Respiratory Monitoring Research Articles

What’s hot in neonatal respiratory monitoring?

Impact Respiratory monitoring is an essential part of routine clinical care of the newborn. Recent technological developments have improved respiratory monitoring and allowed for a two-way interaction between the monitored parameter and the level of the provided respiratory support. We herein discuss applications of monitoring by neurally adjusted ventilatory assist, closed-loop oxygen control, tidal capnography, lung ultrasound, diaphragmatic electromyography and lung magnetic resonance imaging.

Respiratory frequency and activity monitoring using Fibre Bragg Grating arrays

Respiratory frequency and activity monitoring using Fibre Bragg Grating arrays

Humidity Sensing Using Polymers: A Critical Review of Current Technologies and Emerging Trends

In the post-pandemic era, human demand for a healthy lifestyle and a smart society has surged, leading to vibrant growth in the field of flexible electronic sensor technology for health monitoring. Flexible polymer humidity sensors are not only capable of the real-time monitoring of human respiration and skin moisture information but also serve as a non-contact human–machine interaction method. In addition, the development of moist-electric generation technology is expected to break free from the traditional reliance of flexible electronic devices on power equipment, which is of significant importance for the miniaturization, reliability, and environmentally friendly development of flexible devices. Currently, flexible polymer humidity sensors are playing a significant role in the field of wearable electronic devices and thus have attracted considerable attention. This review begins by introducing the structural types and working principles of various humidity sensors, including the types of capacitive, impedance/resistive, frequency-based, fiber optic, and voltage-based sensors. It mainly focuses on the latest research advancements in flexible polymer humidity sensors, particularly in the modification of humidity-sensitive materials, sensor fabrication, and hygrosensitivity mechanisms. Studies on material composites including different types of polymers, polymers combined with porous nanostructured materials, polymers combined with metal oxides, and two-dimensional materials are reviewed, along with a comparative summary of the fabrication and performance mechanisms of related devices. This paper concludes with a discussion on the current challenges and opportunities faced by flexible polymer humidity sensors, providing new research perspectives for their future development.

A 3-D-Printed Multiparametric Wearable System Based on Fiber Bragg Gratings for Shoulder Movement and Respiratory Rate Monitoring

A 3-D-Printed Multiparametric Wearable System Based on Fiber Bragg Gratings for Shoulder Movement and Respiratory Rate Monitoring

Respiratory Disease Surveillance in the Middle East and Latin America during the COVID-19 Pandemic, 2020-2022.

Characterizing the epidemiology of circulating respiratory pathogens during the COVID-19 pandemic could clarify the burden of acute respiratory infections and monitor outbreaks of public health and military relevance. The US Department of Defense supported 2 regions for influenza-like illness and severe acute respiratory infections surveillance, one in the Middle East through US Naval Medical Research Unit EURAFCENT, and another in Latin America through US Naval Medical Research Unit SOUTH. During 2020‒2022, coinciding with the COVID-19 pandemic, we collected a total of 16,146 nasopharyngeal and oropharyngeal swab samples from sentinel sites in Jordan (n = 11,305) and Latin America (n = 4,841). Samples were tested for SARS-CoV-2, influenza, and other respiratory pathogens. SARS-CoV-2 was the most frequently detected pathogen during 2020; other respiratory pathogens had distinct temporal and frequency distributions according to geographic location. Our findings support the need for continued sentinel surveillance as a vital tool for assessing the burden of respiratory diseases globally.

Noncontace Monitoring of Respiration and Heartbeat Based on Two-Wave Model Using a Millimeter-Wave MIMO FM-CW Radar

This paper deals with the non-contact measurement of heartbeat and respiration using a millimeter-wave multiple-input–multiple-output (MIMO) frequency-modulated continuous-wave (FM-CW) radar. Monitoring heartbeat and respiration is useful for detecting cardiac diseases and understanding stress levels. Contact sensors are not suitable for these sorts of long-term measurements due to the discomfort and skin irritation they cause. Therefore, the use of non-contact sensors, such as radars, is desirable. In this study, we obtained heartbeat and respiration information from phase data measured using a millimeter-wave MIMO FM-CW radar. We propose a two-wave model based on a Fourier series expansion and extract respiration and heartbeat information as a minimization problem. This model makes it possible to produce respiration and heartbeat waveforms. The produced heartbeat waveform can be used for estimating the interbeat interval (IBI). Experiments were conducted to confirm the usefulness of the proposed method. Moreover, the estimated results were compared with the contact sensor’s results. The results for both types of sensors were in good agreement.

