Graduation project: Using surface EMG to detect different types of apnea in neonates

Respiration is one of the most important vital signs monitored in the neonatal intensive care unit (NICU). Currently respiration rate (i.e. quantity of breathing) is measured using chest impedance (CI), where electrodes placed on the neonate’s chest measure the change in electrical impedance of the thorax caused by respiration. The same electrodes are also used to monitor the ECG and the heart rate.

A disadvantage of CI is that it cannot measure the quality of breathing, i.e. amount of effort it takes to breathe. Furthermore, this technique suffers from cardiac interference, resulting in the serious issue of interpreting heart rate as respiration rate during apnea episodes.

There have been developments towards the use of surface electromyography (sEMG) to detect the electrical activity of the diaphragm, the main breathing muscle, thereby providing a measure of both breathing rate and the effort required to breathe. We are interested in this technique as it might have an important benefit over CI to:

  1. Detect normal breathing, obstructive apnea and central apnea

  2. Inform whether a neonate is ready for weaning from respiratory support, e.g. replacing nasal continuous positive airway pressure (nCPAP) by less supportive low flow nasal cannula (LFNC)

  3. Screening of (hemi-) diaphragmatic paresis.

    The current project focusses on the detection of normal breathing, obstructive apnea and central apnea.

    Knowing which type of apnea is occurring is essential for neonatologists as they have to select the correct type of therapy. This project aims at objectively detecting and trying to classify the different types of apnea based on solely sEMG or sEMG in combination with another vital signs commonly registered, without compromising for the current quality of respiration rate. It would entail in-depth signal processing, including the calculation of signal-to-noise ratios, reliability intervals and statistical analyses. This project would ultimately apprise the added value of sEMG over CI. The student will work on data previously collected by the AMC hospital (Amsterdam – NL) in which 30 neonates suffering from episodes of apnea were monitored. This project will objectively evaluate the clinical assessment performed by the AMC.

    The Master student will be recruited by Philips Research (High Tech Campus, Eindhoven, NL) at the Patient Care & Measurements department, which focusses on tailored monitoring solutions for acute patients.

For more information, please contact dr. Carlijn Vernooij, carlijn.vernooij@philips.com