Abstract
Heart rate monitoring is the predominant quantitative health indicator of a newborn in the delivery room. A rapid and accurate heart rate measurement is vital during the first minutes after birth. Clinical recommendations suggest that electrocardiogram (ECG) monitoring should be widely adopted in the neonatal intensive care unit to reduce infant mortality and improve long term health outcomes in births that require intervention. Novel non-contact electrocardiogram sensors can reduce the time from birth to heart rate reading as well as providing unobtrusive and continuous monitoring during intervention. In this work we report the design and development of a solution to provide high resolution, real time electrocardiogram data to the clinicians within the delivery room using non-contact electric potential sensors embedded in a neonatal intensive care unit mattress. A real-time high-resolution electrocardiogram acquisition solution based on a low power embedded system was developed and textile embedded electrodes were fabricated and characterised. Proof of concept tests were carried out on simulated and human cardiac signals, producing electrocardiograms suitable for the calculation of heart rate having an accuracy within ±1 beat per minute using a test ECG signal, ECG recordings from a human volunteer with a correlation coefficient of ~ 87% proved accurate beat to beat morphology reproduction of the waveform without morphological alterations and a time from application to heart rate display below 6 s. This provides evidence that flexible non-contact textile-based electrodes can be embedded in wearable devices for assisting births through heart rate monitoring and serves as a proof of concept for a complete neonate electrocardiogram monitoring system.
Highlights
During birth the cardiorespiratory transition of the foetus from intra- to extrauterine life often involves fast and complex decision making to ensure neonatal survival
If the measured heart rate (HR) is less than 100 beats per minute positive pressure ventilation should be administered and if it is below 60 bpm chest compressions should be initiated [4]
In this study we aim to provide a proof of concept system for ECG monitoring based on a full data acquisition and filtering system and two different materials suitable for use as fabric embedded textile-based electrodes for use in the neonatal intensive care unit (NICU)
Summary
During birth the cardiorespiratory transition of the foetus from intra- to extrauterine life often involves fast and complex decision making to ensure neonatal survival. The clinician counts the number of beats in 6 s and multiplies this by 10 to get the heart rate in beats per minute. These methods provide a rapid acquisition time of 7–19 s [5] and are used for the initial HR assessment. A member of clinical staff is required to administer these tests; noise, stress and cognitive load can influence measurement. These readings can vary as much as 15 bpm from actual HR where errors in HR determination have been shown to occur in 26–48% of initial assessments [6]
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