Epidermal electronics for noninvasive, wireless, quantitative assessment of ventricular shunt function in patients with hydrocephalus
| Autor: | Zachary A. Abecassis, Kun Hyuck Lee, Yinji Ma, Siddharth Krishnan, Barry Ng, John A. Rogers, Chen Wei, Yonggang Huang, Camille Goudeseune, Natalie Kim, Philipp Gutruf, Juliet Freudman, Matthew C. Tate, Matthew B. Potts, Izabela Stankiewicz, Jong Yoon Lee, Tyler R. Ray, Nikhil K. Murthy, Amit Ayer, John Ciraldo, Grace Young, Xue Feng, Julia Stillman |
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| Rok vydání: | 2018 |
| Předmět: |
02 engineering and technology
law.invention Bluetooth 03 medical and health sciences Wearable Electronic Devices 0302 clinical medicine law Medicine Wireless Humans In patient Electronics medicine.diagnostic_test business.industry Continuous monitoring Uncertainty Magnetic resonance imaging General Medicine 021001 nanoscience & nanotechnology medicine.disease Cerebrospinal Fluid Shunts Hydrocephalus Epidermis 0210 nano-technology business Rheology Wireless Technology 030217 neurology & neurosurgery Shunt (electrical) Biomedical engineering |
| Zdroj: | Science translational medicine. 10(465) |
| ISSN: | 1946-6242 |
| Popis: | Hydrocephalus is a common and costly neurological condition caused by the overproduction and/or impaired resorption of cerebrospinal fluid (CSF). The current standard of care, ventricular catheters (shunts), is prone to failure, which can result in nonspecific symptoms such as headaches, dizziness, and nausea. Current diagnostic tools for shunt failure such as computed tomography (CT), magnetic resonance imaging (MRI), radionuclide shunt patency studies (RSPSs), and ice pack–mediated thermodilution have disadvantages including high cost, poor accuracy, inconvenience, and safety concerns. Here, we developed and tested a noninvasive, skin-mounted, wearable measurement platform that incorporates arrays of thermal sensors and actuators for precise, continuous, or intermittent measurements of flow through subdermal shunts, without the drawbacks of other methods. Systematic theoretical and experimental benchtop studies demonstrate high performance across a range of practical operating conditions. Advanced electronics designs serve as the basis of a wireless embodiment for continuous monitoring based on rechargeable batteries and data transmission using Bluetooth protocols. Clinical studies involving five patients validate the sensor’s ability to detect the presence of CSF flow ( P = 0.012) and further distinguish between baseline flow, diminished flow, and distal shunt failure. Last, we demonstrate processing algorithms to translate measured data into quantitative flow rate. The sensor designs, fabrication schemes, wireless architectures, and patient trials reported here represent an advance in hydrocephalus diagnostics with ability to visualize flow in a simple, user-friendly mode, accessible to the physician and patient alike. |
| Databáze: | OpenAIRE |
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