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      An E-Textile Respiration Sensing System for NICU Monitoring: Design and Validation

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          Abstract

          The world is witnessing a rising number of preterm infants who are at significant risk of medical conditions. These infants require continuous care in Neonatal Intensive Care Units (NICU). Medical parameters are continuously monitored in premature infants in the NICU using a set of wired, sticky electrodes attached to the body. Medical adhesives used on the electrodes can be harmful to the baby, causing skin injuries, discomfort, and irritation. In addition, respiration rate (RR) monitoring in the NICU faces challenges of accuracy and clinical quality because RR is extracted from electrocardiogram (ECG). This research paper presents a design and validation of a smart textile pressure sensor system that addresses the existing challenges of medical monitoring in NICU. We designed two e-textile, piezoresistive pressure sensors made of Velostat for noninvasive RR monitoring; one was hand-stitched on a mattress topper material, and the other was embroidered on a denim fabric using an industrial embroidery machine. We developed a data acquisition system for validation experiments conducted on a high-fidelity, programmable NICU baby mannequin. We designed a signal processing pipeline to convert raw time-series signals into parameters including RR, rise and fall time, and comparison metrics. The results of the experiments showed that the relative accuracies of hand-stitched sensors were 98.68 (top sensor) and 98.07 (bottom sensor), while the accuracies of embroidered sensors were 99.37 (left sensor) and 99.39 (right sensor) for the 60 BrPM test case. The presented prototype system shows promising results and demands more research on textile design, human factors, and human experimentation.

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          Most cited references11

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          Revised National Pressure Ulcer Advisory Panel Pressure Injury Staging System

          Our understanding of pressure injury etiology and development has grown in recent years through research, clinical expertise, and global interdisciplinary expert collaboration. Therefore, the National Pressure Ulcer Advisory Panel (NPUAP) has revised the definition and stages of pressure injury. The revision was undertaken to incorporate the current understanding of the etiology of pressure injuries, as well as to clarify the anatomical features present or absent in each stage of injury. An NPUAP-appointed Task Force reviewed the literature and created drafts of definitions, which were then reviewed by stakeholders and the public, including clinicians, educators, and researchers around the world. Using a consensus-building methodology, these revised definitions were the focus of a multidisciplinary consensus conference held in April 2016. As a result of stakeholder and public input, along with the consensus conference, important changes were made and incorporated into the new staging definitions. The revised staging system uses the term injury instead of ulcer and denotes stages using Arabic numerals rather than Roman numerals. The revised definition of a pressure injury now describes the injuries as usually occurring over a bony prominence or under a medical or other device. The revised definition of a Stage 2 pressure injury seeks to clarify the difference between moisture-associated skin damage and injury caused by pressure and/or shear. The term suspected has been removed from the Deep Tissue Pressure Injury diagnostic label. Each definition now describes the extent of tissue loss present and the anatomical features that may or may not be present in the stage of injury. These important revisions reflect the methodical and collaborative approach used to examine the available evidence and incorporate current interdisciplinary clinical expertise into better defining the important phenomenon of pressure injury etiology and development.
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            Medical Adhesives and Patient Safety

            Skin injury related to medical adhesive usage is a prevalent but underrecognized complication that occurs across all care settings and among all age groups. If proper technique for application and/or removal of adhesive products is not used, tissue trauma can occur, impacting patient safety and quality of life and increasing healthcare costs. Little guidance exists in the literature regarding appropriate selection and proper use of adhesive products to minimize medical adhesive-related skin injury, as well as best practices for skin care preventive strategies, application and removal techniques, and assessment and treatment of such injuries. In an effort to define best practices for prevention of such injury, a consensus panel of 23 recognized key opinion leaders convened to establish consensus statements on the assessment, prevention, and treatment of medical adhesive-related skin injury. The consensus summit was held in December 2012 and was made possible by an unrestricted educational grant from 3M. This document details the consensus definitions and statements and identifies research priorities for development of new adhesive technologies and protocols for skin protection.
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              • Record: found
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              • Article: not found

              Alarm Safety and Alarm Fatigue.

              Clinical alarm systems have received significant attention in recent years following warnings from hospital accrediting and health care technology organizations regarding patient harm caused by unsafe practices. Alarm desensitization or fatigue from frequent, false, or unnecessary alarms, has led to serious events and even patient deaths. Other concerns include settings inappropriate to patient population or condition, inadequate staff training, and improper use or disabling. Research on human factors in alarm response and of functionality of medical devices will help clinicians develop appropriate policies, practices, and device settings for clinical alarms in neonatal intensive care units.
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                Author and article information

                Contributors
                gozdecay@uri.edu
                Journal
                J Signal Process Syst
                J Signal Process Syst
                Journal of Signal Processing Systems
                Springer US (New York )
                1939-8018
                1939-8115
                17 July 2021
                : 1-15
                Affiliations
                [1 ]GRID grid.20431.34, ISNI 0000 0004 0416 2242, Department of Electrical, Computer, and Biomedical Engineering, , University of Rhode Island, ; Kingston, RI USA
                [2 ]GRID grid.20431.34, ISNI 0000 0004 0416 2242, Department of Computer Science and Statistics, , University of Rhode Island, ; Kingston, RI USA
                [3 ]GRID grid.241223.4, Pediatrics, Women and Infants Hospital, ; Providence, RI USA
                [4 ]GRID grid.224260.0, ISNI 0000 0004 0458 8737, School of Nursing, , Virginia Commonwealth University, ; Richmond, VA USA
                [5 ]GRID grid.429997.8, ISNI 0000 0004 1936 7531, Center for Applied Brain and Cognitive Sciences, , Tufts University, ; Medford, MA USA
                [6 ]GRID grid.447266.5, ISNI 0000 0001 2285 171X, Department of Textiles, , Rhode Island School of Design, ; Providence, RI USA
                Author information
                http://orcid.org/0000-0003-1985-1772
                Article
                1669
                10.1007/s11265-021-01669-9
                8286045
                34306304
                54fea176-9efc-4ab8-82ad-f6fb22b05bcb
                © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2021

                This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

                History
                : 6 December 2020
                : 16 April 2021
                : 2 May 2021
                Categories
                Article

                respiration monitoring,e-textiles,textile pressure sensors,nicu,baby monitoring

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