Respiration Monitoring via Forcecardiography Sensors

In the last few decades, a number of wearable systems for respiration monitoring that help to significantly reduce patients’ discomfort and improve the reliability of measurements have been presented. A recent research trend in biosignal acquisition is focusing on the development of monolithic sensors for monitoring multiple vital signs, which could improve the simultaneous recording of different physiological data. This study presents a performance analysis of respiration monitoring performed via forcecardiography (FCG) sensors, as compared to ECG-derived respiration (EDR) and electroresistive respiration band (ERB), which was assumed as the reference. FCG is a novel technique that records the cardiac-induced vibrations of the chest wall via specific force sensors, which provide seismocardiogram-like information, along with a novel component that seems to be related to the ventricular volume variations. Simultaneous acquisitions were obtained from seven healthy subjects at rest, during both quiet breathing and forced respiration at higher and lower rates. The raw FCG sensor signals featured a large, low-frequency, respiratory component (R-FCG), in addition to the common FCG signal. Statistical analyses of R-FCG, EDR and ERB signals showed that FCG sensors ensure a more sensitive and precise detection of respiratory acts than EDR (sensitivity: 100% vs. 95.8%, positive predictive value: 98.9% vs. 92.5%), as well as a superior accuracy and precision in interbreath interval measurement (linear regression slopes and intercepts: 0.99, 0.026 s (R2 = 0.98) vs. 0.98, 0.11 s (R2 = 0.88), Bland–Altman limits of agreement: ±0.61 s vs. ±1.5 s). This study represents a first proof of concept for the simultaneous recording of respiration signals and forcecardiograms with a single, local, small, unobtrusive, cheap sensor. This would extend the scope of FCG to monitoring multiple vital signs, as well as to the analysis of cardiorespiratory interactions, also paving the way for the continuous, long-term monitoring of patients with heart and pulmonary diseases.

[1]  Sergio Silvestri,et al.  Contact-Based Methods for Measuring Respiratory Rate , 2019, Sensors.

[2]  D. Loyd,et al.  Heat transfer evaluation of the nasal thermistor technique , 1996, IEEE Transactions on Biomedical Engineering.

[3]  Antonino S. Fiorillo,et al.  Theory, technology and applications of piezoresistive sensors: A review , 2018, Sensors and Actuators A: Physical.

[4]  Maria Romano,et al.  Problems in Assessment of Novel Biopotential Front-End with Dry Electrode: A Brief Review , 2014 .

[5]  V. Larsen,et al.  Impedance pneumography for long-term monitoring of respiration during sleep in adult males. , 1984, Clinical physiology.

[6]  D. Zheng,et al.  Fabrication and Evaluation of a Novel Non-Invasive Stretchable and Wearable Respiratory Rate Sensor Based on Silver Nanoparticles Using Inkjet Printing Technology , 2019, Polymers.

[7]  Ping Lu,et al.  Fiber Bragg grating sensor for simultaneous measurement of flow rate and direction , 2008 .

[8]  Lijing Wang,et al.  Design, Development and Characterization of Textile Stitch-Based Piezoresistive Sensors for Wearable Monitoring , 2020, IEEE Sensors Journal.

[9]  Minoru Sasaki,et al.  A Wearable Capacitive Sensor for Monitoring Human Respiratory Rate , 2013 .

[10]  Michael Brutscheck,et al.  Non-invasive respiratory rate detection in spontaneous respiration by humidity measurement , 2017, 2017 28th Irish Signals and Systems Conference (ISSC).

[11]  Pasqualina M. Sarro,et al.  Thermal sensors based on the seebeck effect , 1986 .

[12]  I. Pavlidis,et al.  Touchless monitoring of breathing function , 2004, The 26th Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[13]  Anh Dinh,et al.  Artifact Noise Removal Techniques on Seismocardiogram Using Two Tri-Axial Accelerometers , 2018, Sensors.

[14]  Ramesh Jain,et al.  Respiration rate and volume measurements using wearable strain sensors , 2019, npj Digital Medicine.

[15]  Gaetano D Gargiulo,et al.  Electro-resistive bands for non-invasive cardiac and respiration monitoring, a feasibility study , 2015, Physiological measurement.

[16]  Keya Pandia,et al.  Extracting respiratory information from seismocardiogram signals acquired on the chest using a miniature accelerometer , 2012, Physiological measurement.

