Phase I results demonstrated a non-contact device that could sense the respiration rate (RR) and heart rate (HR) of infants confined to a neonatal intensive care unit (NICU) at the University of Virginia. Electrodes are presently the standard of care, but are themselves the cause of infections and skin tearing due to the sensitive nature of premature infant skin. Many infants of very low birth weight cannot use skin-based electrodes at all and must rely on pulse oxcimetry at the hand, which does not provide RR. Home monitors for apnea of prematurity (AOP) also rely on electrodes and further require accurately positioned, carefully tightened chest belts, attention to electrical connections, and the hazard of wires bound to the infant. We propose testing of six mattress monitors for infants weighing less than 1500 g and six for infants near discharge, but suffering AOP. The latter will provide statistics on the likelihood of success for a home monitor. The new device will be compared with the Collaborative Home Infant Monitor Evaluation (CHIME) monitoring device for which performance statistics are known. Two units will be installed in the birthing rooms for nearly instantaneous readings of HR and RR. No current devices fill this need. These modified mattress pads will record all breathing and heartbeat signals along with episodes of sneezing, apnea, and coughing. Improvements in the sensor system include an electronic pre-filter to attenuate the very large respiratory signal relative to the heartbeat signal. This reduces the second harmonic contribution of RR so as to interfere less with HR. The first part of the Phase II effort will improve the signal processing algorithms using Gauss-Hermite wavelet analysis to separate HR & RR signals in periods of competing noise caused by sneezing, coughing, gross movement, and apnea. RR & RR wavelet filters will be constructed. The transforms will operate in real time and a visual display will be provided. The objective of this work is to eliminate or augment ECG electrodes both in the NICU and the home for the important clinical exercise of close monitoring of infants at risk. ? ? ?
