Ukubaluleka kwezimpawu ezibalulekile zomzimba njengezinkomba zempilo yabantu sekuyisikhathi eside kuqondwa ochwepheshe bezokwelapha, kodwa ubhubhane olukhona manje lwe-COVID-19 lukhulise nokuqwashisa umphakathi ngokubaluleka kwalo.
Ngeshwa, abantu abaningi abazithola beqashwe ngezimpawu ezibalulekile ngokuqhubekayo kungenzeka ukuthi kakade basesimeni somtholampilo lapho belashelwa khona ukugula okuyingozi.Esikhundleni sokusebenzisa izimpawu ezibalulekile njengenkomba yokuphumelela kokwelashwa kwezifo kanye nokululama kwesiguli, imodeli yesikhathi esizayo yesifo sikashukela. Ukunakekelwa kwezempilo kuzosebenzisa ukuqapha kwezimpawu ezibalulekile okuqhubekayo nokude njengethuluzi lokuhlonza izinkomba ezingase zibe khona zokuqala kwesifo, okuvumela odokotela ukuba bangenelele ekuthuthukiseni isifo esibi.Ithuba lokuqala ngaphambili.
Kucatshangwa ukuthi ukuhlanganiswa okwandayo kwezinzwa zebanga lomtholampilo kuzogcina kuvumela ukuthuthukiswa kwezimpawu ezibalulekile zezempilo ezilahlwayo, ezigqokekayo ezingalahlwa njalo futhi zishintshwe, njengamalensi okuxhumana.
Nakuba okugqokwayo okuningi kwezempilo nokufaneleka kuhlanganisa amandla okulinganisa izimpawu ezibalulekile, ubuqotho bokufundwa kwazo kungatshazwa ngenxa yezizathu ezimbalwa, okuhlanganisa ikhwalithi yezinzwa ezisetshenzisiwe (eziningi akuzona izinga lomtholampilo), lapho zifakwe khona, nalapho izinzwa. izinga.Ukuthintana ngokomzimba ngenkathi ugqokile.
Nakuba lezi zixhobo zanele isifiso sochwepheshe abangewona abezempilo ukuze bazibuke nje besebenzisa idivayisi egqokekayo elula nenethezekile, abafanele ochwepheshe bezokwelapha abaqeqeshiwe ukuze bahlole kahle impilo yomuntu ngamunye futhi benze ukuxilonga benolwazi.
Ngakolunye uhlangothi, amadivaysi okwamanje asetshenziselwa ukunikeza ukubonwa kwezimpawu ezibalulekile zebanga lomtholampilo ngokuhamba kwesikhathi eside angaba mkhulu futhi angakhululeki, futhi abe namazinga ahlukahlukene okuphatheka.Kulesi sixazululo sokuklama, sibuyekeza ukubaluleka komtholampilo kwezilinganiso ezine zezimpawu ezibalulekile—igazi. ukugcwala komoyampilo (i-SpO2), izinga lokushaya kwenhliziyo (HR), i-electrocardiogram (ECG), nezinga lokuphefumula (RR)—futhi ucabangele ukunikeza uhlobo lwenzwa olungcono kakhulu lomtholampilo - Ukufundwa kwebanga ngalinye.
