{"id":18192,"date":"2023-11-28T13:25:46","date_gmt":"2023-11-28T13:25:46","guid":{"rendered":"https:\/\/interhospi.com\/?p=18192"},"modified":"2023-11-28T13:25:46","modified_gmt":"2023-11-28T13:25:46","slug":"first-of-their-kind-acoustic-wearables-capture-body-sounds-to-continuously-monitor-health","status":"publish","type":"post","link":"https:\/\/interhospi.com\/first-of-their-kind-acoustic-wearables-capture-body-sounds-to-continuously-monitor-health\/","title":{"rendered":"First-of-their-kind acoustic wearables capture body sounds to continuously monitor health"},"content":{"rendered":"
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First-of-their-kind acoustic wearables capture body sounds to continuously monitor health<\/h1>\/ in Featured Articles<\/a> <\/span><\/span><\/header>\n<\/div><\/section>
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During even the most routine visits, physicians listen to sounds inside their patients\u2019 bodies \u2013 air moving in and out of the lungs, heart beats and even digested food progressing through the gastrointestinal tract. These sounds provide valuable information about a person\u2019s health. And when these sounds subtly change or downright stop, it can signal a serious problem that warrants time-sensitive intervention.<\/strong><\/h3>\n

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Northwestern University researchers are introducing new soft, miniaturized wearable devices that go well beyond episodic measurements obtained during occasional doctor exams. Softly adhered to the skin, the devices continuously track these subtle sounds simultaneously and wirelessly at multiple locations across nearly any region of the body.<\/p>\n

Their study was published November 16, 2023 in the journal Nature Medicine [1].<\/p>\n

In pilot studies, researchers tested the devices on 15 premature babies with respiratory and intestinal motility disorders and 55 adults, including 20 with chronic lung diseases. Not only did the devices perform with clinical-grade accuracy, they also offered new functionalities that have not been developed nor introduced into research or clinical care.<\/p>\n

\u201cCurrently, there are no existing methods for continuously monitoring and spatially mapping body sounds at home or in hospital settings,\u201d explained Northwestern\u2019s John A. Rogers, a bioelectronics pioneer who led the device development. \u201cPhysicians have to put a conventional, or a digital, stethoscope on different parts of the chest and back to listen to the lungs in a point-by-point fashion. In close collaborations with our clinical teams, we set out to develop a new strategy for monitoring patients in real-time on a continuous basis and without encumbrances associated with rigid, wired, bulky technology.\u201d<\/p>\n

\u201cThe idea behind these devices is to provide highly accurate, continuous evaluation of patient health and then make clinical decisions in the clinics or when patients are admitted to the hospital or attached to ventilators,\u201d said Dr Ankit Bharat, a thoracic surgeon at Northwestern Medicine, who led the clinical research in the adult subjects. \u201cA key advantage of this device is to be able to simultaneously listen and compare different regions of the lungs. Simply put, it\u2019s like up to 13 highly trained doctors listening to different regions of the lungs simultaneously with their stethoscopes, and their minds are synced to create a continuous and a dynamic assessment of the lung health that is translated into a movie on a real-life computer screen.\u201d<\/p>\n<\/div><\/section>
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John Rogers was instrumental in developing the acoustic wearable device. He is the Louis Simpson and Kimberly Querrey Professor of Materials Science and Engineering, Biomedical Engineering and Neurological Surgery at Northwestern\u2019s McCormick School of Engineering and Northwestern University Feinberg School of Medicine. He also directs the Querrey Simpson Institute for Bioelectronics.<\/em><\/p>\n<\/div><\/section>
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Rogers is the Louis Simpson and Kimberly Querrey Professor of Materials Science and Engineering, Biomedical Engineering and Neurological Surgery at Northwestern\u2019s McCormick School of Engineering and Northwestern University Feinberg School of Medicine. He also directs the Querrey Simpson Institute for Bioelectronics. Dr Bharat is the chief of thoracic surgery and the Harold L. and Margaret N. Method Professor of Surgery at Feinberg. As the director of the Northwestern Medicine Canning Thoracic Institute, Dr Bharat performed the first double-lung transplants on COVID-19 patients in the U.S. and started a first-of-its-kind lung transplant programme for certain patients with stage 4 lung cancers.<\/p>\n

