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Monitoring Respiratory Health in Children With Acute Asthma Using Wearable Electrical Bioimpedance and Breath Sounds:
Jesus Antonio Sanchez-Perez1, John Berkebile2, Natalie Jordan3
1Department of Electrical and Computer Engineering, College of Engineering, University of Puerto Rico-Mayaguez, Mayagüez, Puerto Rico.
Insights
Wearable sensors can quantify respiratory health in children with acute asthma, tracking changes during hospitalization. This technology shows promise for real-time monitoring and improved patient care.
Area of Science:
- Biomedical Engineering
- Pediatric Pulmonology
- Wearable Technology
Background:
- Asthma is a critical childhood disease causing severe breathlessness and PICU admissions.
- Current assessments lack the temporal resolution to monitor rapidly changing respiratory physiology.
- Severe asthma exacerbations in children can lead to mechanical ventilation and mortality.
Purpose of the Study:
- To assess the feasibility of using wearable multimodal sensing to quantify respiratory health in children experiencing acute asthma.
- To evaluate the effectiveness of impedance pneumography (IP) and lung sounds (LS) in monitoring pediatric asthma patients.
Main Methods:
- 17 children with acute asthma and 9 healthy controls were monitored using wearable IP and LS sensors.
- Measurements were taken at pediatric intensive care unit (PICU) admission (T1) and discharge (T2).
- Respiratory rate, inspiration time (Ti), expiration time (Te), Te:Ti ratio, Ti/IBI, and spectral integrated intensity (SI) features were analyzed.
Main Results:
- In asthma patients, respiratory rate decreased while Te and Ti lengthened from T1 to T2.
- Spectral integrated intensity features showed significant changes, with lower frequencies decreasing and higher frequencies increasing.
- All analyzed features differed significantly between asthma patients (T1 and T2) and controls, indicating a trend toward normalcy at discharge.
Conclusions:
- Wearable multimodal sensing, combining IP and LS, is feasible for quantifying and tracking respiratory health in pediatric acute asthma.
- This technology can serve as an adjunctive clinical tool for real-time respiratory monitoring.
- Timely monitoring may enable better titration of care and improve outcomes for children with asthma.
Background:
Asthma remains one of the most serious chronic diseases of childhood. Individuals with severe asthma experience sudden episodes of breathlessness due to acute airflow obstruction, leading to recurrent pediatric intensive care unit (PICU) admissions that often result in mechanical ventilation and even death. Existing clinical assessments lack temporal resolution to effectively track the rapidly changing physiology.
Objective:
This study aimed to evaluate the feasibility of quantifying respiratory health during acute asthma in children using wearable multimodal sensing.
Methods:
Wearable-based impedance pneumography (IP) and multichannel lung sounds (LSs) were measured on 17 children admitted to the PICU with an acute asthma attack and on 9 healthy controls. Short-term multimodal measurements were obtained throughout hospitalization, specifically at PICU admission (T1) and discharge (T2). Measurements were also obtained from controls without any signs of acute asthma or otherwise healthy. Statistical and clustering analyses were performed to identify trends in IP- and LS-derived respiratory markers from T1 to T2 across all patients with paired time points (n=13), as well as across the matched cohort (T1: n=10 and T2: n=7), who were compared against controls (n=9). Five features were computed from the IP signal: respiratory rate, inspiration time (Ti), expiration time (Te), expiration-to-inspiration time ratio (Te:Ti), and the normalized Ti by interbreath interval (Ti/IBI). Leveraging the breathing context provided by the IP signal, 4 spectral integrated intensity (SI) acoustic features were computed in 4 different subbands for the inspiration and expiration phases.
Results:
Within the patient group (n=13), we found that respiratory rate decreased (W(12)=79; P=.02), whereas Te (W(12)=12; P=.02) and Ti (W(12)=13; P=.02) lengthened. Meanwhile, the SIs for the lowest subband (100-300 Hz) decreased for both inspiration and expiration phases (P<.01), while they increased for the highest subband (800-1000 Hz) for both inspiration and expiration phases (P<.01). Significant differences also existed between T1 and control and T2 and control of the matched cohort. We found that all features were significantly different between T1 and control (P<.05), and all SIs together with Te:Ti and Ti/IBI were significantly different between T2 and control (P<.05), all exhibiting trends toward normalcy.
Conclusions:
These results demonstrate the feasibility of quantifying and tracking respiratory health in children with acute asthma using wearable multimodal sensing, specifically with the fusion of IP- and LS-derived markers. Such technology may provide a new adjunctive clinical tool for real-time respiratory monitoring and enable timely titration of care, thereby improving patient outcomes.
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