Apnéia da prematuridade : proposta de uma tecnologia para a detecção e interrupção do episódio apnéico
2006
Apnea of prematurity (AP) is a breathing disorder very frequent in premature newborns (PN). It is estimated that 50% of the newborns with less than 1.500 g suffer apnea of prematurity as a consequence of their central nervous system immaturity. If the apnea episode is not stopped immediately, it may cause severe damages to childs central nervous system. The research described in this dissertation has the goal of developing a detecting technology for episodes of AP based on parameters such as pulse frequency (PF) and oxygen saturation pressure (SpO2) simultaneously, and reverting them using vibrotactile stimuli. A field research was carried through in order to diagnose the scenario of premature baby apnea treatment performed at Curitiba, Parana, Brazil and at Hartford, Connecticut, U.S.A. The results evidenced the lack of an official protocol for the accomplishment of hand stimulation for apnea reversion. For the development of the proposed system which detects automatically AP, it was defined the conjunction of pulse frequency and SpO2 parameters and their thresholds for apnea episodes in premature babies, whose values are: for newborn newer than <35 gestational weeks, PF is <100 bpm and SpO2 <80%. For PN older than 35 gestational weeks, PF is 100 bpm and SpO2<80%. For apnea interruption the PN was submitted, at distinct moments, to the vibratory and hand stimulation. The system yielded the vibratory stimulus at 250 Hz for 4 s. The vibrotactile stimulation was triggered for FP and SpO2 parameters configured as an apnea event. To manage all systems tasks, a program was developed aiming to acquire and store the behavior of the SpO2 and PF, before, during and after the automated vibratory stimuli application. Also, it may register the period of apnea occurrence, and the moments the vibratory and/or hand stimuli application. The method of apnea detection was tested with in vivo protocol performed on 4 PN with AP. The apnea episodes reverted for the hand stimulation had shown to a lesser time 2,5 faster in time for return physiological normal standards, compared with the reverted ones for the vibratory stimulation, however, The vibratory stimulation presented, on average, 4.3 faster in time than hand stimulation time to promote the return of the respiratory movements. The method for ending the apnea event using vibrotactile stimulation had been revealed a promising form of handling the problem, therefore 10 of the detected apneas, it was able to promote the return of the respiratory movements in 9 and the breath accomplishes in 5 of them.%%%%A apneia da prematuridade (AP) e uma desordem respiratoria muito frequente no recem-nascido (RN) prematuro. Estima-se que 50% dos que pesam menos de 1500g manifestam a AP e essa se deve a imaturidade do seu sistema nervoso central. O episodio de apneia, se nao interrompido a tempo, pode causar severos danos ao sistema nervoso central do prematuro. Neste trabalho, propoe-se o desenvolvimento de uma tecnologia de deteccao e reversao do episodio de AP no recem-nascido baseada nos…
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