Amazinga okugcwala komoyampilo wegazi kubantu abanempilo ngokuvamile acishe abe ngu-95-100. Nokho, izinga le-SpO2 elingu-93% noma ngaphansi lingabonisa ukuthi umuntu unenkinga yokuphefumula—njengophawu oluvamile ezigulini ezine-COVID-19—okuyenza uphawu olubalulekile olubalulekile lokuqapha njalo ochwepheshe bezokwelapha.I-Photoplethysmography (PPG) iyindlela yokulinganisa yokubona esebenzisa ama-LED emitter amaningi ukuze kukhanye imithambo yegazi ngaphansi kwesikhumba kanye nomamukeli we-photodiode ukuze kutholwe isignali yokukhanya eveziwe ukubala i-SpO2.Ngenkathi isishintshile. isici esivamile sezinto eziningi ezigqokwayo ezigqokwa esihlakaleni, isignali yokukhanya ye-PPG isengozini yokuphazamiseka kusuka kuma-artifact anyakazayo kanye nezinguquko zesikhashana ekukhanyeni kwe-ambient, okungaholela ekufundweni okungamanga, okusho ukuthi lawa madivayisi awanikezi izilinganiso zebanga lomtholampilo .Esimeni somtholampilo , I-SpO2 ilinganiswa kusetshenziswa i-pulse oximeter egqokwe ngomunwe (Umfanekiso 2), ngokuvamile exhunywe ngokuqhubekayo emunweni wesiguli esimile.Nakuba izinguqulo eziphathwayo eziqhutshwa yibhethri zikhona, zifaneleka kuphela ukwenza izilinganiso zesikhashana.
Ukushaya kwenhliziyo okunempilo (HR) ngokuvamile kubhekwa njengokushaya okungu-60-100 ngomzuzu, nokho, isikhawu sesikhathi phakathi kokushaya kwenhliziyo ngakunye asishintshi. ukushaya kwenhliziyo isilinganiso esikalwa ngemijikelezo yokushaya kwenhliziyo eminingana. Kubantu abanempilo, izinga lokushaya kwenhliziyo nokushaya kwenhliziyo kucishe kufane, ngoba ngokufinyela ngakunye komsipha wenhliziyo, igazi limpontshelwa kuwo wonke umzimba. Nokho, ezinye izimo ezinzima zenhliziyo zingabangela amazinga enhliziyo nokushaya kwenhliziyo ahluka.
Isibonelo, kuma-arrhythmias afana ne-atrial fibrillation (Afib), akuwona wonke ukufinyela kwemisipha enhliziyweni okumpompa igazi kuwo wonke umzimba - esikhundleni salokho, igazi liqoqana emagumbini enhliziyo ngokwalo, okungaba yingozi empilweni .I-Atrial fibrillation ingaba nzima ukubona ngoba kwesinye isikhathi kwenzeka ngezikhathi ezithile kanye nezikhawu ezimfushane kuphela.
Ngokusho kwe-World Health Organization, i-Afib ibangela i-stroke eyodwa kwezine kubantu abaneminyaka engaphezu kuka-40, iqiniso elibonisa ukubaluleka kokukwazi ukubona nokwelapha lesi sifo.Njengoba izinzwa ze-PPG zenza izilinganiso zokukhanya ngaphansi kokucabangela okufanayo njengo-HR kanye izinga lokushaya kwenhliziyo, ngeke kuthenjelwe kukho ukuze zithole i-AF. Lokhu kudinga ukurekhodwa okuqhubekayo komsebenzi kagesi wenhliziyo -- ukumelwa okuyisithombe kwamasignali kagesi wenhliziyo okubizwa ngokuthi i-electrocardiogram (ECG) -- ngokuhamba kwesikhathi eside.
Ama-Holter monitors angamadivayisi aphathwayo ebanga lomtholampilo ajwayeleke kakhulu asetshenziselwa le njongo.Ngenkathi esebenzisa ama-electrode ambalwa kunamamonitha e-ECG amile asetshenziswa kuzilungiselelo zomtholampilo, angaba mkhulu futhi angakhululeki ukuwagqoka, ikakhulukazi lapho ulele.