[17]  Jianxiong Zhou,et al.  A Low-Power and Portable Biomedical Device for Respiratory Monitoring with a Stable Power Source , 2015, Sensors.

[18]  Emiliano Schena,et al.  Contactless Methods For Measuring Respiratory Rate: A Review , 2021, IEEE Sensors Journal.

[19]  S. Silvestri,et al.  Analysis of breathing via optoelectronic systems: comparison of four methods for computing breathing volumes and thoraco-abdominal motion pattern , 2017, Computer methods in biomechanics and biomedical engineering.

[20]  Chenxi Yang,et al.  An Independent Component Analysis Approach to Motion Noise Cancelation of Cardio-Mechanical Signals , 2019, IEEE Transactions on Biomedical Engineering.

[21]  Ozgur Atalay,et al.  Weft-Knitted Strain Sensor for Monitoring Respiratory Rate and Its Electro-Mechanical Modeling , 2015, IEEE Sensors Journal.

[22]  Giuseppe Andreoni,et al.  Wearable textile based on silver plated knitted sensor for respiratory rate monitoring , 2018, 2018 40th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC).

[23]  Sung-Bock Kim,et al.  Wearable Respiratory Rate Monitoring using Piezo-resistive Fabric Sensor , 2009 .

[24]  Chia-Chin Chiang,et al.  Sandwiched Long-Period Fiber Grating Fabricated by MEMS Process for CO2 Gas Detection , 2016, Micromachines.

[25]  Cheng-Ta Yang,et al.  Design of Wearable Breathing Sound Monitoring System for Real-Time Wheeze Detection , 2017, Sensors.

[26]  S. Fonash,et al.  A rapid-response, high-sensitivity nanophase humidity sensor for respiratory monitoring , 2004, IEEE Electron Device Letters.

[27]  J. Houtveen,et al.  Validation of the thoracic impedance derived respiratory signal using multilevel analysis. , 2006, International journal of psychophysiology : official journal of the International Organization of Psychophysiology.

[28]  Sabit Ekin,et al.  Non-Contact Vital Signs Monitoring Through Visible Light Sensing , 2020, IEEE Sensors Journal.

[29]  D. Schriger.  7 – Approach to the Patient with Abnormal Vital Signs , 2012 .

[30]  P. Bifulco,et al.  A wearable device for recording of biopotentials and body movements , 2011, 2011 IEEE International Symposium on Medical Measurements and Applications.

[31]  Hong Yan,et al.  A principal component analysis based data fusion method for ECG-derived respiration from single-lead ECG , 2017, Australasian Physical & Engineering Sciences in Medicine.

[32]  Sophie LaRochelle,et al.  Wearable Contactless Respiration Sensor Based on Multi-Material Fibers Integrated into Textile , 2017, Sensors.

[33]  D. Zheng,et al.  Comparison of different modulations of photoplethysmography in extracting respiratory rate: from a physiological perspective , 2020, Physiological measurement.

[34]  Hsiao-Lung Chan,et al.  Instantaneous Respiratory Estimation from Thoracic Impedance by Empirical Mode Decomposition , 2015, Sensors.

[35]  Emiliano Schena,et al.  Remote Respiratory Monitoring in the Time of COVID-19 , 2020, Frontiers in Physiology.

[36]  B. Popov,et al.  Comparison of Respiratory Rate Estimation Based on Tracheal Sounds Versus a Capnograph , 2005, 2005 IEEE Engineering in Medicine and Biology 27th Annual Conference.

[37]  S Leonhardt,et al.  Respiratory Monitoring System on the Basis of Capacitive Textile Force Sensors , 2011, IEEE Sensors Journal.

[38]  I. Yoshiya,et al.  A bidirectional respiratory flowmeter using the hot-wire principle. , 1975, Journal of applied physiology.

[39]  Enzo Pasquale Scilingo,et al.  Comparative Evaluation of Susceptibility to Motion Artifact in Different Wearable Systems for Monitoring Respiratory Rate , 2010, IEEE Transactions on Information Technology in Biomedicine.

[40]  Inmaculada Plaza,et al.  Sensing Systems for Respiration Monitoring: A Technical Systematic Review , 2020, Sensors.

[41]  L. Tarassenko,et al.  An assessment of algorithms to estimate respiratory rate from the electrocardiogram and photoplethysmogram , 2016, Physiological measurement.

[42]  Kouhyar Tavakolian,et al.  Analyzing Seismocardiogram Cycles to Identify the Respiratory Phases , 2017, IEEE Trans. Biomed. Eng..

