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Thursday, 26 January 2017 15:07

How to prevent sudden infant death syndrome Featured

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Marta Valero Martínez1, Juan Manuel Belda-Lois1, David Moro Perez1, María Luisa Morell Salor2, Gonzalo Pin Arboledas2, Tomás Zamora Alvarez3, Laura Martínez Gómez1, Javier Diez Domingo,4, Mercedes Sanchis Almenara1, Raquel Marzo Roselló1.

(1)Instituto de Biomecánica (IBV). Universitat Politècnica de València. Edificio 9C. Camino de Vera s/n. (46022) Valencia. Spain
 (2)Sleep Unit of Quirón Hospital Valencia,
3)Elastic Confort,
(4)ASEIP Association for the Study of Pediatrics Research.

The BabyCareSleep project developed a new non-invasive intelligent control system to prevent sudden death cases in babies who do not have any previous health problems.

The IBV developed the algorithm of prevention used by the system and collaborated with the sleep unit of Quirón Hospital in Valencia to perform the tests with babies for its development and validation.

INTRODUCTION

Sudden infant death syndrome (SIDS) is the leading cause of death in the post-neonatal period (between 2 and 8 months of life). Only in Europe, 2,400 babies die each year from this syndrome (about 3,000 in the USA). In addition, with the reduction of infant mortality in recent decades, the importance of sudden infant death syndrome has increased with respect to other death causes.

A baby is considered to have suffered sudden death syndrome when the infant dies while sleeping without evidence of accidental asphyxia, inflicted injury or organic disease. It is a multifactorial syndrome resulting from the confluence of three causes: an innate vulnerability, a critical moment in development, and an external factor. External factors include excess heat, prolonged apnea, tobacco smoke, gastroesophageal reflux, and inadequate sleep posture.

The most supported hypotheses point to a failure of the baby's wake-up mechanism as one of the most frequent causes, which leads to death due to hypoxia. Under normal circumstances, when a baby stops breathing while sleeping for more than 10 seconds (apnea), there is an arousal that allows the baby to breathe again. It is the failure of this mechanism that can produce sudden death.

The BabyCareSleep project has developed a new non-invasive intelligent system (Figure 1) to prevent sudden death syndrome in infants who do not have any previous health problems by early detecting risk situations. This system is integrated into the baby's mattress and, by means of textile biosensor matrices, it measures the relevant biological parameters: pH for gastroesophageal reflux episodes, temperature for hyperthermia (fever), and movement to detect breathing. Identifying potential risk situations makes it possible to carry out an active prevention by provoking an arousal by means of micro-vibrators incorporated in the mattress, so that the baby's breathing resumes without waking him or her.

Figure 1. Conceptual scheme of the BabyCareSleep system. Left: Vibration. Right: Data. Sensors: pH, Temperature and Breathing

PREVENTION ALGORITHM

The prevention algorithm based on the physiological signals measured by the textile biosensors detects potential risk situations and establishes the preventive actions to be performed. Three action scenarios were set:

♦ Imminent risk. This system status appears when a prolonged apnea is detected. At that time, the micro-vibrators activate at the appropriate power level, depending on the characteristics of the baby, to try to produce an arousal without completely waking up the baby. If breathing is detected again, the system records the data to be checked in the recommendation scenario. If breathing is still undetected, the system goes into the emergency status.

♦ Emergency: The objective of this status is to make apnea end as soon as possible, even if the baby is awakened. The micro-vibrators activate at the maximum power level and parents or caregivers are alerted.

♦ Recommendation: Whenever there is an apnea, the recommendation scenario can be checked. It is also possible to view the other physiological variables measured.

One of the disadvantages of this type of system is the fact that there are so many false positives that parents or caregivers stop using it, that is why the BabyCareSleep system was designed to minimize these false positives thanks to the imminent risk scenario. This scenario makes it possible to filter most of such false positives with the only drawback being that the baby may be awakened; however, vibration levels are set to produce an arousal and not to completely wake up the baby.

Therefore, one critical aspect is the definition of the appropriate vibration level for each baby. The algorithm that defines this level of vibration was established by means of tests with infants between 2 and 8 months of age (Table 1 and Figure 2). During these tests, brain signals were recorded (EEG) to determine the sleep phase and whether an arousal had been provoked, as well as breathing and the baby characteristics.

Table 1. Babies that took part in the tests

The algorithm was validated with 6 additional babies who had not previously participated, and only once did the baby wake up completely.

Figure 2. Tests with babies. Configuration only required for the tests, the BabyCareSleep system is non-invasive

CONCLUSIONS

The BabyCareSleep project has developed a mattress that, in addition to meeting all the physical features to promote a good rest, is an active element in the prevention of sudden infant death syndrome.

The prevention algorithm defined by the IBV identifies the actions to be performed by the BabyCareSleep system in case the baby has a prolonged apnea, which is one of the key elements of the system.

ACKNOWLEDEGMENTS

The BabyCareSleep project is an initiative jointly financed by the 7th Framework Programme of the European Union (FP7-SME-2013 BSG-SME (Research for SMEs) Proposal Number 606088).

The project was coordinated by the Valencian company Elastic Confort—manufacturer of the Babykeeper crib mattress—. Besides the Sleep Unit of Quirón Hospital in Valencia, the Instituto de Biomecánica (IBV), technology centers from both Belgium (CENTEXBEL) and the United Kingdom (ISSRI), as well as the companies PIN Arboledas (Spain), the British COGENT and the Belgian VdS were involved in the project. The ASEIP (Association for the Study of Pediatrics Research) also participated actively in the project.

 

Read 4758 times Last modified on Thursday, 26 January 2017 15:47



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