In neonatal intensive care units (NICU) across the country, premature babies in need of constant monitoring are attached to wires and electrodes that take vital signs of the baby. Electrocardiograms are attached to the chest, while tiny devices that measure blood oxygen saturation, SpO2 are wrapped around the feet. These crucial measurements often come with hassle. It is hard to cuddle babies and do simple tasks like change a diaper, without interfering with the wire systems. It is also invasive for the baby. The tape adhesives for the electrodes irritate the skin, and some babies in the NICU develop scars later in life. An article recently came out with a study that demonstrates a new technology that surpasses the wires and invasive nature of adhesions to infants. Science Magazine produced a research article summary called “Binodal, wireless epidermal electronic systems with in-sensor analytics for neonatal intensive care” about a study that created a wireless and pad that gently adheres to the skin’s surface that continuously transmits accurate vital sign data called ECG EES and PPG EES. I am interested in this study because as a nursing student, this technology could develop to a wide variety of patients and change patient care for the better. So now I wonder in what ways will EES pads benefit infants in the NICU?
There are a couple ways the innovation of the ECG EES will be beneficial to infants and infant care units. One of the beneficial properties is how gentle the pad is on neonate’s skin. For patients being admitted to the NICU, one would not think some of the most damage a neonate can suffer is from abrasion of the skin. Removing sticky electrodes on the skin’s surface can cause up to “15% of a neonate’s total skin surface area can be traumatized daily”(Chung et al, 6). Infants in the NICU are at high risk for damage, “by age 7, more than 90% of children born preterm (<30 weeks gestation) and previously cared for in the NICU exhibit residual scars secondary to monitoring probes, adhesives, and invasive medical interventions”(Chung et al, 6). Before testing it on a skin’s surface, research teams tested the adhesion pad in a variety of ways to find what aspects of mechanical stress the pad would be undertaking. The reason to test for mechanical stresses is to show how the EES devices “ decrease risks for skin injury relative to existing clinical standards”( Chung et al, 6). They tested EES pads that included microfluidic and did not include microfluid. “..Microfluidic chambers provide mechanical isolation between interconnected components and the skin” ( Chung et al, 2). Shear and normal stress was tested between the ECG EES and the skin, and as shown in the image below, the test with the ECG EES containing microfluid are less than the skin’s threshold of sensation : ~20kPa. This means that when stress is applied to the ECG EES pads that contain microfluidic chambers, the stress won’t affect the infant’s skin.
One of the reasons the application of this study is so important in the world of medicine, is how new technology will benefit the patients. Because they have designed devices with compassion that leads to better care for the infants, healthier babies will be the outcome. The neonates benefit from non invasive wireless data collector pads because they will physically be healthier by not getting their skin ripped off and be will given more skin to skin contact as a result of ECG EES. Having skin to skin contact, or being able to cuddle a baby stabilizes the infant more quickly. Below is an image of the EES device being put to use so a mother can hold the infant without a jumble of wires.
Another important aspect of these wireless devices are the accuracy of what they measure. The devices were tested against the gold standard of measurements, or clinical standard readings. For example, the heart rate, respiratory rate and temperature were measured and compared. The accuracy is obviously seen in the images below. After doing extensive lab testing for these products, volunteer adult participants vital signs were measured using normal gold standard operations and ECG EES devices.
They used this data to show the validity of the ECG EES technology on healthy adult volunteers to be further advanced to clinical trials. They then did the same test on healthy neonates, and measured vital signs against gold standards, mechanical force applied to skin, and compatibility when submerged in water. This further exemplifies the robustness of this study because as it goes through each stage of testing, the results are still safe and accurate. An important consideration for this developing technology is expense. While the ECG EES devices are as accurate and safer for infants compared to regular electrode monitoring, advancements in technology can get expensive and may reach to only better funded hospitals. However, the article argues once fully developed, the cost will become less than $20.00 USD, and therefore become common in US hospitals. Because the devices are also reusable, there will be greater potential to distribute in developing countries. That being said, large companies who may buy the technology can charge more and it may not get distributed to those in need.
This research went through years of lab testing and is in the middle of clinical trials. This technology not only has the capability of helping infants in the NICU become healthier by taking away the harmful adhesives and allowing more skin to skin contact, but also by helping nurses with constant monitoring of temperature, ECG, and heart rate. ECG EES devices are reusable, which will benefit the waste hospitals produce and can be implemented in other units of a hospital setting. It may be a new learning curve to apply these devices to NICU units, but in the end it will be favorable.
Resources:
Chung, Ha Uk. “Binodal, Wireless Epidermal Electronic Systems With In-Sensor Analytics For Neonatal Intensive Care”. Science.Sciencemag.Org, 2019, http://science.sciencemag.org/content/sci/363/6430/eaau0780.full.pdf. Accessed 1 Mar 2019.
Data/Society/Decision-making Spring 2019 