A Wearable Daily Respiration Monitoring System Using PDMS-graphene Compound Tensile Sensor for Adult.

A wearable respiration monitoring system based on Respiratory induction plethysmography (RIP) using a new Polydimethylsiloxane-graphene (PDMS-graphene) compound tensile sensor is proposed. The manufacture procedure of this novel resistance-based tensile sensor is presented together with a wireless acquisition system. The proposed sensor shows a high sensitivity during stretching and a promising cyclic stability for continuous 3,600 cycles.

Anatomically Realistic Neonatal Heart Model for Use in Neonatal Patient Simulators.

Neonatal patient simulators (NPS) are artificial patient surrogates used in the context of medical simulation training. Neonatologists and nursing staff practice clinical interventions such as chest compressions to ensure patient survival in the case of bradycardia or cardiac arrest. The simulators used currently are of low physical fidelity and therefore cannot provide qualitative insight into the procedure of chest compressions.

Changes in autonomic regulation due to Kangaroo care remain unaffected by using a swaddling device.

Aim: To investigate the effects of a swaddling device known as the Hugsy (Hugsy, Eindhoven, the Netherlands) towards improving autonomic regulation. This device can be used both in the incubator and during Kangaroo care to absorb parental scent and warmth. After Kangaroo care, these stimuli can continue to be experienced by infants, while in the incubator.

Unlike Kangaroo care, mechanically simulated Kangaroo care does not change heart rate variability in preterm neonates.

Background: While numerous positive effects of Kangaroo care (KC) have been reported, the duration that parents can spend kangarooing is often limited.

Aim: To investigate whether a mattress that aims to mimic breathing motion and the sounds of heartbeats (BabyBe GMBH, Stuttgart, Germany) can simulate aspects of KC in preterm infants as measured by features of heart rate variability (HRV).

Methods: A within-subject study design was employed in which every routine KC session was followed by a BabyBe (BB) session, with a washout period of at least 2 h in between.

Antenatal mother-infant bonding scores are related to maternal reports of infant crying behaviour.

Objective: To assess the relation between antenatal mother-infant bonding scores and maternal reports of infant crying behaviour.

Background: Crying is normal behaviour and it is important for parent-infant bonding. Even though bonding starts antenatally, the relation between antenatal bonding scores and infant crying behaviour has never been studied.

Viewpoints of Parents and Nurses on How to Design Products to Enhance Parent-Infant Bonding at Neonatal Intensive Care Units: A Qualitative Study Based on Existing Designs.

Aim: To investigate how product design can be used to improve parent-infant bonding in a neonatal intensive care unit.

Background: Impaired parent-infant bonding is an inevitable consequence of premature birth, which negatively influences development. Products, systems, or services that support the bonding process might counter these negative influences.

An innovative design for cardiopulmonary resuscitation manikins based on a human-like thorax and embedded flow sensors.

Cardiopulmonary resuscitation manikins are used for training personnel in performing cardiopulmonary resuscitation. State-of-the-art cardiopulmonary resuscitation manikins are still anatomically and physiologically low-fidelity designs. The aim of this research was to design a manikin that offers high anatomical and physiological fidelity and has a cardiac and respiratory system along with integrated flow sensors to monitor cardiac output and air displacement in response to cardiopulmonary resuscitation.

Features of Heart Rate Variability Capture Regulatory Changes During Kangaroo Care in Preterm Infants.

Objective: To determine whether heart rate variability (HRV) can serve as a surrogate measure to track regulatory changes during kangaroo care, a period of parental coregulation distinct from regulation within the incubator.

Study Design: Nurses annotated the starting and ending times of kangaroo care for 3 months. The pre-kangaroo care, during-kangaroo care, and post-kangaroo care data were retrieved in infants with at least 10 accurately annotated kangaroo care sessions.

A Review of Wearable Sensor Systems for Monitoring Body Movements of Neonates.

Characteristics of physical movements are indicative of infants' neuro-motor development and brain dysfunction. For instance, infant seizure, a clinical signal of brain dysfunction, could be identified and predicted by monitoring its physical movements. With the advance of wearable sensor technology, including the miniaturization of sensors, and the increasing broad application of micro- and nanotechnology, and smart fabrics in wearable sensor systems, it is now possible to collect, store, and process multimodal signal data of infant movements in a more efficient, more comfortable, and non-intrusive way.

