Wireless Breathing System for Long Term Telemonitoring of Respiratory Activity

Razvan Ciobotariu1, Cristian Rotariu2, Felix Adochiei3 and Hariton Costin2 Faculty of Electrical, Energetical Engineering and Applied Informatics, Gh. Asachi Technical University of Iasi 2 Faculty of Medical Bioengineering, Gr. T. Popa University of Medicine and Pharmacy, Iasi 3 Faculty of Electronics, Telecommunications and Information Technology, Gh. Asachi Technical University of Iasi e-mail: razvan.ciobotariu@yahoo.com
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Abstract - The current common goal in medical services and medical information technology is finding solutions for reducing response time of medical treatment, earlier diagnosis, increasing the accuracy of long-time monitoring for people with medical disorders or during recovery from an acute event or surgical procedure, providing an enhancement of their quality of life. Advances in wireless sensor network technology, the overall miniaturization of their associated hardware low-power integrated circuits and wireless communications enable the design of low-cost, miniature and intelligent physiological sensor modules with applications in the medical services. These modules are capable of measuring, processing, communicating one or more physiological parameters and can be integrated into a wireless personal area network (WPAN). The use of wireless low-power breathing module is suitable for continuous long-time monitoring of human respiration for a number of medical conditions requiring analysis of respiratory rhythm, sleeprelated breathing disorder, ischemic heart disease etc. In this paper is presented the realization of an intelligent breathing system for patient home care, capable of measuring, real-time local digital signal processing and transmission of respiratory signals, using GSM/GPRS protocol, and, in case of disorder, even alert the medical staff, providing the real-time position of mobile patient.

I.

INTRODUCTION

concentration, loss of efficiency of work, sexual dysfunction or even with traffic accidents [1]. According to current studies, some respiratory disorders may be a projection of some disorders of nervous system, specifically the vagus nerve, spinal nucleus or even sinoatrial node (during inspiration, vagus nerve activity is attenuated, leading to an increase heart rate; during expiration, vagus nerve activity is increased, leading to lower heart rate [2][3]). From this can be concluded that long-term respiratory disorders could cause heart diseases, and changes in respiratory rhythm can be used as indicators of heart failure or decompensation [4][5]. Also, recent studies show the relationship between respiratory activity and emotional activities [6]. Considering this aspects, it is obvious the need to study more closely this vital parameter, which requires a long-term monitoring in various situations of daily life of the patients. This, as well as current technological advances, have led to the development of miniature portable devices, that do not compromise convenience and freedom of movement of the patient, enhancing thus their quality of life [7] and in case of emergency, to be able of making decisions and to alert the medical staff [8]. II. MATERIALS AND METHOD Some monitoring methods of the respiratory signal use thermistor based sensors [9], recording the thorax noises with precordial stethoscope [10], radio-waves [11], microwaves [12][13] or respiratory inductive plethysmography [14]. Other methods extract the respiratory signal from the ECG waveform [15]. The wireless breathing system described in this paper is composed by the following components: near patient an wireless breathing module attached on the patient, a monitoring device in form of a PDA (for displaying the signals and processing data); remote units telemonitoring server and terminal monitors. The entire system is depicted in Fig. 1. After local signal processing made by the PDA, the salient data are transmitted using WiFi or GSM/GPRS to the telemonitoring server. In this paper we discuss only the implementation of the breathing system and the monitoring device.

One of the vital signs that should be closely monitored is breathing, especially respiratory frequency and its fluctuations. Usually this parameter is shallow watched, as a doctor who evaluate the breath at a certain moment of time, may find a rate of 20 breaths per minute. However, this parameter can be manifested in various ways, so that at one time it may appear to be normal, but at the immediately following moments, to change its characteristics. In human breath can be seen a series of patterns in its evolution, important to diagnose various diseases [1]. Every breath may differ from the previous one as well as period, amplitude or duration. Respiratory disorders during sleep can induce dysfunctions or diseases which may manifest during the day [1]. Episodes of apnea, hipopnea, partial or total obstruction of the airways, as snoring, lead to a decrease in oxygen saturation of hemoglobin, which, on its turn, lead to poor oxygenation of tissues and organs, causing them, in time, dysfunctions. Thus, these disorders can be associated with tiredness, morning headaches, excessive daytime sleepiness, decreased

Fig. 3. Low-power wireless breathing module with the piezoelectric belt (prototype).

Fig. 1. Wireless breathing system and the remote units for telemonitoring.

The breathing module is presented in Fig. 2 without the piezoelectric belt and in Fig. 3, the piezoelectric belt is attached to the analogical module. The patients Personal Server (PS) is presented in Fig. 4 and Fig. 7. The realization of the breathing system is based on eZ430-RF2500 board, from Texas Instruments [16]. This is a complete development tool, which include the MSP430F2274 microcontroller, with 10 bits A/D converter and CC2500 transceiver working in ISM (industrial, scientific and medical) radio band, at 2.4GHz, for wireless communication. The eZ430-RF2500 is configured as End-Device (ED) and is connected with the thoracic belt (Pneumotrace). Pneumotrace is a sturdy piezoelectric respiration transducer, which require no excitation voltage, the output voltage level being form 20 to 200mV into a one MOhm load and it has an 122cm hook-and-loop strap provided to link ends of transducer package, which has 280mm in length. The belt is placed around the thorax and generates a high-level, linear signal in response to changes in thoracic circumference, associated with respiration [17]. The respiratory module uses a 3V CR2023 battery as power supply. The voltage form the thoracic belt is amplified by the MSP430F2274 internal operational amplifier and digitized with 10 bits by internal A/D converter. The sampling frequency for the A/D converter was chosen at 10 Hz and the voltage reference was set at 1,5V.

