P2.023: Electronic Textile-based Remote Physiologic Monitoring in Children: An Evaluation of Heart Rate Concordance with Intensive Care Unit Grade Monitoring Devices

Background: Remote physiologic monitoring (RPM) with electronic wearables has become widely used in adult medicine. However, in pediatrics, and especially in pediatric heart disease (PHD), there remains a technology gap that is generated by the lack of validation of adult-approved devices and pediatric variability in physical size, physiology and developmental stage. Electronic textile (e-textile) based wearable technologies hold potential in allowing comfortable RPM in children of varying sizes in addition to capturing data on physiologic parameters relevant to PHD.

Methods: This study explored the concordance between acquired heart rate from an e-textile wearable chest band with hospital grade physiologic monitoring devices in the cardiac intensive care unit (ICU) setting (Philips IntelliVue MX750 Bedside patient monitor). We prospectively enrolled 10 children with PHD who were admitted to the cardiac ICU. Participants were fitted with a wearable chest band with textile electrodes (Myant® Skiin) to collect various physiologic parameters including heart rate (HR) and electrocardiogram (ECG) for 2-10 hours. Concordance of HR was compared between the wearable and the ICU grade monitor. Qualitative surveys were provided to bedside providers with regards to adverse event monitoring such as the challenges in application and removal of the e-textile.

Results: The median age of the 10 participants was 0.4 years (range: 0.17 to 6.6 years) with an average of 215.4 (10.7 - 699.4) minutes of simultaneous monitoring, of whom 2 participants were excluded due to poor signal/data capture on the ICU monitor end. In the 8 participants, an average 247.3 (114.6 - 699.4) minutes of simultaneous monitoring, there was no statistically significant difference between mean HR from the e-textile band (mean HR = 118.5, Standard Deviation [SD] = 19.5) and the ICU system (mean HR = 119.1, SD= 19.7, p = 0.66). On average, there was 0.58 (-7.09 to 0.06) difference in mean HR between the e-textile band and the ICU system. Mean HR demonstrated statistically significant correlations between the two systems (r= 0.98, p< 0.001), and ranged between 0.94 - 0.99 between the e-textile band and the ICU system HR measurements of participants. No adverse events were noted with application and removal of e-textile.

Conclusion: The e-textile wearable band demonstrated overall excellent agreement with respect to HR when compared to data acquired from the ICU monitors in this cohort. The anticipation is to further study e-textiles in a larger cohort such that the wearable can be validated for RPM in children with pediatric heart disease, both in and out of the hospital setting. Future studies will also explore pediatric validation of other physiologic parameters for RPM.