Skin-interfacing wearable biosensors for smart health monitoring of infants and neonates
Campbell-Yeo, M., Disher, T., Benoit, B. & Johnston, C. Understanding kangaroo care and its benefits to preterm infants. Pediatric Health Med. Therapeutics 15, (2015).
Lund, C. Medical adhesives in the NICU. Newborn Infant Nursing Rev. 14, 160–165 (2014).
Google Scholar
Low Birth Weight. Stanford Medicine Children’s Health – Lucile Packard Children’s Hospital. (2%2C500%20grams). (Accessed Nov 2023).
Finn, D., Boylan, G. B., Ryan, C. A. & Dempsey, E. M. Enhanced monitoring of the preterm infant during stabilization in the delivery room. Front. Pediatr. 4, 30 (2016).
Google Scholar
Cruz, M. D., Fernandes, A. M. & Oliveira, C. R. Epidemiology of painful procedures performed in neonates: a systematic review of observational studies. Eur. J. Pain 20, 489–498 (2016).
Stamatas, G. N., Nikolovski, J., Luedtke, M. A., Kollias, N. & Wiegand, B. C. Infant skin microstructure assessed in vivo differs from adult skin in organization and at the cellular level. Pediatr. Dermatol. 27, 125–131 (2010).
Google Scholar
Lund, C. H. et al. Disruption of barrier function in neonatal skin associated with adhesive removal. J. Pediatrics 131, 367–372 (1997).
Google Scholar
Darmstadt, G. L. et al. Infection control practices reduce nosocomial infections and mortality in preterm infants in Bangladesh. J. Perinatol. 25, 331–335 (2005).
Google Scholar
Kim, D.-H. et al. Epidermal electronics. Science 333, 838–843 (2011).
Google Scholar
Chircov, C. & Grumezescu, A. M. Microelectromechanical systems (MEMS) for biomedical applications. Micromachines (Basel) 13, 164 (2022).
Yeo, W. H. et al. Multifunctional epidermal electronics printed directly onto the skin. Adv. Mater. 25, 2773–2778 (2013).
Google Scholar
Kim, Y. S. et al. All‐in‐one, wireless, stretchable hybrid electronics for smart, connected, and ambulatory physiological monitoring. Adv. Sci. 6, 1900939 (2019).
Google Scholar
Fan, J. A. et al. Fractal design concepts for stretchable electronics. Nat. Commun. 5, 3266 (2014).
Google Scholar
Arumugam, V., Naresh, M. D. & Sanjeevi, R. Effect of strain rate on the fracture behaviour of skin. J. Biosci. 19, 307–313 (1994).
Google Scholar
Lund, C. & Tucker, J. A. in Neonatal Skin: Structure and Function 2nd edn (eds. Hoath, S. B. & Maibach, H. I.) 299–324 (Marcel Dekker, Inc., 2003).
Pocius, A. V. The relationship of Fundamental Forces of Adhesion and Practical Adhesion. In Adhesion and Adhesives Technology: An Introduction 3rd edn. 99–103 (Hanser Publications, Cincinnati, Ohio, 2012).
Chung, H. U. et al. Skin-interfaced biosensors for advanced wireless physiological monitoring in neonatal and pediatric intensive-care units. Nat. Med. 26, 418–429 (2020).
Google Scholar
Xue, Y. et al. Trigger‐detachable hydrogel adhesives for bioelectronic interfaces. Adv. Funct. Mater. 31, 2106446 (2021).
Google Scholar
Kwak, S. S. et al. Skin‐integrated devices with soft, holey architectures for wireless physiological monitoring, with applications in the neonatal intensive care unit. Adv. Mater. 33, 2103974 (2021).
Google Scholar
Wang, C. et al. Mussel inspired trigger-detachable adhesive hydrogel. Small 18, 2200336 (2022).
Google Scholar
Swanson, S. et al. Prototype development of a temperature-sensitive high-adhesion medical tape to reduce medical-adhesive-related skin injury and improve quality of care. Int. J.Mol. Sci. 23, 7164 (2022).
