Feasibility of a Wireless Vital Signal Monitoring System in the NICU
Bibliographic record
Abstract
In the Neonatal Intensive Care Unit (NICU), vital signs are monitored continuously via skin sensors connected to bedside monitors using wires and cables. This may interfere with patient care and increase the risks of skin damage, and infection. Wires may also tangle around the body. Recently, a wireless system called ANNE® One (Sibel Health, Chicago, USA) was developed, and investigated in a pilot study at the Montreal Children’s Hospital. 25 neonates with a median gestational age at birth of 28 weeks (IQR: 26-31 weeks) were monitored simultaneously by this wireless system and a wired reference monitor (Intellivue MX450, Philips Healthcare, Best, Netherlands) for 8 hours a day, on 4 consecutive days. To assess the feasibility of using this wireless monitoring system in the NICU, we examined the coverage (defined as the percentage of time for which signal values were available with respect to total record length) of three vitals signs: heart rate (HR), oxygen saturation (SpO2) and respiratory rate (RR). The coverage of HR and SpO2were further compared to that of corresponding electrocardiograms (ECGs) and photoplethysmograms (PPGs), respectively. We found the coverage of wired vital recordings to be 99% for HR, 94% for SpO2, and 97% for RR. In the wireless system, coverage was significantly lower for all three vitals: 86% for HR (compared to 94% in ECG), 66% for SpO2(compared to 99% in PPG), and 47% for RR. To investigate the reason for wireless gaps - defined as continuous periods with no signal for 1.25 seconds (equivalent to one missed sample) or more - we correlated them with automatically generated alert signals and manually recorded annotations. The alerts tracked wireless sensor functionality, including Bluetooth disconnection and drops in signal intensity; annotations tracked interactions between the infant and parents or healthcare professionals during recordings. We found: (1) 91% of gaps in wireless HR recordings were correlated with alert flags, with 56% linked to Bluetooth disconnections (67% of which occurred during kangaroo care); (2) only 10% of SpO2gaps and 25% of RR gaps were correlated with alerts; and (3) only 49% of gaps in SpO2and 34% in RR coincided with annotated activities. More investigations to explain the widespread occurrence of gaps in SpO2and RR signals are necessary. For this reason, future work will examine the relations of: (1) movement artifact, (2) signal-to-noise ratio, and (3) the algorithms used to display SpO2and RR, on gap classification with the use of the ANNE® system. At present, the coverage issues, especially in SpO2and RR, limit the feasibility of wireless vital sign monitoring in the NICU, but our results pinpoint key areas of improvement to be addressed.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.017 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".