Review of sensors for remote patient monitoring

Remote patient monitoring (RPM) of physiological measurements can provide an efficient method and high quality care to patients. The physiological signals measurement is the initial and the most important factor in RPM. This paper discusses the characteristics of the most popular sensors, which are used to obtain vital clinical signals in prevalent RPM systems. The sensors discussed in this paper are used to measure ECG, heart sound, pulse rate, oxygen saturation, blood pressure and respiration rate, which are treated as the most important vital data in patient monitoring and medical examination

Telemedicine

Telemedicine is a rapidly evolving field as new technologies are implemented for example for the development of wireless sensors, quality data transmission. Using the Internet applications such as counseling, clinical consultation support and home care monitoring and management are more and more realized, which improves access to high level medical care in underserved areas. The 23 chapters of this book present manifold examples of telemedicine treating both theoretical and practical foundations and application scenarios

REDUCTION OF SKIN STRETCH INDUCED MOTION ARTIFACTS IN ELECTROCARDIOGRAM MONITORING USING ADAPTIVE FILTERING

Cardiovascular disease (CVD) is the leading cause of death in many regions worldwide, accounting for nearly one third of global deaths in 2001. Wearable electrocardiographic cardiovascular monitoring devices have contributed to reduce CVD mortality and cost by enabling the diagnosis of conditions with infrequent symptoms, the timely detection of critical signs that can be precursor to sudden cardiac death, and the long-term assessment/monitoring of symptoms, risk factors, and the effects of therapy. However, the effectiveness of ambulatory electrocardiography to improve the treatment of CVD can be significantly impaired by motion artifacts which can cause misdiagnoses, inappropriate treatment decisions, and trigger false alarms. Skin stretch associated with patient motion is a main source of motion artifact in current ECG monitors. A promising approach to reduce motion artifact is the use of adaptive filtering that utilizes a measured reference input correlated with the motion artifact to extract noise from the ECG signal. Previous attempts to apply adaptive filtering to electrocardiography have employed either electrode deformation or acceleration, body acceleration, or skin/electrode impedance as a reference input, and were not successful at reducing motion artifacts in a consistent and reproducible manner. This has been essentially attributed to the lack of correlation between the reference input selected and the induced noise. In this study, motion artifacts are adaptively filtered by using skin strain as the reference signal. Skin strain is measured non-invasively using a light emitting diode (LED) and an optical sensor incorporated in an ECG electrode. The optical strain sensor is calibrated on animal skin samples and finally in-vivo, in terms of sensitivity and measurement range. Skin stretch induced artifacts are extracted in-vivo using adaptive filters. The system and method are tested for different individuals and under various types of ambulatory conditions with the noise reduction performance quantified

CMOS Hyperbolic Sine ELIN filters for low/audio frequency biomedical applications

Hyperbolic-Sine (Sinh) filters form a subclass of Externally-Linear-Internally-Non- Linear (ELIN) systems. They can handle large-signals in a low power environment under half the capacitor area required by the more popular ELIN Log-domain filters. Their inherent class-AB nature stems from the odd property of the sinh function at the heart of their companding operation. Despite this early realisation, the Sinh filtering paradigm has not attracted the interest it deserves to date probably due to its mathematical and circuit-level complexity. This Thesis presents an overview of the CMOS weak inversion Sinh filtering paradigm and explains how biomedical systems of low- to audio-frequency range could benefit from it. Its dual scope is to: consolidate the theory behind the synthesis and design of high order Sinh continuous–time filters and more importantly to confirm their micro-power consumption and 100+ dB of DR through measured results presented for the first time. Novel high order Sinh topologies are designed by means of a systematic mathematical framework introduced. They employ a recently proposed CMOS Sinh integrator comprising only p-type devices in its translinear loops. The performance of the high order topologies is evaluated both solely and in comparison with their Log domain counterparts. A 5th order Sinh Chebyshev low pass filter is compared head-to-head with a corresponding and also novel Log domain class-AB topology, confirming that Sinh filters constitute a solution of equally high DR (100+ dB) with half the capacitor area at the expense of higher complexity and power consumption. The theoretical findings are validated by means of measured results from an 8th order notch filter for 50/60Hz noise fabricated in a 0.35μm CMOS technology. Measured results confirm a DR of 102dB, a moderate SNR of ~60dB and 74μW power consumption from 2V power supply

Motion Artifact Reduction in Impedance Plethysmography Signal

The research related to designing portable monitoring devices for physiological signals has been at its peak in the last decade or two. One of the main obstacles in building such devices is the effect of the subject\u27s movements on the quality of the signal. There have been numerous studies addressing the problem of removing motion artifact from the electrocardiogram (ECG) and photoplethysmography (PPG) signals in the past few years. However, no such study exists for the Impedance Plethysmography (IP) signal. The IP signal can be used to monitor respiration in mobile devices. However, it is very susceptible to motion artifact. The main aim of this dissertation is to develop adaptive and non-adaptive filtering algorithms to address the problem of motion artifact reduction from the IP signal

Low power low noise analog front-end IC design for biomedical sensor interface

Ph.DDOCTOR OF PHILOSOPH

Wireless remote patient monitoring on general hospital wards.

A novel approach which has potential to improve quality of patient care on general hospital wards is proposed. Patient care is a labour-intensive task that requires high input of human resources. A Remote Patient Monitoring (RPM) system is proposed which can go some way towards improving patient monitoring on general hospital wards. In this system vital signs are gathered from patients and sent to a control unit for centralized monitoring. The RPM system can complement the role of nurses in monitoring patients’ vital signs. They will be able to focus on holistic needs of patients thereby providing better personal care. Wireless network technologies, ZigBee and Wi-Fi, are utilized for transmission of vital signs in the proposed RPM system. They provide flexibility and mobility to patients. A prototype system for RPM is designed and simulated. The results illustrated the capability, suitability and limitation of the chosen technology