Monitoring the temperature of the newborn through a wireless device with an alert system: development and proof of concept / Monitoramento da temperatura do recém-nascido através de um dispositivo sem fio com sistema de alertas: desenvolvimento e prova de conceito

Authors

  • Wagner Bento de Magalhães
  • Rodney do Nascimento Guimarães
  • Elaine Alvarenga de Almeida Carvalho
  • Zilma Silveira Nogueira Reis

DOI:

https://doi.org/10.34117/bjdv7n8-432

Keywords:

Infant, Newborn, Monitoring, Skin Temperature, Hypothermia, Wireless Technology.

Abstract

Introduction: The maintenance of the newborn temperature is one of the most relevant factors for his survival. Maintaining thermal control prevents several complications related to hypothermia and hyperthermia and reduces the chance of dying from different causes. Temperature monitoring systems are common in neonatal intensive care units. However, outside of this environment, the detection of hypothermia is still a challenge.

Objective: The objective of the study is to develop a prototype neonatal temperature monitoring system to alert thermal uncontrolled.

Method: In an observational cohort study, the temperature of 21 newborns was monitored in a conventional manner and by a new monitoring system under test. All were born with a gestational age above 35 weeks, healthy and were accommodated in a joint accommodation ward, in a public university maternity hospital. To this end, a prototype system consisting of a temperature sensor, a Wi-Fi emitter and a data collection and processing center was developed. The value measured by the prototype was hidden, as well as the warnings of thermal uncontrolled. The reliability of the temperature sensor was evaluated in an experiment that compared measurements made by the sensor with that of a conventional thermometer. In a real scenario, the temperature sensor was affixed to the skin of the newborn's infra-axillary region, the temperature being automatically measured every 10 minutes. The performance of the prototype was evaluated by comparing the episodes of thermal uncontrolled detected by the two measurement techniques, in relation to the closest pair of measures. The total set of measurements of the prototype was also analyzed. Hypothermia was characterized by temperature <36.5ºC and hyperthermia> 37.5ºC. The Kappa concordance analysis compared the results of the two measurement modes.

Results: The temperature measured by the prototype sensor and the conventional digital thermometer had an intraclass correlation coefficient = 1. In the care scenario, the average time to monitor the temperature of the newborns was 22:36 hours. The difference between the 115 pairs of measures performed by nursing in relation to those recorded by the prototype averaged 0.014 ºC (SD = 0.14). Comparing the measurement pairs, hypothermia was detected by nursing in 14 (66.7%) newborns and by the prototype in 15 (71.5%) newborns, Kappa index = 0.889. When all measurements performed by the real-time monitoring system were considered, hypothermia was recorded in 520/2809 (28.8%) measurements, while by the intermittent mode, hypothermia was recorded in 30/115 (26.8%). There were three episodes of hypothermia or hyperthermia detected by the new device, at times not monitored by nursing.

Conclusions: Temperature monitoring by a computerized system detected more thermal abnormalities than the conventional method. The developed prototype demonstrated its potential to offer continuous and simultaneous monitoring to a group of newborns hospitalized in a maternity unit. 

 

 

References

Cramer K, Wiebe N, Hartling L, Crumley E, Vohra S. Heat Loss Prevention: A Systematic Review of Occlusive Skin Wrap for Premature Neonates. Journal Of Perinatology. 2005; 25: 763. doi: 10.1038 / sj.jp.7211392.

Klersy C, De Silvestri A, Gabutti G, Raisaro A, Curti M, Regoli F, et al. Economic impact of remote patient monitoring: an integrated economic model derived from a meta-analysis of randomized controlled trials in heart failure. European Journal of Heart Failure. 2011; 13 (4): 450-9. doi: 10.1093 / eurjhf / hfq232.

Lunze K, Hamer D. Lunze K, Hamer DH. Thermal protection of the newborn in resource-limited environments. J Perinatol. 2012; 32 (5): 317-24. 2012.

