2023-11-20 22:50:49
MONTREAL — Flexible sensors designed by a Montreal doctor might replace the use of the stethoscope in certain situations, particularly with premature babies.
Placed directly on the baby’s skin, these sensors continuously monitor and map sounds inside the patient’s body in real time ― for example, the sounds of breathing or digestion ― providing caregivers with information that goes well beyond episodic measurements obtained during occasional medical examinations.
“I really wanted to have a miniaturized version of the stethoscope, but one that went a little further than the stethoscope in the sense that it’s not just my ear that listens to the air coming in and the air coming out, but rather the do it intelligently,” explained the product’s creator, Dr. Wissam Shalish, a neonatologist at the Montreal Children’s Hospital who is also the co-first author of a study recently published by the journal “Nature Medicine.” .
“Often, the alarms go off and when you get to the (patient’s) bedside, you don’t really know what happened because it’s too late. Having sensors like that allows us to better understand why it sounded, and this data helps us at the bedside.”
Dr. Shalish and his colleagues, notably at Northwestern University in the United States, tested the devices on fifteen premature babies suffering from respiratory and intestinal disorders and on fifty-five adults, including twenty who had chronic lung diseases.
Measuring 40 millimeters long and 20 millimeters wide, and only eight millimeters thick, the sensors contain, among other things, highly sophisticated microphones and accelerometers that create “a complete non-invasive detection network”. Their Bluetooth capability allows wireless transmission of recorded data.
The devices, we assure in a press release, “gave results with clinical level precision”, in addition to offering “new functionalities which had never been developed or introduced in research or clinical care”. For example, they are able to separate sounds that come from inside the baby from sounds that come from his environment.
A Northwestern researcher compared the devices to several highly trained doctors who listen “simultaneously to different regions of the lungs using their stethoscope.”
Moreover, these are the two main populations that researchers are targeting at the moment: newborns in the neonatal intensive care unit and adults who have undergone surgical intervention, for example a resection which has reduced their capacity. pulmonary.
“I can imagine a scenario with a patient who is intubated and ventilated,” Dr. Shalish said. Often the tube is not in the right place or part of the lung collapses, and air entry is reduced on one side compared to the other.”
Currently, he continues, the only way to detect the problem would be to listen to each side with a stethoscope, compare the sounds and try to determine, subjectively, whether one side seems to be receiving more air than the other. other. Sensors might be more effective by monitoring and comparing both sides in real time.
Apnea, moreover, is very common among premature babies and is a major cause of prolonged hospitalization or even death, since an obstruction of the airways then restricts air flow.
The new device can continuously monitor babies’ breathing and even diagnose apnea subtypes. For example, if sensors were placed on the left and right side of the chest, caregivers might be quickly alerted if it was detected that air entry was reduced on one side compared to the other.
The devices would also improve babies’ comfort by preventing them from having to be undressed and examined by a succession of doctors and nurses, Dr. Shalish said.
“And studies have shown that there are a lot of bacteria on stethoscopes,” he stressed. If we can reduce the comings and goings, it’s (a risk of transmission) less.”
The sensors might finally be used to monitor the intestinal sounds of newborns, since a decrease in these sounds might indicate a problem. An increase in these noises, on the other hand, might demonstrate that the little patient’s health is improving, for example in the days following gastrointestinal surgery.
Other studies are underway to continue to validate the effectiveness of the sensors. Researchers are also working with partners to develop a commercial version of their product.
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