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ObeSense Monitoring the Consequences of Obesity
Motivations
Obesity is associated with multiple health problems
Cardiovascular diseases
Atrial fibrillation
Hypertension
Obstructive sleep apnea
Diabetes
Certain types of cancer
Has been proven to reduce life expectancy
10% of premature adult deaths
Is reaching epidemic proportions
i. e. Switzerland: 48.7% overweight, 8.3% obese
7.3% of the total healthcare expenses
Guidelines about identification, evaluation and treatment exist
Those guidelines require long-term monitoring
Such monitoring systems do not exist
2
Objectives
Answer a clear medical need by joining research in
physiological markers sensors with clinical end-users
Develop innovative and non-invasive sensors.
Integrate them into single long-term monitoring systems adapted
to obese patients.
• Multi-parametric, low-power, allergy-free, comfortable, with online feedback.
Sophisticated software and algorithms.
Central involvement of end-users.
• Through 3 clinical scenarios
3
Monitoring system 4
Mo
nit
ori
ng
sys
tem
WP1:
respiratory rate and volume Flexible optical fibers
WP2:
cardiac output
Electrical Impedance Tomograohy
WP3:
energy expenditure NIRS
Anaerobic threshold WP4:
blood pressure
ICG, ECG, PPG WP5:
ECG T-shirt
Textile based ECG electrodes
WP6:
wireless body sensor network
WP7:
ECG analysis
Monitoring system 5
Mo
nit
ori
ng
sys
tem
WP1:
respiratory rate and volume Flexible optical fibers
WP2:
cardiac output
Electrical Impedance Tomograohy
WP3:
energy expenditure NIRS
Anaerobic threshold WP4:
blood pressure
ICG, ECG, PPG WP5:
ECG T-shirt
Textile based ECG electrodes
WP6:
wireless body sensor network
WP7:
ECG analysis
Monitoring system
WP1: Monitoring of respiratory rate and volume
EMPA - CSEM
7
Monitoring system 8
Mo
nit
ori
ng
sys
tem
WP1:
respiratory rate and volume Flexible optical fibers
WP2:
cardiac output
Electrical Impedance Tomography
WP3:
energy expenditure NIRS
Anaerobic threshold WP4:
blood pressure
ICG, ECG, PPG WP5:
ECG T-shirt
Textile based ECG electrodes
WP6:
wireless body sensor network
WP7:
ECG analysis
… Monitoring system
WP2: Cardiac output CSEM – EPFL/LTS5 – EPFL/LHTC
9
CO =
5 l/min EIT
feasibility of measuring cardiac output non-invasively via
electrical impedance tomography (EIT)
EIT
1. S
imu
lati
on
s
2. M
ea
su
rem
en
ts
4D Bio-Impedance Model
In planning…
… Monitoring system
Monitoring system 11
Mo
nit
ori
ng
sys
tem
WP1:
respiratory rate and volume Flexible optical fibers
WP2:
cardiac output
Electrical Impedance Tomography
WP3:
energy expenditure
Oxygen consumption by NIRS
Anaerobic threshold WP4:
blood pressure
ICG, ECG, PPG WP5:
ECG T-shirt
Textile based ECG electrodes
WP6:
wireless body sensor network
WP7:
ECG analysis
… Monitoring system
WP3: Estimation of energy expenditure Detection of anaerobic threshold (AT)
IRR, CSEM, EPFL-ASPG
12
Respiratory variables recorded from
12 healthy subjects while exercising
incrementally.
BR and VT by ergospirometer,
HR by instrumented t-shirt (CSEM
SEW model).
13 … Monitoring system
…Estimation of energy expenditure
Platform with 3D accelerometer and ECG front-end
almost complete
Front view
Front view with
electronic
components
Back view
… Monitoring system 14
Energy expenditure
estimation based on
acceleration and ECG
compared to indirect
calorimetry.