Unobtrusive Monitoring of Neonatal Brain Temperature Using a Zero-Heat-Flux Sensor Matrix.

The temperature of preterm neonates must be maintained within a narrow window to ensure their survival. Continuously measuring their core temperature provides an optimal means of monitoring their thermoregulation and their response to environmental changes. However, existing methods of measuring core temperature can be very obtrusive, such as rectal probes, or inaccurate/lagging, such as skin temperature sensors and spot-checks using tympanic temperature sensors.

Maternal allopurinol administration during suspected fetal hypoxia: a novel neuroprotective intervention? A multicentre randomised placebo controlled trial.

Objective: To determine whether maternal allopurinol treatment during suspected fetal hypoxia would reduce the release of biomarkers associated with neonatal brain damage.

Design: A randomised double-blind placebo controlled multicentre trial.

Patients: We studied women in labour at term with clinical indices of fetal hypoxia, prompting immediate delivery.

Mimo pillow--an intelligent cushion designed with maternal heart beat vibrations for comforting newborn infants.

Premature infants are subject to numerous interventions ranging from a simple diaper change to surgery while residing in neonatal intensive care units. These neonates often suffer from pain, distress, and discomfort during the first weeks of their lives. Although pharmacological pain treatment often is available, it cannot always be applied to relieve a neonate from pain or discomfort.

Non-contact heart rate monitoring utilizing camera photoplethysmography in the neonatal intensive care unit - a pilot study.

Background: Presently the heart rate is monitored in the Neonatal Intensive Care Unit with contact sensors: electrocardiogram or pulse oximetry. These techniques can cause injuries and infections, particularly in very premature infants with fragile skin. Camera based plethysmography was recently demonstrated in adults as a contactless method to determine heart rate.

Efficacy of feed forward and feedback signaling for inflations and chest compression pressure during cardiopulmonary resuscitation in a newborn mannequin.

Background: The objective of the study was to evaluate a device that supports professionals during neonatal cardiopulmonary resuscitation (CPR). The device features a box that generates an audio-prompted rate guidance (feed forward) for inflations and compressions, and a transparent foil that is placed over the chest with marks for inter nipple line and sternum with LED's incorporated in the foil indicating the exerted force (feedback).

Methods: Ten pairs (nurse/doctor) performed CPR on a newborn resuscitation mannequin.

Multi-channel amplitude-integrated EEG characteristics in preterm infants with a normal neurodevelopment at two years of corrected age.

Aim: To analyze quantitatively multi-channel amplitude-integrated EEG (aEEG) characteristics and assess regional differences.

Methods: We investigated 40 preterm infants (postmenstrual age, PMA: range 27-37 weeks) with normal follow-up at 24 months of age, at a median postnatal age of 8 days using 4-h EEG recordings according to the international 10-20 system reduced montage. Nine (3 transverse and 6 longitudinal) channels were selected and converted to aEEG registrations.

Maturational changes in automated EEG spectral power analysis in preterm infants.

Our study aimed at automated power spectral analysis of the EEG in preterm infants to identify changes of spectral measures with maturation. Weekly (10-20 montage) 4-h EEG recordings were performed in 18 preterm infants with GA <32 wk and normal neurological follow-up at 2 y, resulting in 79 recordings studied from 27(+4) to 36(+3) wk of postmenstrual age (PMA, GA + postnatal age). Automated spectral analysis was performed on 4-h EEG recordings.

Rhythm of Life Aid (ROLA): an integrated sensor system for supporting medical staff during cardiopulmonary resuscitation (CPR) of newborn infants.

During the stress of cardiopulmonary resuscitation (CPR), it is difficult to maintain the right rhythm and correct ratio of insufflations to chest compressions and to exert the compressions at a constant pressure. In this paper, we propose and demonstrate an integrated sensor system-the "Rhythm of Life Aid" (ROLA) to support medical staff during CPR of newborn infants. The design concept is based on interactive audio and visual feedback with consideration of functionalities and user friendliness.

