.
This report concerns the work related to the monitoring of only one vitals sign, namely: respiration.
The aim of the E-Nemo respiration monitoring project is to design and develop a neonatal respiration monitoring system using sensors embedded in a patient support system (e.g., a mattress).
A key challenge of this system is achieving the same robustness and reliability as existing monitoring equipment for neonates.
Before the respiration sensor can be moved from the chest of the neonate into the underlying support system some questions need to be answered. Such as: Where can we place this sensor? Is one sensor enough? Which type of sensor is most suitable?
To answer these (and more) questions regarding the design of the neonatal respiration monitoring system, a clinical trial was conducted at the NICU of the Máxima Medical Centre in Veldhoven.
During this trial firsthand knowledge on the position and movement of neonates in an incubator, and general NICU workflow issues was gained.
The clinical trial has resulted in a list of design specifications for the neonatal respiration monitoring system and a better understanding of the workflow and possible measurement disturbances in a NICU.
Furthermore, this project has successfully demonstrated the possibility of measuring the neonatal respiration signal without direct skin contact with the neonate. However, in order to achieve the quality and reliability needed for intensive care respiration monitoring more research is necessary.
Measuring the deformation of the mattress is expected to be a better measure for the respiration movements, than the pressure changes underneath the mattress which were measured in this study.
Furthermore, more research is needed to determine the accuracy that will be demanded of the system, as this research has demonstrated that the current gold standard (transthoracic impedance plethysmography) does not function continously either.