Google Scholar
Jinkins, K. R. et al. Thermally switchable, crystallizable oil and silicone composite adhesives for skin-interfaced wearable devices. Sci. Adv. 8, eabo0537 (2022).
Google Scholar
Jakubas, A., Łada-Tondyra, E. & Nowak, M. Textile sensors used in smart clothing to monitor the vital functions of young children. In: 2017 Progress in Applied Electrical Engineering (PAEE) 25–30 June 2017, 1–4. (2017).
Jakubas, A. & Łada-Tondyra, E. A study on application of the ribbing stitch as sensor of respiratory rhythm in smart clothing designed for infants. J. Textile Inst. 109, 1208–1216 (2018).
Google Scholar
Bouwstra, S., Chen, W., Feijs, L. & Oetomo, S. B. Smart jacket design for neonatal monitoring with wearable sensors. In: 2009 Sixth International Workshop on Wearable and Implantable Body Sensor Networks 3–5 June 2009, 162–167. (2009).
Alzaidi, A. Bajwa, H. Patra, P. & Zhang, L. Noncontact Textile Electrodes for Wireless ECG System 1–5 (2013).
Linti, C., Horter, H. Osterreicher, P. & Planck, H. Sensory baby vest for the monitoring of infants. In: International Workshop on Wearable and Implantable Body Sensor Networks (BSN’06) 3–5 April 2006, 3–137 (2006).
Cay, G. et al. Baby-guard: an IoT-based neonatal monitoring system integrated with smart textiles. In 2021 IEEE International Conference on Smart Computing (SMART COMP). 129–136 (IEEE, 2023).
Chen, W. et al. Design of an integrated sensor platform for vital sign monitoring of newborn infants at neonatal intensive care units. J. Healthcare Eng. 1, 124270 (2010).
Patron, D. et al. On the use of knitted antennas and inductively coupled RFID tags for wearable applications. IEEE Trans. Biomed. Circuits Syst. 10, 1047–1057 (2016).
Google Scholar
Pan, J. & Tompkins, W. J. A real-time QRS detection algorithm. IEEE Trans. Biomed. Eng. 32, 230–236 (1985).
Google Scholar
Kim, Y. S. et al. Wireless, skin-like membrane electronics with multifunctional ergonomic sensors for enhanced pediatric care. IEEE Trans. Biomed. Eng. 67, 2159–2165 (2020).
Google Scholar
Chung, H. U. et al. Binodal, wireless epidermal electronic systems with in-sensor analytics for neonatal intensive care. Science 363, 6430 (2019).
Google Scholar
Iyer, K. K. et al. Early detection of preterm intraventricular hemorrhage from clinical electroencephalography Crit. Care Med. 43, [Online]. Available: (2015).
El-Dib, M. et al. Neuromonitoring in neonatal critical care part II: extremely premature infants and critically ill neonates. Pediatric Res. 94, 55–63 (2023).
Google Scholar
Ibrahim, Z. H. et al. Wireless multichannel electroencephalography in the newborn. J. Neonatal-Perinatal Med. 9, 341–348 (2016).
Google Scholar
Asayesh, A., Ilen, E., Metsäranta, M. & Vanhatalo, S. Developing disposable EEG cap for infant recordings at the neonatal intensive care unit. Sensors 22, 7869 (2022).
Google Scholar
Askari, S., Bastany, Z., Holsti, L. & Dumont, G. D. Lighting up babies’ brains: development of a combined NIRS/EEG system for infants. In Proc. SPIE 11638, Biophotonics in Exercise Science, Sports Medicine, Health Monitoring Technologies, and Wearables II (eds Shadgan, B. & Gandjbakhche, A. H.) 116380N (SPIE, 2021).
Wong, J. N. et al. A comprehensive wireless neurological and cardiopulmonary monitoring platform for pediatrics. PLOS Digital Health 2, e0000291 (2023).