Lyu Y, Shah PS, Ye XY, et al. Association between admission temperature and mortality and major morbidity in preterm infants born at fewer than 33 weeks' gestation. JAMA Pediatrics. 2015; 169 (4): e150277. doi: 10.1001 / jamapediatrics.2015.0277.

Macfarlane F. PAEDIATRIC ANATOMY AND PHYSIOLOGY AND THE BASICS OF PAEDIATRIC ANAESTHESIA. Anesthesia UK [diunduh 6 Oktober 2006] Tersedia dari: http: // www frca co uk / article aspx. 2006.

Mok Q, Bass CA, Ducker DA, McIntosh N. Temperature instability during nursing procedures in preterm neonates. Archives of Disease in Childhood. 1991; 66 (7 Spec No): 783. doi: 10.1136 / adc.66.7_Spec_No.783.

Murkovic I, Steinberg Md Fau - Murkovic B, Murkovic B. Sensors in neonatal monitoring: current practice and future trends. (0928-7329 (Print)).

World Health O. Thermal protection of the newborn: a practical guide. Geneva: World Health Organization; 1997.

Zhu Z, Liu T, Li G, Li T, Inoue Y. Wearable sensor systems for infants. Sensors (Basel, Switzerland). 2015; 15 (2): 3721-49. doi: 10.3390 / s150203721.

Couto Carvalho Barra D, Marcon Dal Sasso GT, Antunes Baccin CR. Alert systems in a computerized nursing process for Intensive Care Units. Journal of the School of Nursing at USP. 2014; 48 (1).

Vousden N, Lawley E, Nathan HL, Seed PT, Gidiri MF, Goudar S, et al. Effect of a novel vital sign device on maternal mortality and morbidity in low-resource settings: a pragmatic, stepped-wedge, cluster-randomized controlled trial. The Lancet Global Health. 2019; 7 (3): e347-e56.

Santos I, Gazelle G, Rocha L, Tavares J. DEVELOPMENT OF MEDICAL DEVICES: ADVANTAGES OF A DEDICATED METHODOLOGY. 2011.

Hirakata V, Camey S. Analysis of Agreement between Bland-Altman Methods. Rev HCPA. 2009; 29: 261-8.

Hinsenkamp A, Kardos D, Lacza Z, Hornyák I. A Practical Guide to Class IIa Medical Device Development. Applied Sciences. 2020; 10 (10). doi: 10.3390 / app10103638.

Chung HU, Rwei AY, Hourlier-Fargette A, Xu S, Lee K, Dunne EC, et al. Skin-interfaced biosensors for advanced wireless physiological monitoring in neonatal and pediatric intensive-care units. Nature Medicine. 2020; 26 (3): 418-29. doi: 10.1038 / s41591-020-0792-9.

Lunze K, Bloom DE, Jamison DT, Hamer DH. The global burden of neonatal hypothermia: systematic review of a major challenge for newborn survival. BMC medicine. 2013; 11: 24-. doi: 10.1186 / 1741-7015-11-24.

Rao H, Saxena D, Kumar S, Sagar GV, Amrutur B, Mony P, et al. Low Power Remote Neonatal Temperature Monitoring Device. P. 28-38.

Chen W, Dols S, Oetomo SB, Feijs L. Monitoring body temperature of newborn infants at neonatal intensive care units using wearable sensors. ACM. P. 188-94.

Sund-Levander M, Grodzinsky E, Loyd D, Wahren LK. Errors in body temperature assessment related to individual variation, measuring technique and equipment. International Journal of Nursing Practice. 2004; 10 (5): 216-23. doi: 10.1111 / j.1440-172X.2004.00483.x.

Published

2021-08-17

How to Cite

de Magalhães, W. B., Guimarães, R. do N., Carvalho, E. A. de A., & Reis, Z. S. N. (2021). Monitoring the temperature of the newborn through a wireless device with an alert system: development and proof of concept / Monitoramento da temperatura do recém-nascido através de um dispositivo sem fio com sistema de alertas: desenvolvimento e prova de conceito. Brazilian Journal of Development, 7(8), 82199–82215. https://doi.org/10.34117/bjdv7n8-432

Issue

Section

Original Papers