Antenatal allopurinol for reduction of birth asphyxia induced brain damage (ALLO-Trial); a randomized double blind placebo controlled multicenter study.

Background: Hypoxic-ischaemic encephalopathy is associated with development of cerebral palsy and cognitive disability later in life and is therefore one of the fundamental problems in perinatal medicine. The xanthine-oxidase inhibitor allopurinol reduces the formation of free radicals, thereby limiting the amount of hypoxia-reperfusion damage. In case of suspected intra-uterine hypoxia, both animal and human studies suggest that maternal administration of allopurinol immediately prior to delivery reduces hypoxic-ischaemic encephalopathy.

Cerebral MRI abnormalities in a premature infant with later confirmed congenital central hypoventilation syndrome.

We present a premature infant with an inability to ventilate spontaneously during sleep periods. In addition, the patient showed general hypotonia. The child had a delayed passage of stool and increased anal muscle tone, indicating Hirschsprung's disease.

Furosemide in preterm infants treated with indomethacin for patent ductus arteriosus.

Objective: To evaluate the effect of furosemide on renal function and water balance in preterm infants treated with indomethacin (3 x 0.2 mg/kg at 12-h intervals) for symptomatic patent ductus arteriosus.

Patients And Methods: We performed a retrospective multi-centre double cohort study in preterm infants <32 weeks of gestational age.

Feasibility of noninvasive continuous finger arterial blood pressure measurements in very young children, aged 0-4 years.

Our goal was to study the feasibility of continuous noninvasive finger blood pressure (BP) monitoring in very young children, aged 0-4 y. To achieve this, we designed a set of small-sized finger cuffs based on the assessment of finger circumference. Finger arterial BP measured by a volume clamp device (Finapres technology) was compared with simultaneously measured intra-arterial BP in 15 very young children (median age, 5 mo; range, 0-48), admitted to the intensive care unit for vital monitoring.

Baroreceptor reflex sensitivity in human neonates: the effect of postmenstrual age.

We performed a cross-sectional study in human infants to determine if indices of R-R interval variability, systolic blood pressure (SBP) variability, and baroreceptor reflex sensitivity change with postmenstrual age (PMA: gestational age+postnatal age). The electrocardiogram, arterial SBP and respiration were recorded in clinically stable infants (PMA, 28-42 weeks) in the quiet sleep state in the first days after birth. (Cross-)spectral analyses of R-R interval series and SBP series were performed to calculate the power of low-frequency (LF, indicating baroreceptor reflex activity, 0.

Early neonatal dexamethasone treatment for prevention of bronchopulmonary dysplasia. Randomised trial and meta-analysis evaluating the duration of dexamethasone therapy.

Unlabelled: The aim of the aborted trial was to determine whether the short early dexamethasone (DX) given after the birth improves the early outcome. We also reviewed the evidence (meta-analysis) to determine whether the duration of early DX treatment influences the early outcome, particularly in terms of bronchopulmonary dysplasia (BPD). The participants of the randomised multicentre, double-blinded placebo-controlled trial had a birth weight 500-999 g, gestation < or = 31.

Activation of the inflammatory reaction within minutes after birth in ventilated preterm lambs with neonatal respiratory distress syndrome.

To study the activation of the inflammatory reaction within minutes after birth, we measured parameters of inflammation before and immediately after birth. To assess whether respiratory distress syndrome (RDS) or birth itself initiates activation, we compared preterm ventilated lambs with term nonventilated lambs. Preterm lambs were delivered by cesarean section at 132 days gestational age (term 145 days) and were ventilated by conventional ventilation (n = 9).

Antenatal glucocorticoids attenuate activation of the inflammatory reaction and clotting in preterm lambs.

Recently we have shown that activation of inflammatory reaction and clotting can be found immediately after delivery in preterm lambs ventilated for respiratory distress syndrome (RDS). To investigate whether antenatal glucocorticoids would attenuate postnatal activation of the inflammatory reaction and clotting, we studied ventilated preterm lambs delivered by cesarean section, 24 h after antenatal administration of betamethasone or placebo. Blood was sampled before clamping the cord, 5, 10, and 15 min after delivery, and 2-hourly afterwards.