Abstract

To describe and test the accuracy of respiratory rate assessment in long-term surveillance using an open-source infant wearable, NAPping PAnts (NAPPA). We recorded 24 infants aged 1-9months using our newly developed infant wearable that is a diaper cover with an integrated programmable electronics with accelerometer and gyroscope sensors. The sensor collects child's respiration rate (RR), activity and body posture in 30-s epochs, to be downloaded afterwards into a mobile phone application. An automated RR quality measure was also implemented using autocorrelation function, and the accuracy of RR estimate was compared with a reference obtained from the simultaneously recorded capnography signal that was part of polysomnography recordings. Altogether 88h 27min of data were recorded, and 4147 epochs (39% of all data) were accepted after quality detection. The median of patient wise mean absolute errors in RR estimates was 1.5 breaths per minute (interquartile range 1.1-2.6bpm), and the Blandt-Altman analysis indicated an RR bias of 0.0bpm with the 95% limits of agreement of -5.7-5.7bpm. Long-term monitoring of RR and posture can be done with reasonable accuracy in out-of-hospital settings using NAPPA, an openly available infant wearable.

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