Abstract
Respiratory rate (RR) has been shown to be a reliable predictor of cardio-pulmonary deterioration, but standard RR monitoring methods in the neonatal intensive care units (NICU) with contact leads have been related to iatrogenic complications. Video-based monitoring is a potential non-contact system that could improve patient care. This iterative design study developed a novel algorithm that produced RR from footage analyzed from stable NICU patients in open cribs with corrected gestational ages ranging from 33 to 40 weeks. The final algorithm used a proprietary technique of micromotion and stationarity detection (MSD) to model background noise to be able to amplify and record respiratory motions. We found significant correlation—r equals 0.948 (p value of 0.001)—between MSD and the current hospital standard, electrocardiogram impedance pneumography. Our video-based system showed a bias of negative 1.3 breaths and root mean square error of 6.36 breaths per minute compared to standard continuous monitoring. Further work is needed to evaluate the ability of video-based monitors to observe clinical changes in a larger population of patients over extended periods of time.
Highlights
The drive and control of breaths is an intricate system involving the circulatory, pulmonary, and central nervous systems
Effective ventilation is the key objective in neonatal resuscitation, and Respiratory rate (RR) is included in all early warning systems for neonatal sepsis and necrotizing enterocolitis [2,3]
Spirometry, is designed to measure lung volumes, and respiratory inductance plethysmography (RIP) is currently used in neonates to detect airway obstruction and for sleep apnea monitoring as it accurately records respiratory waveforms over time [5]
Summary
The drive and control of breaths is an intricate system involving the circulatory, pulmonary, and central nervous systems. The gold standard for measuring RR is counting breaths for a minute while auscultating the patient or palpating for chest rise. While this is the most accurate, it is time consuming and not practical for an intensive care unit where continuous vital signs monitoring is required. Inventions measured breaths by airflow into a device, spirometry, or by attaching a circumferential strap around the chest, respiratory inductance plethysmography (RIP). Spirometry, is designed to measure lung volumes, and RIP is currently used in neonates to detect airway obstruction and for sleep apnea monitoring as it accurately records respiratory waveforms over time [5]
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