Acoustic sensing network maps sound of body processes<\/h4>\n

Containing pairs of high-performance, digital microphones and accelerometers, the small, lightweight devices gently adhere to the skin to create a comprehensive non-invasive sensing network. By simultaneously capturing sounds and correlating those sounds to body processes, the devices spatially map how air flows into, through and out of the lungs as well as how cardiac rhythm changes in varied resting and active states, and how food, gas and fluids move through the intestines.<\/p>\n

Encapsulated in soft silicone, each device measures 40 millimetres long, 20 mm wide and 8 mm thick. Within that small footprint, the device contains a flash memory drive, tiny battery, electronic components, Bluetooth capabilities and two tiny microphones \u2013 one facing inward toward the body and another facing outward toward the exterior. By capturing sounds in both directions, an algorithm can separate external (ambient or neighbouring organ) sounds and internal body sounds.<\/p>\n

\u201cLungs don\u2019t produce enough sound for a normal person to hear,\u201d Dr Bharat said. \u201cThey just aren\u2019t loud enough, and hospitals can be noisy places. When there are people talking nearby or machines beeping, it can be incredibly difficult. An important aspect of our technology is that it can correct for those ambient sounds.\u201d<\/p>\n

Not only does capturing ambient noise enable noise cancelling, it also provides contextual information about the patients\u2019 surrounding environments, which is particularly important when treating premature babies.<\/p>\n

\u201cIrrespective of device location, the continuous recording of the sound environment provides objective data on the noise levels to which babies are exposed,\u201d said Dr Wissam Shalish, a neonatologist at the Montreal Children\u2019s Hospital and co-first author of the paper. \u201cIt also offers immediate opportunities to address any sources of stressful or potentially compromising auditory stimuli.\u201d<\/p>\n

Non-invasive continuous monitoring of breathing in premature babies<\/h4>\n

When developing the new devices, the researchers had two vulnerable communities in mind: premature babies in the neonatal intensive care unit (NICU) and post-surgery adults. In the third trimester during pregnancy, babies\u2019 respiratory systems mature so babies can breathe outside the womb. Babies born either before or in the earliest stages of the third trimester, therefore, are more likely to develop lung issues and disordered breathing complications.<\/p>\n

Apnoeas are particularly common in premature babies and are a leading cause of prolonged hospitalization and potentially death. When apnoeas occur, infants either do not take a breath (due to immature breathing centres in the brain) or have an obstruction in their airway that restricts airflow. Some babies might even have a combination of the two. Yet, there are no current methods to continuously monitor airflow at the bedside and to accurately distinguish apnoea subtypes, especially in these most vulnerable infants in the clinical NICU.<\/p>\n

\u201cMany of these babies are smaller than a stethoscope, so they are already technically challenging to monitor,\u201d said Dr Debra E. Weese-Mayer, a study co-author, chief of autonomic medicine at Ann & Robert H. Lurie Children\u2019s Hospital of Chicago and the<\/p>\n<\/div><\/section>
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A health care worker sticks acoustic wearable devices onto an adult patient\u2019s chest.
\nPhoto Credit: Northwestern University
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Beatrice Cummings Mayer Professor of Autonomic Medicine at Feinberg. \u201cThe beauty of these new acoustic devices is they can non-invasively monitor a baby continuously \u2013 during wakefulness and sleep \u2013 without disturbing them. These acoustic wearables provide the opportunity to safely and non-obtrusively determine each infant\u2019s \u2018signature\u2019 pertinent to their air movement (in and out of airway and lungs), heart sounds and intestinal motility day and night, with attention to circadian rhythmicity. And these wearables simultaneously monitor ambient noise that might affect the internal acoustic \u2018signature\u2019 and\/or introduce other stimuli that might affect healthy growth and development.\u201d<\/p>\n

