Ukubaluleka kweempawu ezibalulekileyo zomzimba njengezalathi zempilo yabantu kudala ziqondwa ngoochwephesha bezonyango, kodwa ubhubhani wangoku we-COVID-19 uphakamise nokwazisa uluntu ngokubaluleka kwawo.
Ngelishwa, abaninzi abantu abazifumana bephantsi koqwalaselo olubalulekileyo oluqhubekayo basenokuba sele bekwimeko yeklinikhi apho banyangwa khona ngenxa yesifo esiqatha.Endaweni yokusebenzisa iimpawu ezibalulekileyo njengesalathisi sokusebenza konyango lwesifo kunye nokubuyiswa kwesigulane, imodeli yexesha elizayo ukhathalelo lwezempilo luya kusebenzisa uhlolo oluqhubekayo kunye nolukude olubalulekileyo njengesixhobo sokuchonga izibonakaliso ezinokuthi zenzeke ukuqala kwesifo, ukuvumela oogqirha ukuba bangenelele ekuphuhliseni isifo esibi.Ithuba lokuqala ngaphambili.
Kucingelwa ukuba ukudityaniswa okunyukayo kwezinzwa zenqanaba leklinikhi kuya kwenza ukuba ekugqibeleni kuphuhliswe iimpawu ezibalulekileyo zezempilo ezinokulahlwa, ezinokuthi zilahlwe rhoqo kwaye zitshintshwe, njengee-contact lens.
Ngelixa izinto ezininzi ezinxitywayo zempilo kunye nokomelela zibandakanya amandla okulinganisa iimpawu ezibalulekileyo, ukuthembeka kokufunda kwabo kunokubuzwa ngenxa yezizathu ezininzi, kubandakanywa nomgangatho wezinto zoluvo ezisetyenzisiweyo (uninzi alulo bakala lonyango), apho zifakwe khona, kwaye apho izinzwa. umgangatho.Ukudibana ngokomzimba ngelixa unxibe.
Ngelixa ezi zixhobo zanele umnqweno wabasebenzi abangengabo bezempilo ukuze bazijonge ngokungaqhelekanga besebenzisa isixhobo esinxitywayo esifanelekileyo nesikhululekileyo, azifanelekanga ukuba abaqeqeshi bezonyango abaqeqeshiweyo bavavanye ngokufanelekileyo impilo yomntu kwaye benze uxilongo olunolwazi.
Ngakolunye uhlangothi, izixhobo ezisetyenziselwa ukubonelela ngeempawu ezibalulekileyo zeklinikhi kwixesha elide zinokuba zininzi kwaye zingakhululeki, kwaye zinemigangatho eyahlukeneyo yokuphatheka.Kwesi sisombululo soyilo, sihlaziya ukubaluleka kweklinikhi yemilinganiselo emine ebalulekileyo yeempawu-igazi. i-oxygen saturation (SpO2), izinga lentliziyo (HR), i-electrocardiogram (ECG), kunye nesantya sokuphefumula (RR) -kwaye ucinge ngokubonelela ngeklinikhi yoMntu oPhezulu oPhezulu - Ukufundwa kwibakala ngalinye.
Amanqanaba okugcwala kweoksijini yegazi kubantu abasempilweni ahlala amalunga nama-95-100%.Noko kunjalo, inqanaba le-SpO2 lama-93% okanye ngaphantsi linokubonisa ukuba umntu unengxaki yokuphefumla-njengophawu oluqhelekileyo kwizigulana ezine-COVID-19-ezenza uphawu olubalulekileyo olubalulekileyo lokujongwa rhoqo ngabasebenzi bezonyango.I-Photoplethysmography (PPG) yindlela yokulinganisa i-optical esebenzisa ii-emitters ezininzi ze-LED ukuze zikhanyise imithambo yegazi ngaphantsi kwesikhumba kunye ne-photodiode receiver ukubona umqondiso wokukhanya obonakalisiweyo ukubala i-SpO2. into eqhelekileyo yezinto ezininzi ezinxitywayo zesandla, umqondiso wokukhanya we-PPG usengozini yokuphazamiseka kwezinto ezihambayo kunye neenguqu ezidlulayo ekukhanyeni kwe-ambient, oku kunokukhokelela ekufundweni kobuxoki, oku kuthetha ukuba ezi zixhobo aziboneleli ngemilinganiselo yeklinikhi. , I-SpO2 ilinganiswa ngokusebenzisa i-pulse oximeter (Umfanekiso we-2), ngokuqhelekileyo ngokuqhubekayo iqhotyoshelwe kumnwe wesigulane esimileyo.Nangona iinguqulelo eziphathekayo zebhetri zikhona, zifanelekile kuphela ukwenza imilinganiselo ephakathi.