The Role of Respiratory Therapy in Rib Fracture Management

Respiratory therapy (RT) is a key component of modern rib fracture management. This practice encompasses a broad set of nonoperative measures including respiratory monitoring, oxygenation and ventilatory support, device and non-device based maneuvers, and pharmacologic treatments. Despite limited evidence, a number of these measures have demonstrated benefit in patients with traumatic rib fractures, leading to societal recommendations for inclusion in multimodal protocols for rib fracture management.

Mycobacterium abscessus pulmonary infection and associated respiratory function in cystic fibrosis-like βENaC mice

IntroductionChronic pulmonary infection with Mycobacterium abscessus (M. abscessus) is a significant cause of morbidity and mortality in people with cystic fibrosis (CF). Developing an animal model of M. abscessus pulmonary infection, especially under CF conditions, is essential to understanding clinical pulmonary M. abscessus infection. βENaC transgenic mice are known to develop spontaneous CF-like disease characterized by airway mucus obstruction and inflammation. The aim of this study was to evaluate the suitability of βENaC mice as a preclinical model and characterize their respiratory function during M. abscessus lung infection.MethodsMice received an intrapulmonary aerosol of M. abscessus using a high-pressure syringe device (Penn-Century) for subsequent characterization of disease progression and respiratory function. Whole body unrestrained plethysmography (WBP) data was collected to monitor lung function and endpoints determined organ bacterial burden and associated pathology.ResultsEndpoint CFU data in the lung and spleen showed that there was no significant difference in bacterial clearance between βENaC and WT mice. WBP data showed an impairment in overall respiratory function during and after M. abscessus infection in both strains of mice. Interestingly, even in wildtype control mice, lung dysfunction persisted after bacterial clearance.DiscussionEven with CF-like features, the βENaC transgenic mice cleared M. abscessus at a similar rate than WT mice, however, the associated respiratory monitoring revealed that there are long-term implications of M. abscessus lung exposure. The clear decline in respiratory function, even after M. abscessus clearance, suggests that WBP coupled animal modeling provides important insight that is relevant to disease burden and treatment efficacy. The M. abscessus clearance in the βENaC mice may help improve the fields understanding of CF-modulated immune deficiencies in M. abscessus pulmonary infection.

Constructing Long and Stable Ag‐Al2O3 Core–Shell Nanowires for Humidity Sensing and Triboelectric Energy Generation

Silver nanowires (AgNWs) are a promising alternative material to indium tin oxide as flexible transparent electrodes owing to their excellent optoelectrical properties and mechanical performance. However, the main challenge is the poor stability under diverse environments, ranging from high humidity, chemical exposure, and dynamic mechanical deformation. Herein, ultralong AgNWs (≈100 μm) have been synthesized via controlling growth kinetics by a facile acetic acid‐assisted solvothermal method, further decorated with a thin Al2O3 layer by electrodeposition to form a core–shell architecture. The resultant films based on Ag‐Al2O3 core–shell nanowires (NWs) possess a higher conductivity while preserving the optical transparency due to the enhanced NWs contact. More importantly, the constructed films exhibit strong resistance to various conditions, such as exposure to high temperature/humidity and immersion in NaCl, HCl, and Na2S solutions. The laser‐etched interdigital electrodes based on the chemically stable AgNWs are further integrated with graphene oxide layer for humidity sensing and respiration monitoring. Furthermore, the developed NWs with superior mechanical stability are constructed as triboelectric nanogenerators for electricity generation, and reliable output performance has been demonstrated. This work provides a convenient, scalable, and cost‐effective solution that offers great potential for designing robust, transparent electrodes for next‐generation flexible electronics.

Respiratory monitoring via a nanoporous film-coated tilted fiber Bragg grating humidity sensor.

A humidity sensor for respiratory monitoring based on a tilted fiber Bragg grating (TFBG) functionalized with a nanoporous coating consisting of titanium carbide (Ti2C) and fullerene (C60) is proposed. By incorporating the C60 into Ti2C, a nanocomposite film with abundant three-dimensional porousness is coated on the TFBG surface. The nanocomposite film with strong hygroscopicity and desorption properties is highly sensitive to environmental humidity variations, where the induced refractive index changes of the coating result in the spectral responses of TFBG multi-resonances. Experimental results show that the sensitivity of the sensor is as high as 0.055 dB/%RH in the relative humidity range of 10-90%RH with the response and recovery time of 0.59 and 0.91 s, respectively. Furthermore, the humidity sensor was successfully used to perform in vivo respiratory monitoring of the humans.