Google Scholar
Mullen, T. R. et al. Real-time neuroimaging and cognitive monitoring using wearable dry EEG. IEEE Trans. Biomed. Eng. 62, 2553–2567 (2015).
Google Scholar
Grozea, C., Voinescu, C. D. & Fazli, S. Bristle-sensors-low-cost flexible passive dry EEG electrodes for neurofeedback and BCI applications. J. Neural Eng. 8, 025008 (2011).
Google Scholar
Beć, K. B., Grabska, J. & Huck, C. W. Near-infrared spectroscopy in bio-applications. Molecules 25, 2948 (2020).
Google Scholar
Kumar, N., Akangire, G., Sullivan, B., Fairchild, K. & Sampath, V. Continuous vital sign analysis for predicting and preventing neonatal diseases in the twenty-first century: big data to the forefront. Pediatric Res. 87, 210–220 (2020).
Google Scholar
Lee, H. et al. A new algorithm for detecting central apnea in neonates. Physiol. Meas. 33, 1–17 (2012).
Google Scholar
Park, J., Seok, H. S., Kim, S.-S. & Shin, H. Photoplethysmogram analysis and applications: an integrative review. Front. Physiol. 12, 808451 (2022).
Fernandez, M. et al. Evaluation of a new pulse oximeter sensor. Am. J. Crit. Care 16, 146–152 (2007).
Google Scholar
Grubb, M. R. et al. Forehead reflectance photoplethysmography to monitor heart rate: preliminary results from neonatal patients. Physiol. Meas. 35, 881 (2014).
Google Scholar
Henry, C. et al. Accurate neonatal heart rate monitoring using a new wireless, cap mounted device. Acta Paediatrica 110, 72–78 (2021).
Google Scholar
Zonios, G., Bykowski, J. & Kollias, N. Skin melanin, hemoglobin, and light scattering properties can be quantitatively assessed <em>in vivo</em> using diffuse reflectance spectroscopy. J. Investig. Dermatol. 117, 1452–1457 (2001).
Google Scholar
Gottlieb, E. R., Ziegler, J., Morley, K., Rush, B. & Celi, L. A. Assessment of racial and ethnic differences in oxygen supplementation among patients in the intensive care unit. JAMA Internal Med. 182, 849–858, (2022).
Google Scholar
Cabanas, A. M., Fuentes-Guajardo, M., Latorre, K., Leon, D. & Martin-Escudero, P. Skin pigmentation influence on pulse oximetry accuracy: a systematic review and bibliometric analysis. Sensors (Basel) 22, (2022).
Harris, B. U. et al. Accuracy of pulse oximeters intended for hypoxemic pediatric patients. Pediatric Crit. Care Med. 17 (2016). Available: https://journals.lww.com/pccmjournal/fulltext/2016/04000/accuracy_of_pulse_oximeters_intended_for_hypoxemic.6.aspx.
Sood, B. G., McLaughlin, K. & Cortez, J. Near-infrared spectroscopy: applications in neonates. Semin. Fetal Neonatal Med. 20, 164–172 (2015).
Google Scholar
Schober, P., Lust, E. J., Heunks, L. M. A. & Schwarte, L. A. Thinking out-of-the-box: a non-standard application of standard pulse-oximetry and standard near-infrared spectroscopy in a COVID-19 patient. Journal of Intensive Care Medicine 36, 376–380 (2021).
Google Scholar
Howard, R. et al. Optical monitoring in neonatal seizures (in eng). Cells 11, (2022).
van Bel, F. & Mintzer, J. P. Monitoring cerebral oxygenation of the immature brain: a neuroprotective strategy? Pediatric Res. 84, 159–164 (2018).
Google Scholar
Lapointe, A. P. et al. Cerebral hemodynamics and microvasculature changes in relation to white matter microstructure after pediatric mild traumatic brain injury: an A-CAP pilot study (in eng). Neurotrauma Rep. 4, 64–70 (2023).