Ukuphefumula okungu-12-20 ngomzuzu izinga lokuphefumula elilindelekile (RR) kubantu abaningi abanempilo. Izinga le-RR elingaphezu kokuphefumula okungu-30 ngomzuzu lingase libe inkomba yokucindezeleka kokuphefumula ngenxa yemfiva noma ezinye izimbangela. Nakuba ezinye izixazululo zedivayisi ezigqokekayo zisebenzisa i-accelerometer noma i-PPG. ubuchwepheshe bokulinganisa i-RR, izilinganiso ze-RR zezinga lomtholampilo zenziwa kusetshenziswa ulwazi oluqukethwe kusignali ye-ECG noma kusetshenziswa inzwa ye-bioimpedance (BioZ) esebenzisa izinzwa ezimbili ukuze kubonakale Ukuthikamezeka kukagesi esikhumbeni.I-electrode eyodwa noma ngaphezulu exhunywe emzimbeni wesiguli.
Nakuba ukusebenza kwe-ECG esulwe yi-FDA kutholakala kwezinye izinto ezigqokwayo eziphezulu zezempilo nokufaneleka, inzwa ye-bioimpedance iyisici esingatholakali ngokuvamile ngoba idinga ukufakwa kwenzwa ehlukile ye-BioZ IC.Ngaphezu kwe-RR, inzwa ye-BioZ isekela i-Bioelectrical. I-Impedance Analysis (BIA) kanye ne-Bioelectrical Impedance Spectroscopy (BIS), zombili ezisetshenziselwa ukukala amazinga okuhlangana kwemisipha yomzimba, amafutha namanzi.Inzwa ye-BioZ iphinde isekele i-impedance electrocardiography (ICG) futhi isetshenziselwa ukukala ukusabela kwesikhumba se-galvanic ( GSR), okungaba inkomba ewusizo yokucindezeleka.
Umfanekiso we-1 ubonisa umdwebo webhulokhi osebenzayo wezimpawu ezibalulekile zebanga lomtholampilo i-AFE IC ehlanganisa ukusebenza kwezinzwa ezintathu ezihlukene (i-PPG, i-ECG, ne-BioZ) kuphakheji elilodwa.
Umfanekiso 1 MAX86178-ultra-low-power, 3-in-1 izimpawu ezibalulekile zebanga lomtholampilo AFE (Umthombo: Amadivayisi e-Analog)
Uhlelo lwayo lokutholwa kwedatha ye-PPG eneziteshi ezimbili lusekela ama-LED angu-6 kanye nama-photodiode angu-4, nama-LED ahlelekayo ngokusebenzisa izishayeli ze-LED ezimbili zamanje, ezingu-8-bit. ngayinye ihlanganisa ama-ADC angu-20-bit azimele kanye nokujikeleza kokukhanselwa kokukhanya okuzungezile, okuhlinzeka ngaphezu kuka-90dB wokwenqatshwa kwe-ambient ku-120Hz.I-SNR yesiteshi se-PPG iphezulu njengo-113dB, isekela isilinganiso se-SpO2 esingu-16µA kuphela.
Isiteshi se-ECG siwuchungechunge lwesignali oluphelele olunikeza zonke izici ezibalulekile ezidingekayo ukuze kuqoqwe idatha ye-ECG yekhwalithi ephezulu, njengenzuzo eguquguqukayo, ukuhlunga okubalulekile, umsindo ophansi, i-impedance ephezulu yokufaka, kanye nezinketho eziningi zokuhola okuholayo.Izici ezengeziwe ezifana nokululama ngokushesha , ukutholwa okuholayo kwe-AC ne-DC, ukutholwa komthofu wamandla aphansi kakhulu kanye nokushayela komlenze wesokudla kunika amandla ukusebenza okuqinile ezinsizeni ezifunwayo ezifana namadivayisi agqokwe esihlakaleni anama-electrode omile.Uchungechunge lwesignali ye-analog lushayela i-18-bit sigma-delta ADC enobubanzi obubanzi. wamazinga esampula okukhiphayo angakhethwa ngumsebenzisi.