Ukubetha kwentliziyo esempilweni (HR) ngokuqhelekileyo kubonwa kuluhlu lwe-60-100 beats ngomzuzu, nangona kunjalo, ixesha lexesha phakathi kokubetha kwentliziyo yomntu alitshintshi. Ukubetha kwentliziyo ngumlinganiselo olinganiselwa kwimijikelezo emininzi yokubetha kwentliziyo. Kubantu abasempilweni, ukubetha kwentliziyo kunye nesantya sokubetha kwentliziyo kuphantse kufane, kuba ngokufinyela ngakunye kwesihlunu sentliziyo, igazi limpontshelwa kuwo wonke umzimba. Amazinga entliziyo kunye nentliziyo ayahluka.
Ngokomzekelo, kwi-arrhythmias efana ne-atrial fibrillation (i-Afib), akusiyo yonke i-fibrillation ye-atrial (i-Afib), akusiyo yonke i-fibrillation ye-muscle entliziyweni impompa igazi kuwo wonke umzimba - endaweni yoko, igazi liqokelela kumagumbi entliziyo ngokwawo, nto leyo enokubeka ubomi esichengeni .I-fibrillation ye-Atrial ingaba nzima ukubhaqa kuba ngamanye amaxesha yenzeka ngokunqamkileyo kwaye kuphela kumathuba amafutshane amafutshane.
Ngokutsho koMbutho wezeMpilo weHlabathi, i-Afib ibangela enye kwizibetho ezine kubantu abangaphezu kweminyaka eyi-40, into ebonisa ukubaluleka kokukwazi ukubona nokunyanga isifo.Njengoko i-PPG sensors yenza imilinganiselo ye-optical phantsi kwengcinga efanayo ne-HR kunye izinga lokubetha kwentliziyo, abanakuthenjwa ukuba babhaqe i-AF. Oku kufuna ukurekhodwa okuqhubekayo komsebenzi wombane wentliziyo -- umboniso womzobo wemiqondiso yombane wentliziyo ebizwa ngokuba yi-electrocardiogram (ECG) -- ekuhambeni kwexesha elide.
Iimonitha ze-Holter zezona zixhobo eziqhelekileyo eziphathekayo zekliniki ezisetyenziselwa le njongo.Ngelixa zisebenzisa i-electrode ezimbalwa kuneemonitha ze-ECG ezingatshintshiyo ezisetyenziswa kwizicwangciso zeklinikhi, zinokuba zininzi kwaye zingakhathazeki ukugqoka, ngakumbi xa zilele.
Ukuphefumula kwe-12-20 ngomzuzu yizinga elilindelekileyo lokuphefumula (RR) kubantu abaninzi abanempilo.Izinga le-RR ngaphezu kwe-30 yokuphefumula ngomzuzu ingaba ngumqondiso wokuphefumula kokuphefumula ngenxa yomkhuhlane okanye ezinye izizathu.Ngelixa ezinye izisombululo zesixhobo esinxitywayo zisebenzisa i-accelerometer okanye i-PPG. iteknoloji yokunciphisa i-RR, imilinganiselo ye-RR yekliniki yenziwa ngokusebenzisa ulwazi oluqulethwe kwisignali ye-ECG okanye kusetyenziswa i-bioimpedance (BioZ) inzwa esebenzisa i-sensor ezimbini ukubonisa Ukuphazamiseka kombane kwesikhumba.I-electrode enye okanye ngaphezulu eqhotyoshelwe kumzimba wesigulane.
Nangona i-FDA-isulwe ukusebenza kwe-ECG ifumaneka kwezinye izinto ezinxitywayo zempilo kunye nokufaneleka, i-bioimpedance sensing yinto engabonakaliyo kuba idinga ukufakwa kwe-IC. Uhlalutyo lwe-Impedance (BIA) kunye ne-Bioelectrical Impedance Spectroscopy (BIS), zombini ezisetyenziselwa ukulinganisa amanqanaba okubunjwa kwemisipha yomzimba, amafutha kunye namanzi.I-sensor ye-BioZ iphinde ixhase i-impedance electrocardiography (ICG) kwaye isetyenziselwa ukulinganisa impendulo yesikhumba se-galvanic ( GSR), enokuba luphawu oluluncedo loxinzelelo.
Umzobo we-1 ubonisa umzobo webhloko osebenzayo weempawu ezibalulekileyo zekliniki ze-AFE IC ezidibanisa ukusebenza kweenzwa ezintathu ezihlukeneyo (PPG, ECG, kunye ne-BioZ) kwiphakheji enye.
Umzobo 1 MAX86178 ultra-low-power, 3-in-1 clinical-grade ebalulekileyo iimpawu AFE (Umthombo: Analog Devices)
Inkqubo yayo yokufumana idatha ye-PPG ye-optical ye-double-channel isekela ukuya kwii-LED ze-6 kunye ne-4 ye-photodiode inputs, kunye nee-LED ezicwangcisiweyo ngokusebenzisa ezimbini zangoku, ii-8-bit ze-LED zabaqhubi. nganye iquka i-20-bit ADCs ezizimeleyo kunye ne-ambient light cancellation circuitry, ibonelela ngaphaya kwe-90dB ye-ambient rejection kwi-120Hz.I-SNR yetshaneli ye-PPG iphezulu njenge-113dB, ixhasa umlinganiselo we-SpO2 we-16µA kuphela.