[43]  Sandra Costanzo,et al.  Software-Defined Doppler Radar Sensor for Human Breathing Detection , 2019, Sensors.

[44]  Hrvoje Dzapo,et al.  Capacitive sensor for respiration monitoring , 2015, 2015 IEEE Sensors Applications Symposium (SAS).

[45]  Shinya Kano,et al.  Silica Nanoparticle-Based Portable Respiration Sensor for Analysis of Respiration Rate, Pattern, and Phase During Exercise , 2018, IEEE Sensors Letters.

[46]  Xu Guang Huang,et al.  A Simple Fiber-Optic Flowmeter Based on Bending Loss , 2009, IEEE Sensors Journal.

[47]  R. W. Miller,et al.  Flow Measurement Engineering Handbook , 1983 .

[48]  Ki H. Chon,et al.  Tracheal Sounds Acquisition Using Smartphones , 2014, Sensors.

[49]  Andre van Schaik,et al.  Dry electrode bio-potential recordings , 2010, 2010 Annual International Conference of the IEEE Engineering in Medicine and Biology.

[50]  Om Prakash Singh,et al.  Real-time human respiration carbon dioxide measurement device for cardiorespiratory assessment , 2018, Journal of breath research.

[51]  Juuso T. Olkkonen,et al.  Paper as Active Layer in Inkjet-Printed Capacitive Humidity Sensors , 2017, Sensors.

[52]  Jesús Lázaro,et al.  Deriving respiration from photoplethysmographic pulse width , 2013, Medical & Biological Engineering & Computing.

[53]  Shu Zhang,et al.  Utility of transthoracic impedance and novel algorithm for sleep apnea screening in pacemaker patient , 2018, Sleep and Breathing.

[54]  L. P. Adams,et al.  Evaluating regional body surface motion during breathing using stereophotogrammetry , 1990 .

[55]  Zahra Moussavi,et al.  Automatic and Unsupervised Snore Sound Extraction From Respiratory Sound Signals , 2011, IEEE Transactions on Biomedical Engineering.

[56]  Upul Gunawardana,et al.  A Wearable Contactless Sensor Suitable for Continuous Simultaneous Monitoring of Respiration and Cardiac Activity , 2015, J. Sensors.

[57]  R. Saatchi,et al.  Respiration rate monitoring methods: A review , 2011, Pediatric pulmonology.

[58]  Emiliano Schena,et al.  Fiber Bragg Grating Probe for Relative Humidity and Respiratory Frequency Estimation: Assessment During Mechanical Ventilation , 2018, IEEE Sensors Journal.

[59]  Javier Reina-Tosina,et al.  Smart Vest for Respiratory Rate Monitoring of COPD Patients Based on Non-Contact Capacitive Sensing , 2018, Sensors.

[60]  Hooman Sedghamiz,et al.  BioSigKit: A Matlab Toolbox and Interface for Analysis of BioSignals , 2018, J. Open Source Softw..

[62]  M. Marks,et al.  Measurement of respiratory rate and timing using a nasal thermocouple , 1995, Journal of Clinical Monitoring.

[63]  Shuvo Roy,et al.  Quantifying and Reducing Motion Artifacts in Wearable Seismocardiogram Measurements During Walking to Assess Left Ventricular Health , 2017, IEEE Transactions on Biomedical Engineering.

[64]  Benoit Gosselin,et al.  A Wireless Respiratory Monitoring System Using a Wearable Patch Sensor Network , 2019, IEEE Sensors Journal.

[65]  Emiliano Schena,et al.  Experimental Assessment of a Variable Orifice Flowmeter for Respiratory Monitoring , 2015, J. Sensors.

[66]  John Allen,et al.  Recent development of respiratory rate measurement technologies , 2019, Physiological measurement.

[67]  Ganesh R. Naik,et al.  A Piezoresistive Array Armband With Reduced Number of Sensors for Hand Gesture Recognition , 2020, Frontiers in Neurorobotics.

[68]  Sander Stuijk,et al.  Robust respiration detection from remote photoplethysmography. , 2016, Biomedical optics express.

[69]  Jesús M. Corres,et al.  Recent Developments in Fiber Optics Humidity Sensors , 2017, Sensors.

[70]  J. Cooper.  A fast-response pyroelectric thermal detector , 1962 .