Neuron-Inspired Flexible Phase Change Materials for Ambient Energy Harvesting and Respiration Monitoring.

The global energy crisis and climate change pose unprecedented challenges. Wearable devices with personal thermoregulation and energy harvesting hold great promise for achieving energy savings and human thermal comfort. Here, inspired by neurons, a novel phase change material (PCM) is reported for efficient energy harvesting and respiratory monitoring via a self-assembly strategy. The use of gum arabic (GA) enabled the encapsulation of polyethylene glycol (PEG) and the targeted distribution of carboxylated multi-walled carbon nanotubes (cMWCNTs) simultaneously in poly (ethylene vinyl acetate) (EVA) matrix. The material exhibits an outstanding toughness value of 14.88MJ m-3 and high elongation at a break of 565.67%, exhibiting remarkable flexibility. The material with sufficient melting enthalpy (71.11 J g-1) demonstrates high photothermal conversion efficiency (95.27%) under 808nm laser irradiation (105mW cm-2). In addition, due to the synergistic effect of GA and PEG, especially the formation of microdome structures on the surface, the material demonstrates ultrasensitive humidity responsiveness for respiratory monitoring with high precision, excellent repeatability, and fast response/recovery time (50.4/50.5ms). Notably, it shows great potential for moisture-electric generators (MEGs) with the function of non-contact sensing. This material opens the path toward next-generation wearable devices in energy conversion and health monitoring.

High-Performance Supercapacitive Pressure Sensors via Height-Grading Micro-Domes of Ionic Conductive Elastomer.

Soft capacitive sensors present numerous appealing characteristics, including simple structure, low power consumption, and fast response. However, they often suffer from low sensitivity and a limited linear sensing range. Herein, a concept is presented to enhance the sensitivity and linearity of supercapacitive pressure sensors by functionally grading the heights of macrodomes constructed from a highly elastic and ionic conductive elastomer made of poly(vinyl alcohol) and phosphoric acid (PVA/H3PO4). The resultant supercapacitive sensors exhibit a high sensitivity (423.42 kPa-1), wide linear sensing range (0-400 kPa), ultralow limit of detection (0.48 Pa), and high durability (stable signal outputs up to 5000 cycles of loading/unloading). Additionally, the sensors can maintain consistent sensing performance within a temperature range of 25-40 °C. The potential of the sensor in health monitoring is demonstrated through ultrahigh-resolution weight measurement, pulse detection, and respiration monitoring.

Ultra-compact dual-channel integrated CO2 infrared gas sensor

Expiratory CO2 concentrations can directly reflect human physiological conditions, and their detection is highly important in the treatment and rehabilitation of critically ill patients. Existing respiratory gas analyzers suffer from large sizes and high power consumption due to the limitations of the internal CO2 sensors, which prevent them from being wearable to track active people. The internal and external interference and sensitivity limitations must be overcome to realize wearable respiratory monitoring applications for CO2 sensors. In this work, an ultra-compact CO2 sensor was developed by integrating a microelectromechanical system emitter and thermopile detectors with an optical gas chamber; the power consumption of the light source and ambient temperature of the thermally sensitive devices were reduced by heat transfer control; the time to reach stabilization of the sensor was shortened; the humidity resistance of the sensor was improved by a dual-channel design; the light loss of the sensor was compensated by improving the optical coupling efficiency, which was combined with the amplitude trimming network to equivalently improve the sensitivity of the sensor. The minimum size of the developed sensor was 12 mm × 6 mm × 4 mm, and the reading error was <4% of the reading from −20 °C to 50 °C. The minimum power consumption of the sensor was ~33 mW, and the response time and recovery time were 10 s (@1 Hz), and the sensor had good humidity resistance, stability, and repeatability. These results indicate that the CO2 sensor developed using this strategy has great potential for wearable respiratory monitoring applications.