Ishaneli ye-ECG yikhonkco yesignali epheleleyo enikezela zonke iimpawu eziphambili ezifunekayo ukuqokelela idatha ye-ECG ephezulu, njengenzuzo eguquguqukayo, ukuhlunga okubalulekileyo, ingxolo ephantsi, i-impedance ephezulu, kunye neenketho ezininzi zokukhokela.Iimpawu ezongezelelweyo ezifana nokubuyisela ngokukhawuleza. , Ukufunyanwa kwe-AC kunye ne-DC ehamba phambili, ukufunyanwa kwamandla aphantsi kwe-ultra-low kunye ne-right leg drive yenza umsebenzi oqinileyo kwizicelo ezifunwayo ezifana nezixhobo ezigqithisiweyo zesandla kunye ne-electrode eyomileyo.Ikhonkco yesignali ye-analog iqhuba i-18-bit sigma-delta ADC kunye noluhlu olubanzi. yemilinganiselo yemveliso ekhethwa ngumsebenzisi.
I-BioZ ifumana amatshaneli abonisa ukuhluza kwe-EMI kunye nokulinganisa okubanzi. I-BioZ yokufumana amashaneli ikwabonisa i-impedance ephezulu, ingxolo ephantsi, inzuzo enokucwangciswa, i-low-pass and high-pass filter options, kunye ne-high-resolution ADCs.Kukho iindlela ezininzi zokuvelisa igalelo lokuvuselela: i-balanced square wave source/i-sink current, i-sine wave yangoku, kunye ne-sine wave kunye ne-square wave voltage stimulation.Iintlobo ngeentlobo ze-amplitudes zokuvuselela kunye nee-frequencies ziyafumaneka.Ikwaxhasa izicelo ze-BIA, i-BIS, i-ICG kunye ne-GSR.
Idatha yexesha le-FIFO ivumela zonke iziteshi ezintathu zenzwa ukuba zihambelane.Ifakwe kwi-7 x 7 49-bump wafer-level package (WLP), i-AFE IC ilinganisa kuphela i-2.6mm x 2.8mm, iyenza ilungele ukuyila njengebakala leklinikhi. isiqwenga sesifuba esithwalayo (Umfanekiso 2).
Umzobo we-2 I-Chest patch kunye ne-electrode ezimbini ezimanzi, ezixhasa i-BIA kunye ne-RR / ICG eqhubekayo, i-ECG, i-SpO2 AFE (Umthombo: Izixhobo ze-Analog)
Umzobo wesi-3 ubonisa indlela le AFE enokuthi iyilwe ngayo njengento yokunxiba esihlahleni ukubonelela nge-BIA efunwayo kunye ne-ECG nge-HR eqhubekayo, i-SpO2, kunye ne-EDA/GSR.
Umzobo we-3: Isixhobo esifakwe kwisandla esine-electrode ezine ezomileyo, ezixhasa i-BIA kunye ne-ECG, kunye ne-HR eqhubekayo, i-SpO2, kunye ne-GSR AFE (Umthombo: Izixhobo ze-Analog)
I-SpO2, i-HR, i-ECG kunye ne-RR ziyimilinganiselo ebalulekileyo yeempawu ezibalulekileyo ezisetyenziswa ngabaqeqeshi bezempilo ngenjongo yokuxilonga.Iimpawu ezibalulekileyo eziqhubekayo zokubeka iliso usebenzisa izinto ezinxitywayo ziya kuba yinto ephambili kwiimodeli zokunakekelwa kwezempilo ezizayo, ukuxela kwangaphambili isifo ngaphambi kokuba iimpawu zivele.
Uninzi lweempawu ezibalulekileyo ezikhoyo ngoku zivelisa imilinganiselo engenakusetyenziswa ngabasebenzi bezempilo ngenxa yokuba izinzwa abazisebenzisayo azikho ibakala leklinikhi, ngelixa abanye bengenawo amandla okulinganisa ngokuchanekileyo i-RR kuba ingabandakanyi izinzwa ze-BioZ.
Kule sisombululo soyilo, sibonisa i-IC edibanisa i-sensors ezintathu zeklinikhi - i-PPG, i-ECG, kunye ne-BioZ kwiphakheji enye kwaye ibonise indlela enokuyilwa ngayo kwisifuba kunye nesandla sokugqoka, ukulinganisa i-SpO2, i-HR, i-ECG, kunye ne-RR. , ngelixa ikwabonelela neminye imisebenzi eluncedo enxulumene nempilo, kuquka i-BIA, i-BIS, i-GSR, kunye ne-ICG.Ngaphezu kokusetyenziswa kwizinto ezinxitywayo zeklinikhi, i-IC ilungele ukuhlanganiswa kwimpahla ehlakaniphile ukubonelela ngohlobo lolwazi oluphezulu- iimbaleki yokusebenza kufuneka.
U-Andrew Burt unguMphathi woShishino oLawulayo, iCandelo loShishino lwezoShishino kunye neMpilo, izixhobo ze-Analog
Ixesha lokuposa: Aug-05-2022