The same type of board, eZ430-RF2500, is configured as Access-Point (AP) and is connected to a PDA (HTC X7500), which is the patients Personal Server (PS), through an USB interface (Fig. 4 and Fig. 5). The PDA has the following technical specifications: CPU Intel XScale PXA270 at 624MHz, 128MB RAM, 256MB ROM, 8GB HDD, a large TFT display with resolution 640 x 480 pixels, WiFi, GSM/GPRS and Bluetooth (client/host) interfaces and running Windows Mobile 5 as operating system. The role of the PS is to collect the data from the breathing module and, after a signal processing, to display the respiration waveform and to transmit it together with the respiratory interval and frequency, to a database stored on a telemonitoring server. The software that runs on PS uses a derivative method for respiratory rhythm calculus and, in case of long-time abnormal respiration, an alarm is generated and transmitted to the telemonitoring server. The PS communicate with the telemonitoring server using WiFi or GSM/GPRS protocol.

Fig. 2. Low-power wireless breathing module without the piezoelectric belt (prototype).

Fig. 4. The wireless breathing module connected with the Patient Personal Server.

RF communication

The custom USB interface (Fig. 5) is realized using an USB to TTL transceiver (FT232BL) from FTDI [18] and enables the eZ430-RF2500 to remotely send and receive data through USB connection using the MSP430 Application UART. All data bytes transmitted are handled by the FT232BL chip. The interface also contains a voltage regulator (TPS77301) to provide 3.3 V to the eZ430-RF2500. The eZ430-RF2500 modules (AP and ED) use for communication SimpliciTI, a simple low-power RF network protocol, developed by Texas Instruments, aimed at small RF networks, which typically contain battery operated devices, require long battery life, low data rate and low duty cycle and have a limited number of nodes talking directly to each other or through an AP.

In this instance, the respiratory module initialize onto the network, then, after a START command, wakes up ten times per second to sample the piezoelectric band and battery voltage and to communicate the data to PS through AP. In order to lower the energy waste, since the most power consumer element is the radio transceiver, the microcontroller and the RF component are putted in the sleep mode after each cycle. III. RESULTS The regular human breathing presents similar breaths in terms of duration, amplitude, waveform and 10-12 breaths per minute. Instead, irregular breathing presents a series of disorder, e.g. apnea (cessation of breathing for more than 10 seconds, with or without a decrease in oxygen saturation [1]), recorded and displayed on PS, represented in Fig. 7, together with respiration rate (RR), the received strength signal indication (RSSI) and the battery voltage (VBAT). The breathing system was integrated into a multiple physiological monitoring system for vital signs [8]. In the case presented above and illustrated in Fig. 7, the respiratory rhythm is abnormal, and the PS generates an alarm, which is transmitted to the telemonitoring server.

Fig. 5. The Access-Point and the USB interface (prototype).

In Fig. 6 is represented the flowchart of the software working on MSP430F2274 microcontroller from the breathing module.

Fig. 7. Breathing apnea displayed on patients Personal Server (one square equals 4 seconds).

Fig. 6. Flow-chart of the software that runs on the microcontroller of the acquisition board.

The users interface consist of a drawing area for displaying the patients respiratory signal, an area for indicate the respiratory rate, the battery voltage and the received strength signal indicator, and a control area. The software that works on the monitoring device was written using C# from Visual Studio.NET, version 8, and it computes and analyze the following respiration parameters: - breathing interval measured between two minimums representing two inspiration; - breathing frequency calculated from the breathing interval as a number of breaths per minute (BPM). Normal breathing frequency is 12-20 cycles/minute. The technological achievements allowed the realization of ultra-low power modules with a very long battery life. In order to measure the energy consumption of the breathing module, has been used the method described in [19]. The

current profile was determined using the configuration presented in Fig. 8, in order to obtain the area under the voltage curve. The current profile has an integral of 1160V*s, result used for the energy consumption calculus.

[3]

[4] [5] [6]

[7]

[8] Fig. 8. Electronic system for measuring the current consumption of the breathing module. [9]

The results show that the respiratory module is possible to run 8 days without changing the battery: average_current = (measured_voltage / 10 ) / period_of_transmission = 1160V*s / 10 /0,1 s = 1,16 mA; hours_of_operation = current_rating / average_current = 230 [mA*hrs] / 1,16 [mA] = 198 [hrs] / 24 [hrs/day] = 8,2[days]. IV. CONCLUSIONS

[10] [11]

The realization of the low-power, low-sized wireless modules increases the freedom of movement, affecting as low as possible the mobility and the comfort of the patient and gives the opportunity to monitor for a long period of time the physiological parameters. GPS localization and GSM/GPRS protocols allow the real-time monitoring and, in case of emergency, a rapid localization of the patient. Long-term monitoring and diagnosis of various dysfunctions at an early stage lead to an improvement of medical act, lowering the costs of treatment and medical services and, also, increasing life expectancy and quality of life. ACKNOWLEDGMENT This work was financed by a grant of the Ministry of Education, Research and Innovation / National Centre of Programs Management (www.cnmp.ro/Parteneriate), No. 11067/2007 TELEMON project (www.bioinginerie.ro/telemon) and was realized with the support of POSDRU CUANTUMDOC DOCTORAL STUDIES FOR EUROPEAN PERFORMANCES IN RESEARCH AND INOVATION ID79407 project funded by the European Social Found and Romanian Government. REFERENCES
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