[71]  Maria Romano,et al.  Monitoring of respiration, seismocardiogram and heart sounds by a PVDF piezo film sensor , 2014 .

[72]  Esther Rodríguez-Villegas,et al.  Breathing Detection: Towards a Miniaturized, Wearable, Battery-Operated Monitoring System , 2008, IEEE Transactions on Biomedical Engineering.

[73]  Manoj M. Varma,et al.  Highly Sensitive Carbon Nanotubes Coated Etched Fiber Bragg Grating Sensor for Humidity Sensing , 2014, IEEE Sensors Journal.

[74]  Carlo Molardi,et al.  Fiber-Optic Based Smart Textiles for Real-Time Monitoring of Breathing Rate , 2020, Sensors.

[75]  Leonel Paredes-Madrid,et al.  Underlying Physics of Conductive Polymer Composites and Force Sensing Resistors (FSRs) under Static Loading Conditions , 2017, Sensors.

[76]  Eric C. Larson,et al.  SpiroSmart: using a microphone to measure lung function on a mobile phone , 2012, UbiComp.

[78]  Ramon Villarino,et al.  Wireless Wearable Magnetometer-Based Sensor for Sleep Quality Monitoring , 2018, IEEE Sensors Journal.

[79]  Andrea Aliverti,et al.  Assessment of Breathing Parameters Using an Inertial Measurement Unit (IMU)-Based System , 2018, Sensors.

[80]  A S Malik,et al.  Novel health monitoring method using an RGB camera. , 2017, Biomedical optics express.

[81]  Won-Ki Kim,et al.  Improvement of Dynamic Respiration Monitoring Through Sensor Fusion of Accelerometer and Gyro-sensor , 2014 .

[82]  B. Hök,et al.  Critical review of non-invasive respiratory monitoring in medical care , 2003, Medical and Biological Engineering and Computing.

[83]  Zahra Moussavi,et al.  Fundamentals of Respiratory Sounds and Analysis , 2006, Fundamentals of Respiratory Sounds and Analysis.

[84]  S. P. Lee,et al.  Synthesis and Characterization of Carbon Nitride Films for Micro Humidity Sensors , 2008, Sensors.

[85]  Sheng Liu,et al.  A Novel Adaptive Recursive Least Squares Filter to Remove the Motion Artifact in Seismocardiography , 2020, Sensors.

[86]  Yuji Matsuura,et al.  Infrared Hollow Optical Fiber Probe for Localized Carbon Dioxide Measurement in Respiratory Tracts , 2018, Sensors.

[87]  Paolo Bifulco,et al.  Forcecardiography: A Novel Technique to Measure Heart Mechanical Vibrations onto the Chest Wall , 2020, Sensors.

[88]  Yong Zhao,et al.  Novel target type flowmeter based on a differential fiber Bragg grating sensor , 2005 .

[89]  Emiliano Schena,et al.  Smart Textile Based on Piezoresistive Sensing Elements for Respiratory Monitoring , 2019, IEEE Sensors Journal.

[90]  Pablo Laguna,et al.  A robust method for ECG-based estimation of the respiratory frequency during stress testing , 2006, IEEE Transactions on Biomedical Engineering.

[91]  Ludovico Minto,et al.  Time-of-Flight and Structured Light Depth Cameras , 2016, Springer International Publishing.

[92]  Leonel Paredes-Madrid,et al.  Underlying Physics of Conductive Polymer Composites and Force Sensing Resistors (FSRs). A Study on Creep Response and Dynamic Loading , 2017, Materials.

[93]  E. Alasaarela,et al.  Measurement of respiratory rate with high-resolution accelerometer and emfit pressure sensor , 2006, Proceedings of the 2006 IEEE Sensors Applications Symposium, 2006..

[94]  Bor-Shing Lin,et al.  Novel Approach of Respiratory Sound Monitoring Under Motion , 2017, IIH-MSP.

[95]  Ke-Nung Huang,et al.  Monitoring of breathing rate by a piezofilm sensor using pyroelectric effect , 2013, 2013 1st International Conference on Orange Technologies (ICOT).

[96]  Paolo Bifulco,et al.  A Piezoresistive Sensor to Measure Muscle Contraction and Mechanomyography , 2018, Sensors.

[97]  Gaetano D Gargiulo,et al.  Continuous Vital Monitoring During Sleep and Light Activity Using Carbon-Black Elastomer Sensors , 2020, Sensors.