… Monitoring system 15
…Estimation of energy expenditure
Fick-based method
USZ
VO2 = 𝑐𝐻𝑏×co× SaO2
– SvO2
𝑘1
VO2: Oxygen consumption (mL/100g/min),
CO: Cardiac output (mL/100g/min),
cHb: Haemoglobin concentration (g/dL).
CO stroke volume × heart beat,
SV = EDV – ESV ≈ 70 𝑚𝐿,
SaO2 pulse oximetry,
SvO2 novel NIRS system.
measured as part
of other WPs
… Monitoring system
…Estimation of energy expenditure
Fick-based method
USZ
16
Stroke volume
Energy expenditure
Respiration rate
Heart beat
Energy expenditure
Heart beat
(beats/min)
Respiration rate
… Monitoring system
…Estimation of energy expenditure
Sensor design and cell-phone/laptop interface
17
Monitoring system 18
Mo
nit
ori
ng
sys
tem
WP1:
respiratory rate and volume Flexible optical fibers
WP2:
cardiac output
Electrical Impedance Tomography
WP3:
energy expenditure NIRS
Anaerobic threshold WP4:
blood pressure
ICG, ECG, PPG WP5:
ECG T-shirt
Textile based ECG electrodes
WP6:
wireless body sensor network
WP7:
ECG analysis
… Monitoring system
WP4: Blood pressure (BP) CSEM
Estimation of BP based on Pulse Transit Time (PTT).
Non-invasive, continuous measurement based on ICG,
ECG, PPG.
19
Monitoring system 20
Mo
nit
ori
ng
sys
tem
WP1:
respiratory rate and volume Flexible optical fibers
WP2:
cardiac output
Electrical Impedance Tomography
WP3:
energy expenditure NIRS
Anaerobic threshold WP4:
blood pressure
ICG, ECG, PPG WP5:
ECG T-shirt
Textile based ECG electrodes
WP6:
wireless body sensor network
WP7:
ECG analysis
… Monitoring system
WP5: Smart ECG T-shirts EMPA - CSEM
Textile based ECG electrodes with humidication pad,
Integration into T-shirt and short validation.
21
Monitoring system 22
Mo
nit
ori
ng
sys
tem
WP1:
respiratory rate and volume Flexible optical fibers
WP2:
cardiac output
Electrical Impedance Tomography
WP3:
energy expenditure NIRS
Anaerobic threshold WP4:
blood pressure
ICG, ECG, PPG WP5:
ECG T-shirt
Textile based ECG electrodes
WP6:
wireless body sensor network
WP7:
ECG analysis
… Monitoring system
Wireless body sensor network
CSEM
23
Embedded architecture for processing of multiple bio-signals and the
integration of signal processing algorithms on the embedded hardware.
… Monitoring system 24
Multi-parameter sensing
EPFL - ESL Touch based/wearable:
1-lead ECG
Respiration
Skin conductance
Motion
Body fat and hydration
level
Emotions: mood
(valence/arousal), stress
Real time BT 4.0
communication, open
APIs.
Monitoring system 25
Mo
nit
ori
ng
sys
tem
WP1:
respiratory rate and volume Flexible optical fibers
WP2:
cardiac output
Electrical Impedance Tomography
WP3:
energy expenditure NIRS
Anaerobic threshold WP4:
blood pressure
ICG, ECG, PPG WP5:
ECG T-shirt
Textile based ECG electrodes
WP6:
wireless body sensor network
WP7:
ECG analysis
… Monitoring system
ECG analysis
EPFL - ASPG
QRS complexes and fiducial points detection in the ECG by
means of mathematical morphology operators in an adaptive
manner.
26
Clinical scenarios
Scenario 1: physical activity & lifestyle
interventions
– Supervised by Dr O. Dériaz (IRR) and Dr U. Mäder
(SFISM) on patients following activity regimen in lab
settings and at home
Scenario 2: hospitalization monitoring
– Obesity and atrial fibrillation, hypertension and type-
2 diabetes
– Supervised by Dr E. Pruvot (CHUV)
Scenario 3: ambulatory monitoring
– Obesity and outpatient cardiovascular complications
– Supervised by Dr E. Pruvot (CHUV)
27