Clinical implementation of advanced respiratory monitoring with esophageal pressure and electrical impedance tomography: results from an international survey and focus group discussion

BackgroundPopularity of electrical impedance tomography (EIT) and esophageal pressure (Pes) monitoring in the ICU is increasing, but there is uncertainty regarding their bedside use within a personalized ventilation strategy. We aimed to gather insights about the current experiences and perceived role of these physiological monitoring techniques, and to identify barriers and facilitators/solutions for EIT and Pes implementation.MethodsQualitative study involving (1) a survey targeted at ICU clinicians with interest in advanced respiratory monitoring and (2) an expert focus group discussion. The survey was shared via international networks and personal communication. An in-person discussion session on barriers, facilitators/solutions for EIT implementation was organized with an international panel of EIT experts as part of a multi-day EIT meeting. Pes was not discussed in-person, but we found the focus group results relevant to Pes as well. This was confirmed by the survey results and four additional Pes experts that were consulted.ResultsWe received 138 survey responses, and 26 experts participated in the in-person discussion. Survey participants had diverse background [physicians (54%), respiratory therapists (19%), clinical researchers (15%), and nurses (6%)] with mostly > 10 year ICU experience. 84% of Pes users and 74% of EIT users rated themselves as competent to expert users. Techniques are currently primarily used during controlled ventilation for individualization of PEEP (EIT and Pes), and for monitoring lung mechanics and lung stress (Pes). EIT and Pes are considered relevant techniques to guide ventilation management and is helpful for educating clinicians; however, 57% of EIT users and 37% of Pes users agreed that further validation is needed. Lack of equipment/materials, evidence-based guidelines, clinical protocols, and/or the time-consuming nature of the measurements are main reasons hampering Pes and EIT application. Identified facilitators/solutions to improve implementation include international guidelines and collaborations between clinicians/researcher and manufacturers, structured courses for training and use, easy and user-friendly devices and standardized analysis pipelines.ConclusionsThis study revealed insights on the role and implementation of advanced respiratory monitoring with EIT and Pes. The identified barriers, facilitators and strategies can serve as input for further discussions to promote the development of EIT-guided or Pes-guided personalized ventilation strategies.

Continuous Monitoring of Soil Respiration After a Prescribed Fire: Seasonal Variations in CO2 Efflux

Prescribed burns have recently become a widespread environmental management practice for biodiversity restoration to reduce fuel load, to provide forest fire suppression operational opportunities, to favor plant recruitment or to manage wild species. Prescribed fires were again applied in Doñana National Park (southern Spain) after decades of non-intervention regarding fire use. Here, we assessed their impacts on the soil CO2 effluxes over two years after burning to test the hypothesis that if the ecosystem is resilient, soil respiration will have a rapid recovery to the conditions previous to the fire. Using soil automated CO2 flux chambers to continuously measure respiration in burned and unburned sites, we showed that soil respiration varies among seasons but only showed significant differences between burned and unburned plots in the fall season one year after fire, which corresponded with the end of the dry season. Comparing soil respiration values from the burned plots in the three fall seasons studied, soil respiration increased significantly in the fall one year after fire, but decreased in the following fall to the values of the control plots. This study highlights the resilience of soil respiration after prescribed fire, showing the potential benefits of prescribed fire to reduce catastrophic wildfires, especially in protected areas subjected to non-intervention.

The Impact of Lung Function on Sleep Monitoring in Obstructive Sleep Apnea Associated with Obstructive Lung Diseases: Insights from a Clinical Study.

Background/Objectives: Obstructive sleep apnea (OSA) and obstructive lung diseases (OLD) are common and interdependent respiratory disorders, where one condition may contribute to the development and worsening of the other (OLDOSA syndrome). The term OLDOSA syndrome includes two different conditions: Overlap syndrome (OVS: OSA + chronic obstructive pulmonary disease, COPD) and Alternative Overlap syndrome (aOVS: OSA + Asthma). Data on the interactions between lung function and respiratory monitoring during sleep in OLDOSA patients are few and controversial. Our study aims to evaluate the impact of lung function impairment on sleep breathing disorders, paying attention to the lack of literature about comparisons between OVS, aOVS, and the impact of small airways disease (SAD) in these patients. Methods: In total, 101 patients with a diagnosis of OSA and asthma or COPD underwent pulmonary function tests (PFTs) and nocturnal home sleep cardiorespiratory monitoring (HSCM). Exclusion criteria: Obesity hypoventilation syndrome (OHS) and other non-respiratory sleep disorders. Results: Sleep time with oxygen saturation below 90% (T90) was negatively correlated with forced expiratory volume in the first second, % of predicted (%FEV1), forced vital capacity, % of predicted (%FVC), forced expiratory flow at 25-75% of the pulmonary volume, % of predicted (%FEF25-75), and, after multivariable linear regression analysis, %FEF25-75 remained an independent factor for T90 with a negative correlation in mild and moderate OSA. Obstructive apnea index (oAI) and FEV1/FVC were negatively correlated in mild and moderate OSA. OVS presented with more severe OSA (higher AHI, oAI, and T90) and SAD (lower FEF25-75) compared to aOVS. Conclusions: This study highlights a possible interdependence between OLD and OSA; obstruction of the large and small airways at PFTs contributes to the worsening of these patients' nocturnal hypoxemia and obstructive events of the upper airway during sleep. Furthermore, this study shows that patients with OVS should be carefully monitored, as they present worse data at HSCM and have greater small airways involvement compared to aOVS.