I-BioZ ithola iziteshi ifaka ukuhlunga kwe-EMI kanye nokulinganisa okubanzi.Amashaneli atholayo e-BioZ aphinde abe nokuvinjelwa kokufakwayo okuphezulu, umsindo ophansi, inzuzo ehlelekayo, izinketho zokuhlunga zephasi eliphansi kanye nephezulu, kanye nama-ADCs anokulungiswa okuphezulu.Kunezindlela ezimbalwa zokukhiqiza izisusa zokufaka: i-balanced square wave source/sink current, i-sine wave current, kanye ne-sine wave kanye ne-square wave voltage stimulation.Izinhlobonhlobo zama-amplitude okuvuselelayo namafrikhwensi ayatholakala.Iphinde isekele izinhlelo zokusebenza ze-BIA, BIS, ICG kanye ne-GSR.
Idatha yesikhathi ye-FIFO ivumela zonke iziteshi zezinzwa ezintathu ukuthi zivumelaniswe.Ifakwe kuphakheji ye-wafer-level ye-7 x 7 49-bump (WLP), i-AFE IC ikala kuphela u-2.6mm x 2.8mm, okuyenza ilungele ukuklanywa njengebanga lomtholampilo. isikhwama sesifuba esigqokekayo (Umfanekiso 2).
Umfanekiso 2 Isiqephu sesifuba esinama-electrode amabili amanzi, asekela i-BIA kanye ne-RR/ICG eqhubekayo, i-ECG, i-SpO2 AFE (Umthombo: Amadivayisi we-Analog)
Umfanekiso wesi-3 ubonisa ukuthi le AFE ingaklanywa kanjani njengento egqokwa esihlakaleni ukuze ihlinzeke nge-BIA efunwa kakhulu kanye ne-ECG nge-HR eqhubekayo, i-SpO2, ne-EDA/GSR.
Umfanekiso 3: Idivayisi egqokwe esihlakaleni enama-electrode amane omile, asekela i-BIA ne-ECG, ene-HR eqhubekayo, i-SpO2, ne-GSR AFE (Umthombo: Amadivayisi we-Analog)
I-SpO2, i-HR, i-ECG kanye ne-RR yizilinganiso ezibalulekile zezimpawu ezibalulekile ezisetshenziswa ochwepheshe bezokunakekelwa kwempilo ngezinhloso zokuxilonga.Ukuqapha izimpawu ezibalulekile eziqhubekayo kusetshenziswa okugqokwayo kuzoba ingxenye ebalulekile yamamodeli okunakekelwa kwezempilo esikhathini esizayo, ukubikezela ukuqala kwesifo ngaphambi kokuba kuvele izimpawu.
Abaningi abakhona njengamanje abaqaphi bezimpawu ezibalulekile bakhiqiza izilinganiso ezingeke zisetshenziswe ochwepheshe bezokunakekelwa kwempilo ngenxa yokuthi izinzwa abazisebenzisayo azilona izinga lomtholampilo, kuyilapho abanye bemane bengakwazi ukukala i-RR ngokunembile ngenxa yokuthi azibandakanyi izinzwa ze-BioZ.
Kulesi sixazululo sokuklama, sibonisa i-IC ehlanganisa izinzwa ezintathu zebanga lomtholampilo - i-PPG, i-ECG, ne-BioZ ibe yiphakheji eyodwa futhi ibonise ukuthi ingaklanywa kanjani ibe okugqokekayo esifubeni nasesihlakaleni , ukukala i-SpO2, HR, ECG, ne-RR , kuyilapho ihlinzeka neminye imisebenzi ewusizo ehlobene nezempilo, okuhlanganisa i-BIA, i-BIS, i-GSR, ne-ICG.Ngaphezu kokusetshenziswa ezimbathweni ezigqokwa emtholampilo, i-IC ilungele ukuhlanganiswa ezingutsheni ezihlakaniphile ukuze kunikezwe uhlobo lolwazi oluphakeme- abasubathi ukusebenza kudingeka.
U-Andrew Burt uyiMenenja Yebhizinisi Eliphezulu, Uphiko Lwebhizinisi Lezimboni Nezempilo, Amadivayisi we-Analog
Isikhathi sokuthumela: Aug-05-2022