Google Scholar
Rwei, A. Y. et al. A wireless, skin-interfaced biosensor for cerebral hemodynamic monitoring in pediatric care. Proc. Natl Acad. Sci. 117, 31674–31684 (2020).
Google Scholar
Inamori, G. et al. Neonatal wearable device for colorimetry-based real-time detection of jaundice with simultaneous sensing of vitals. Sci. Adv. 7, eabe3793 (2021).
Google Scholar
Desmond, F. A. & Namachivayam, S. Does near-infrared spectroscopy play a role in paediatric intensive care? BJA Educ. 16, 281–285 (2016).
Google Scholar
World Health Organization. Thermal Protection of the Newborn: A Practical Guide (WHO, 1997).
Ma, Y. et al. Soft elastomers with ionic liquid‐filled cavities as strain isolating substrates for wearable electronics. Small 13, 1602954 (2017).
Google Scholar
Lodha, R., Mukerji, N., Sinha, N., Pandey, R. M. & Jain, Y. Is axillary temperature an appropriate surrogate for core temperature? Indian J. Pediatrics 67, 571–574 (2000).
Google Scholar
McCarthy, L. K. & O’Donnell, C. P. F. Comparison of rectal and axillary temperature measurements in preterm newborns. Arch. Dis. Childhood—Fetal Neonatal Edn 106, 509 (2021).
Google Scholar
Ji, Y., Han, D., Han, L., Xie, S. & Pan, S. The accuracy of a wireless axillary thermometer for core temperature monitoring in pediatric patients having noncardiac surgery: an observational study. J. PeriAnesthesia Nursing 36, 685–689 (2021).
Google Scholar
Atallah, L., Bongers, E., Lamichhane, B. & Bambang-Oetomo, S. Unobtrusive monitoring of neonatal brain temperature using a zero-heat-flux sensor matrix. IEEE J. Biomed. Health Informatics 20, 100–107 (2016).
Google Scholar
Mellergård, P. Intracerebral temperature in neurosurgical patients: Intracerebral temperature gradients and relationships to consciousness level. Surg. Neurol. 43, 91–95 (1995).
Google Scholar
Teunissen, L. P., Klewer, J., de Haan, A., de Koning, J. J. & Daanen, H. A. Non-invasive continuous core temperature measurement by zero heat flux. Physiol. Meas. 32, 559–570 (2011).
Google Scholar
Zeiner, A. et al. Non-invasive continuous cerebral temperature monitoring in patients treated with mild therapeutic hypothermia: an observational pilot study. Resuscitation 81, 861–866 (2010).
Google Scholar
Oh, S. et al. Simple, miniaturized biosensors for wireless mapping of thermoregulatory responses. Biosens. Bioelectron. 237, 115545 (2023).
Google Scholar
Klunk, C. J. et al. An initiative to decrease laboratory testing in a NICU. Pediatrics 148 (2021).
García-Carmona, L. et al. Pacifier biosensor: toward noninvasive saliva biomarker monitoring. Anal. Chem. 91, 13883–13891 (2019).
Google Scholar
Lim, H.-R. et al. Smart bioelectronic pacifier for real-time continuous monitoring of salivary electrolytes. Biosensors Bioelectron. 210, 114329 (2022).
Google Scholar
Parrilla, M., Vanhooydonck, A., Watts, R. & De Wael, K. Wearable wristband-based electrochemical sensor for the detection of phenylalanine in biofluids. Biosensors Bioelectron. 197, 113764 (2022).
Google Scholar
Emaminejad, S. et al. Autonomous sweat extraction and analysis applied to cystic fibrosis and glucose monitoring using a fully integrated wearable platform. Proc. Natl Acad. Sci. 114, 4625–4630 (2017).
Google Scholar
Lee, H., Hong, Y. J., Baik, S., Hyeon, T. & Kim, D. H. Enzyme‐based glucose sensor: from invasive to wearable device. Adv. Healthcare Mater. 7, 1701150 (2018).
