Instrumentation for the detection and interruption of apnea episodes for premature newborn

Apnea of prematurity is very frequent in premature newborns (PNB). If the apnea episode is not interrupted in time, it can cause several damages to the newborn's central nervous system. In this paper, we introduce a novel technology for detecting apnea of prematurity episodes, based on cardiac pulse frequency (PF) and arterial oxygen saturation (SpO2) simultaneously, and using vibrotactile stimulation to interrupt such episodes. The thresholds of the newborns' PF and SpO2 had been established to identify the apnea episode automatically through the proposed system: for babies ≤ 35 weeks gestation, PF is ≤ 100 bpm and SpO2 ≤ 80%; for babies > 35 weeks gestation, PF is ≤ 80 bpm and SpO2 ≤ 80%. The system used vibrotactile stimuli at 250 Hz for 4 s. To manage the system that activates the vibratory device automatically and registers those parameters, a program had been developed. It registers apnea occurrence, period of manual stimulation and vibratory stimulation duration. This technique was tested on 4 PNB. It was observed 10 apnea episodes and the device was successful in the detection of all of them. The vibrotactile stimulation was capable of promoting the return of respiratory movements in 9 of the 10 detected events of apnea and seemed to be a promising means of handling them.

[1]  Marcel Urner,et al.  Manual De Neonatologia , 2016 .

[2]  Joseph D. Bronzino,et al.  Vibrotactile stimulation system to treat apnea of prematurity. , 2003 .

[3]  M. Samuels,et al.  Oxygen saturation and breathing patterns in preterm infants with cyanotic episodes , 1992, Acta paediatrica.

[4]  R. Martin,et al.  Cardiorespiratory events in preterm infants referred for apnea monitoring studies. , 2001, Pediatrics.

[5]  E. Bancalari,et al.  Apnea of prematurity: I. Lung function and regulation of breathing. , 1984, Pediatrics.

[6]  E. Eichenwald,et al.  Apnea frequently persists beyond term gestation in infants delivered at 24 to 28 weeks. , 1997, Pediatrics.

[7]  C. Poets,et al.  Patterns of oxygenation during periodic breathing in preterm infants. , 1991, Early human development.

[8]  Didier Pittet,et al.  Guideline for Hand Hygiene in Health-Care Settings Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC / SHEA / APIC / IDSA Hand Hygiene Task Force , 2002 .

[9]  J. Kattwinkel,et al.  Margin of safety for discharge after apnea in preterm infants. , 1997, Pediatrics.

[10]  Richard J Martin,et al.  Control of Breathing and Neonatal Apnea , 2005, Neonatology.

[11]  H. Storm,et al.  Skin conductance and behaviour during sensory stimulation of preterm and term infants. , 2002, Early human development.

[12]  J. Perlman,et al.  Histologic Chorioamnionitis: An Occult Marker of Severe Pulmonary Hypertension in the Term Newborn , 2005, Journal of Perinatology.

[13]  S. A. N. Araújo,et al.  Quantificação das manipulações em recém-nascidos pré-termo em Unidade de Terapia Intensiva: uma proposta de elaboração de protocolo , 2008 .

[14]  T. Kashour,et al.  Secondary pulmonary arterial hypertension: treated with endothelin receptor blockade. , 2005, Texas Heart Institute journal.

[15]  J. Ihlenfeld Episodic Airway Obstruction in Premature Infants , 1984 .

[16]  C. Poets,et al.  The Relationship between Bradycardia, Apnea, and Hypoxemia in Preterm Infants , 1993, Pediatric Research.