A wireless, skin-interfaced biosensor for cerebral hemodynamic monitoring in pediatric care

• Published in: Proceedings of the National Academy of Sciences - PNAS Vol. 117; no. 50; pp. 31674 - 31684
• Main Authors: Rwei, Alina Y., Lu, Wei, Wu, Changsheng, Human, Kelia, Suen, Emily, Franklin, Daniel, Fabiani, Monica, Gratton, Gabriele, Xie, Zhaoqian, Deng, Yujun, Kwak, Sung Soo, Li, Lizhu, Gu, Carol, Liu, Alanna, Rand, Casey M., Stewart, Tracey M., Huang, Yonggang, Weese-Mayer, Debra E., Rogersa, John A.
• Format: Journal Article
• Language: English
• Published: United States National Academy of Sciences 15.12.2020
• Subjects: Adhesive bonding; Adolescent; Biosensing Techniques; Biosensors; Cerebrovascular Circulation - physiology; Child; Child Development - physiology; Child, Preschool; Female; Heart rate; Hemodynamic Monitoring - instrumentation; Hemodynamic Monitoring - methods; Hemodynamics; Humans; Hypoventilation; Infant; Infrared spectra; Infrared spectroscopy; Light emitting diodes; Magnetic resonance imaging; Male; Monitoring; Near infrared radiation; Neonates; Neurodevelopmental Disorders - diagnosis; Neurodevelopmental Disorders - physiopathology; Neurology; Neurophysiological Monitoring - instrumentation; Neurophysiological Monitoring - methods; Oxygenation; Patients; Pediatrics; Physical Sciences; Skin; Skin injuries; Spectroscopy, Near-Infrared - instrumentation; Telemedicine; Wavelengths; Wearable Electronic Devices; Wireless Technology - instrumentation; near-infrared spectroscopy; bioelectronics; cerebral hemodynamics; wearable electronics
• ISSN: 0027-8424; 1091-6490; 1091-6490
• DOI: 10.1073/pnas.2019786117

The standard of clinical care in many pediatric and neonatal neurocritical care units involves continuous monitoring of cerebral hemodynamics using hard-wired devices that physically adhere to the skin and connect to base stations that commonly mount on an adjacent wall or stand. Risks of iatrogenic skin injuries associated with adhesives that bond such systems to the skin and entanglements of the patients and/or the healthcare professionals with the wires can impede clinical procedures and natural movements that are critical to the care, development, and recovery of pediatric patients. This paper presents a wireless, miniaturized, and mechanically soft, flexible device that supports measurements quantitatively comparable to existing clinical standards. The system features a multiphotodiode array and pair of light-emitting diodes for simultaneous monitoring of systemic and cerebral hemodynamics, with ability to measure cerebral oxygenation, heart rate, peripheral oxygenation, and potentially cerebral pulse pressure and vascular tone, through the utilization of multiwavelength reflectance-mode photoplethysmography and functional near-infrared spectroscopy. Monte Carlo optical simulations define the tissue-probing depths for source–detector distances and operating wavelengths of these systems using magnetic resonance images of the head of a representative pediatric patient to define the relevant geometries. Clinical studies on pediatric subjects with and without congenital central hypoventilation syndrome validate the feasibility for using this system in operating hospitals and define its advantages relative to established technologies. This platformhas the potential to substantially enhance the quality of pediatric care across a wide range of conditions and use scenarios, not only in advanced hospital settings but also in clinics of lower- and middle-income countries.