Google Scholar
Ning, Z., Long, Z., Yang, G., Xing, L. & Xue, X. Self-powered wearable biosensor in a baby diaper for monitoring neonatal jaundice through a hydrovoltaic-biosensing coupling effect of ZnO nanoarray. Biosensors 12, 164 (2022).
Google Scholar
Galland, B. C., Tan, E. & Taylor, B. J. Pulse transit time and blood pressure changes following auditory-evoked subcortical arousal and waking of infants. Sleep 30, 891–897 (2007).
Google Scholar
Ganti, V. G. et al. Wearable seismocardiography‐based assessment of stroke volume in congenital heart disease. J. Am. Heart Assoc. 11, (2022).
Yoo, J.-Y. et al. Wireless broadband acousto-mechanical sensing system for continuous physiological monitoring. Nat. Med. (2023).
Singh, M. & Patterson, D. J. Involuntary gesture recognition for predicting cerebral palsy in high-risk infants. In International Symposium on Wearable Computers (ISWC) 2010. 1–8 (IEEE, Seoul, Korea (South), 2010).
Jeong, H. et al. Miniaturized wireless, skin-integrated sensor networks for quantifying full-body movement behaviors and vital signs in infants. Proc. Natl Acad. Sci. 118, e2104925118 (2021).
Google Scholar
Lee S. H. et al. Fully portable continuous real-time auscultation with a soft wearable stethoscope designed for automated disease diagnosis. Sci. Adv. (2022).
Wang, C. et al. Monitoring of the central blood pressure waveform via a conformal ultrasonic device. Nat. Biomed. Eng. 2, 687–695 (2018).
Google Scholar
Malon, R. S., Chua, K. Y., Wicaksono, D. H. & Corcoles, E. P. Cotton fabric-based electrochemical device for lactate measurement in saliva. Analyst 139, 3009–3016 (2014).
Google Scholar
Balayan, S., Chauhan, N., Chandra, R. & Jain, U. Electrochemical based C-reactive protein (CRP) sensing through molecularly imprinted polymer (MIP) pore structure coupled with Bi-metallic tuned screen-printed electrode. Biointerface Res. Appl. Chem. 12, 7697–7714 (2021).
Google Scholar
Parnianchi, F. et al. Ultrasensitive electrochemical sensor based on molecular imprinted polymer and ferromagnetic nanocomposite for bilirubin analysis in the saliva and serum of newborns. Microchem. J. 179, 107474 (2022).
Google Scholar
Guess, M. et al. Wireless batteryless soft sensors for ambulatory cardiovascular health monitoring. Soft Sci. 3, 24 (2023).
Google Scholar
Ha, T. et al. A chest‐laminated ultrathin and stretchable E‐tattoo for the measurement of electrocardiogram, seismocardiogram, and cardiac time intervals. Adv. Sci. 6, 1900290 (2019).
Google Scholar
Bonner, O., Beardsall, K., Crilly, N. & Lasenby, J. There were more wires than him’: the potential for wireless patient monitoring in neonatal intensive care. BMJ Innovations 3, 12–18 (2017).
Google Scholar
Johnston, C. C. et al. Kangaroo care is effective in diminishing pain response in preterm neonates. Arch. Pediatrics Adolescent Med. 157, 1084–1088 (2003).
Google Scholar
Charpak, N. et al. Kangaroo mother care: 25 years after. Acta Paediatrica 94, 514–522 (2005).
Google Scholar
Ray, T. R. et al. Soft, skin-interfaced sweat stickers for cystic fibrosis diagnosis and management. Sci. Transl. Med. 13, eabd8109 (2021).
Google Scholar
Ceran, C. et al. Management of pulse oximeter probe–induced finger injuries in children: report of two consecutive cases and review of the literature. J. Pediatric Surg. 47, e27–e29 (2012).
Google Scholar
Gao, W. et al. Fully integrated wearable sensor arrays for multiplexed in situ perspiration analysis. Nature 529, 509–514 (2016).
Google Scholar
Man, P.-K. et al. Blood pressure measurement: from cuff-based to contactless monitoring. Healthcare 10,
link