In collaborative studies conducted at the Montreal Children\u2019s Hospital in Canada, healthcare workers placed the acoustic devices on babies just below the suprasternal notch at the base of the throat. Devices successfully detected the presence of airflow and chest movements and could estimate the degree of airflow obstruction with high reliability, therefore allowing identification and classification of all apnoea subtypes.<\/p>\n

\u201cWhen placed on the suprasternal notch, the enhanced ability to detect and classify apnoeas could lead to more targeted and personalized care, improved outcomes and reduced length of hospitalization and costs,\u201d Dr Shalish explained. \u201cWhen placed on the right and left chest of critically ill babies, the real-time feedback transmitted whenever the air entry is diminished on one side relative to the other could promptly alert clinicians of a possible pathology necessitating immediate intervention.\u201d Tracking infant digestion with acoustic wearables<\/p>\n

In children and infants, cardiorespiratory and gastrointestinal problems are major causes of death during the first five years of life. Gastrointestinal issues, in particular, are accompanied by reduced bowels sounds, which could be used as an early warning sign of digestion issues, intestinal dysmotility and potential obstructions. So, as part of the pilot study in the NICU, the researchers used the devices to monitor these sounds.<\/p>\n

In the study, premature babies wore sensors at four locations across their abdomen. Early results aligned with measurements of adult intestinal motility using wire-based systems, which is the current standard of care.<\/p>\n

\u201cWhen placed on the abdomen, the automatic detection of reduced bowel sounds could alert the clinician of an impending (sometimes life-threatening) gastrointestinal complication,\u201d
\nDr Shalish said. \u201cWhile improved bowel sounds could indicate signs of bowel recovery, especially after a gastrointestinal surgery.\u201d<\/p>\n

\u201cIntestinal motility has its own acoustic patterns and tonal qualities,\u201d Dr Weese-Mayer said. \u201cOnce an individual patient\u2019s acoustic \u2018signature\u2019 is characterized, deviations from that personalized signature have potential to alert the individual and health care team to impending ill health, while there is still time for intervention to restore health.\u201d<\/p>\n

In addition to offering continuous monitoring, the devices also untethered NICU babies from the variety of sensors, wires and cables connected to bedside monitors.<\/p>\n

Mapping a single breath<\/h4>\n

Accompanying the NICU study, researchers tested the devices on adult patients, which included 35 adults with chronic lung diseases and 20 healthy controls. In all subjects, the devices captured the distribution of lung sounds and body motions at various locations simultaneously, enabling researchers to analyze a single breath across a range of regions throughout the lungs.<\/p>\n

\u201cAs physicians, we often don\u2019t understand how a specific region of the lungs is functioning,\u201d Dr Bharat said. \u201cWith these wireless sensors, we can capture different regions of the lungs and assess their specific performance and each region\u2019s performance relative to one another.<\/p>\n

\u201cLungs can make all sorts of sounds, including crackling, wheezing, rippling and howling,\u201d Bharat said. \u201cIt\u2019s a fascinating microenvironment. By continuously monitoring these sounds in real time, we can determine if lung health is getting better or worse and evaluate how well a patient is responding to a particular medication or treatment. Then we can personalize treatments to individual patients.\u201d<\/p>\n

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Wearable devices capture sounds inside a premature baby\u2019s lungs.
\nPhoto Credit: Montreal Children\u2019s Hospital
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Reference<\/strong><\/em>
\n1. Yoo, JY., Oh, S., Shalish, W. et al. Wireless broadband <\/em>acousto-mechanical sensing system for continuous <\/em>physiological monitoring. Nat Med (2023). <\/em>https:\/\/doi.org\/10.1038\/s41591-023-02637-5<\/em><\/a><\/p>\n

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