Bioengineering aspects of sensors and instruments for continuous monitoring of a ventilated newborn

This paper examines critical aspects of sensors and measurement instruments used in the clinical care of mechanically ventilated newborn babies. The key variables for ventilator control are described and sensors for gas flow and volume are evaluated. The continuous real-time monitoring of critical physical and chemical variables can provide important data that can be used to optimize mechanical ventilator parameters. The options for invasive and noninvasive measurement approaches are introduced and issues relating to the trade-offs between measurement precision and accuracy and patient safety are discussed. Sensors for blood gases, hemodynamic variables, pulmonary mechanics parameters, and ventilator characteristics are described. Accurate gas flow sensors are needed for the effective delivery of an optimized ventilator therapy; the hot-wire anemometer and the pneumotachograph are evaluated. A preliminary study to develop a rationale based on artificial intelligence decision trees for choosing sensors and instruments is presented.

[1]  N Nakabayashi,et al.  Hemocompatibility on graft copolymers composed of poly(2-methacryloyloxyethyl phosphorylcholine) side chain and poly(n-butyl methacrylate) backbone. , 1994, Journal of biomedical materials research.

[2]  A. Milner,et al.  Accuracy of the volume and pressure displays of high frequency oscillators , 2004, Archives of Disease in Childhood - Fetal and Neonatal Edition.

[3]  B. Short,et al.  Continuous Blood Gas Monitoring Using an In-Dwelling Optode Method: Clinical Evaluation of the Neotrend Sensor Using a Luer Stub Adaptor to Access the Umbilical Artery Catheter , 2002, Journal of Perinatology.

[4]  M. Walsh,et al.  Pulse oximetry in very low birth weight infants: can oxygen saturation be maintained in the desired range? , 2006, Journal of Perinatology.

[5]  T. Shaffer,et al.  A prototype infant incubator for heliox therapy. , 2006, Biomedical instrumentation & technology.

[6]  Wiley Interscience,et al.  Volume targeted ventilation (volume guarantee) in the weaning phase of premature newborn infants , 2007, Pediatric pulmonology.

[7]  P. Rolfe,et al.  Sensors for Fetal and Neonatal Monitoring , 2008 .

[8]  Jerry L Prince,et al.  Current methods in medical image segmentation. , 2000, Annual review of biomedical engineering.

[9]  P Rolfe,et al.  Development of a haemocompatible pO2 sensor with phospholipid-based copolymer membrane. , 1996, Biosensors & bioelectronics.

[10]  A. Wilkinson,et al.  New fontanometer for continuous estimation of intracranial pressure in the newborn. , 1987, Archives of disease in childhood.

[11]  Anne Greenough,et al.  Compliance and resistance levels and unloading in proportional assist ventilation , 2005, Physiological measurement.

[12]  C. Ou,et al.  Validation of oxygen saturation monitoring in neonates. , 2007, American journal of critical care : an official publication, American Association of Critical-Care Nurses.

[13]  B. Yoder,et al.  Lung function measurements in a preterm animal model of respiratory failure: Comparison of two different neonatal ventilators , 2006, Pediatric pulmonology.

[14]  R. Robinson,et al.  Non‐invasive Method for Measuring Intracranial Pressure in Normal Newborn Infants , 1977, Developmental medicine and child neurology.

[15]  P. Rolfe,et al.  Use of a continuously recording intravascular oxygen electrode in the newborn , 1974, Archives of disease in childhood.

[16]  P. Rolfe,et al.  In vivo near-infrared spectroscopy. , 2000, Annual review of biomedical engineering.

[17]  H. Bada,et al.  The fontogram: a noninvasive intracranial pressure monitor. , 1977, Pediatrics.

[18]  Louis Vessot King,et al.  On the Convection of Heat from Small Cylinders in a Stream of Fluid: Determination of the Convection Constants of Small Platinum Wires with Applications to Hot-Wire Anemometry , 1914 .

[19]  P. Davis,et al.  Does measuring respiratory function improve neonatal ventilation? , 2006, Journal of paediatrics and child health.

[20]  B. Skotko Mothers of Children With Down Syndrome Reflect on Their Postnatal Support , 2005, Pediatrics.

[21]  W. Carlo,et al.  Ventilation strategies and outcome in randomised trials of high frequency ventilation , 2005, Archives of Disease in Childhood - Fetal and Neonatal Edition.

[22]  M. Weiss,et al.  Evaluation of a New Combined Transcutaneous Measurement of Pco2/Pulse Oximetry Oxygen Saturation Ear Sensor in Newborn Patients , 2004, Pediatrics.