Camera-Based Respiratory Imaging System for Monitoring Infant Thoracoabdominal Patterns of Respiration.

Existing respiratory monitoring techniques primarily focus on respiratory rate measurement, neglecting the potential of using thoracoabdominal patterns of respiration for infant lung health assessment. To bridge this gap, we exploit the unique advantage of spatial redundancy of a camera sensor to analyze the infant thoracoabdominal respiratory motion. Specifically, we propose a camera-based respiratory imaging (CRI) system that utilizes optical flow to construct a spatio-temporal respiratory imager for comparing the infant chest and abdominal respiratory motion, and employs deep learning algorithms to identify infant abdominal, thoracoabdominal synchronous, and thoracoabdominal asynchronous patterns of respiration. To alleviate the challenges posed by limited clinical training data and subject variability, we introduce a novel multiple-expert contrastive learning (MECL) strategy to CRI. It enriches training samples by reversing and pairing different-class data, and promotes the representation consistency of same-class data through multi-expert collaborative optimization. Clinical validation involving 44 infants shows that MECL achieves 70% in sensitivity and 80.21% in specificity, which validates the feasibility of CRI for respiratory pattern recognition. This work investigates a novel video-based approach for assessing the infant thoracoabdominal patterns of respiration, revealing a new value stream of video health monitoring in neonatal care.

Integrated One-Step Fabrication of Protonic Sensing Devices for Respiratory Monitoring.

The development of direct fabrication routes with seamless integration of both the macro/micropatterning process and nanostructure synthesis is crucial for the commercial realization of cost-effective nanoscale sensor devices. This, if realized, can liberate us from the conventional limitations inherent in nanoscale device manufacturing. Specifically, such fabrication routes can, in principle, address the challenges such as the complexity, multistep nature, and substantial costs associated with existing technologies, which are not suitable for widespread market adoption in everyday-use devices. Herein, we propose a novel yet facile one-step fabrication approach that simultaneously accomplishes both patterning and nanostructure synthesis by employing low-power, cost-effective laser technology with a minimal environmental footprint. Versatile in nature, this approach can enable the incorporation of diverse functionalities spanning a broad spectrum of technologies, encompassing fields such as sensors, catalysts, photonics, energy storage, and biomedical monitoring devices. As a proof of concept, using our approach, we fabricated an ultra responsive, high-speed protonic sensing device for real-time respiratory monitoring. The enhanced temporal characteristics of our as-fabricated device, particularly in the relative humidity levels of interest in breath monitoring (typically over 55%), exhibited a superior response/recovery time in rapid humidity fluctuations. We envisage that the advantages brought by the presented fabrication approach can pave the way to establish a new method for inexpensive large-scale functional-material-based device fabrication.

Development and Validation of a Portable EIT System for Real-Time Respiratory Monitoring.

This work contributes to the improvement of novel medical technologies for the prevention and treatment of diseases. Electrical impedance tomography (EIT) has gained attention as a valuable tool for non-invasive monitoring providing real-time insights. The purpose of this work is to develop and validate a novel portable EIT system with a small form factor for respiratory monitoring. The device uses a 16-electrode architecture with adjacent stimulation and measurement patterns, an integrated circuit current source and a single high-speed ADC operating with multiplexers to stimulate and measure across all electrodes. Tests were conducted on 25 healthy subjects who performed a pulmonary function test with a flowmeter while using the EIT device. The results showed a good performance of the device, which was able to recognize all respirations correctly, and from the EIT signals and images, correlations of 96.7% were obtained for instantaneous respiratory rate and 96.1% for tidal volume prediction. These results validate the preliminary technical feasibility of the EIT system and demonstrates its potential as a reliable tool for non-invasive respiratory assessment. The significance of this work lies in its potential to democratize advanced respiratory monitoring technologies, making them accessible to a wider population, including those in remote or underserved areas.

Real time respiration monitoring using a highly sensitive wearable mesoporous ZnO@KIT-5 humidity sensor

Real time respiration monitoring using a highly sensitive wearable mesoporous ZnO@KIT-5 humidity sensor