A new, miniaturized, multichannel, personal radiotelemetry system

Evolution of Biotelemetry in Medical Devices: From Radio Pills to mm-Scale Implants

The advent of semiconductor technology in the mid-20th century created unprecedented opportunities to develop a new generation of small-scale wireless medical sensing devices that can support remote monitoring of patients' vital signs. The first radio pills were developed as early as the 1950's using only a few transistors. These swallowable capsules could sense and wirelessly transmit vital parameters from inside the human body. Since then we have witnessed the rapid progress of medical devices driven by the evolution of semiconductor technology, from single-transistor oscillators to complex mixed-signal multi-channel and multi-modal systems. This paper retraces the evolution of biotelemetry devices from their very early inception to the smart miniaturized systems of modern days, focusing on semiconductor-enabled sensing methods and circuits developed over the last six decades. The paper also includes the author's perspective on current and future trends in the development of CMOS-based biotelemeters, focusing on concepts of implant modularity, miniaturization and hybrid energy harvesting solutions.

Open-circuit respirometry: real-time, laboratory-based systems

This review explores the conceptual and technological factors integral to the development of laboratory-based, automated real-time open-circuit mixing-chamber and breath-by-breath (B × B) gas-exchange systems, together with considerations of assumptions and limitations. Advances in sensor technology, signal analysis, and digital computation led to the emergence of these technologies in the mid-20th century, at a time when investigators were beginning to recognise the interpretational advantages of nonsteady-state physiological-system interrogation in understanding the aetiology of exercise (in)tolerance in health, sport, and disease. Key milestones include the 'Auchincloss' description of an off-line system to estimate alveolar O₂ uptake B × B during exercise. This was followed by the first descriptions of real-time automated O₂ uptake and CO₂ output B × B measurement by Beaver and colleagues and by Linnarsson and Lindborg, and mixing-chamber measurement by Wilmore and colleagues. Challenges to both approaches soon emerged: e.g., the influence of mixing-chamber washout kinetics on mixed-expired gas concentration determination, and B × B alignment of gas-concentration signals with respired flow. The challenging algorithmic and technical refinements required for gas-exchange estimation at the alveolar level have also been extensively explored. In conclusion, while the technology (both hardware and software) underpinning real-time automated gas-exchange measurement has progressively advanced, there are still concerns regarding accuracy especially under the challenging conditions of changing metabolic rate.

Open-circuit respirometry: a historical review of portable gas analysis systems

Scientists such as physiologists, engineers, and nutritionists have often sought to estimate human metabolic strain during daily activities and physical pursuits. The measurement of human metabolism can involve direct calorimetry as well as indirect calorimetry using both closed-circuit respirometry and open-circuit methods that can include diluted flow chambers and laboratory-based gas analysis systems. For field studies, methods involving questionnaires, pedometry, accelerometery, heart rate telemetry, and doubly labelled water exist, yet portable metabolic gas analysis remains the gold standard for most field studies on energy expenditure. This review focuses on research-based portable systems designed to estimate metabolic rate typically under steady-state conditions by critically examining each significant historical innovation. Key developments include Zuntz's 1906 innovative system, then a significant improvement to this purely mechanical system by the widely adopted Kofranyi-Michaelis device in the 1940s. Later, a series of technical improvements: in electronics lead to Wolf's Integrating Motor Pneumotachograph in the 1950s; in polarographic O₂ cells in 1970-1980's allowed on-line oxygen uptake measures; in CO₂ cells in 1990s allowed on-line respiratory exchange ratio determination; and in advanced sensors/computing power at the turn of the century led to the first truly breath-by-breath portable systems. Very recent significant updates to the popular Cosmed and Cortex systems and the potential commercial release of the NASA-developed 'PUMA' system show that technological developments in this niche area are still incrementally advancing.

Automated metabolic gas analysis systems: a review

The use of automated metabolic gas analysis systems or metabolic measurement carts (MMC) in exercise studies is common throughout the industrialised world. They have become essential tools for diagnosing many hospital patients, especially those with cardiorespiratory disease. Moreover, the measurement of maximal oxygen uptake (VO2max) is routine for many athletes in fitness laboratories and has become a defacto standard in spite of its limitations. The development of metabolic carts has also facilitated the noninvasive determination of the lactate threshold and cardiac output, respiratory gas exchange kinetics, as well as studies of outdoor activities via small portable systems that often use telemetry. Although the fundamental principles behind the measurement of oxygen uptake (VO2) and carbon dioxide production (VCO2) have not changed, the techniques used have, and indeed, some have almost turned through a full circle. Early scientists often employed a manual Douglas bag method together with separate chemical analyses, but the need for faster and more efficient techniques fuelled the development of semi- and full-automated systems by private and commercial institutions. Yet, recently some scientists are returning back to the traditional Douglas bag or Tissot-spirometer methods, or are using less complex automated systems to not only save capital costs, but also to have greater control over the measurement process. Over the last 40 years, a considerable number of automated systems have been developed, with over a dozen commercial manufacturers producing in excess of 20 different automated systems. The validity and reliability of all these different systems is not well known, with relatively few independent studies having been published in this area. For comparative studies to be possible and to facilitate greater consistency of measurements in test-retest or longitudinal studies of individuals, further knowledge about the performance characteristics of these systems is needed. Such information, along with the costs and the common features associated with these systems, may aid physicians and scientists to select a system that is best suited to their requirements and may also improve the quality of these frequently-reported physiological measures.

A radiotelemetry system for chronic measurement of blood pressure and heart rate in the unrestrained rat validation of the method

Chronic measurements of systemic arterial blood pressure and heart rate via a chronically implanted telemetric transmitter in unrestrained rats, was validated in a three-phase study. In the first part, week-to-week variability of systolic, diastolic, and mean arterial pressures, and heart rate was found to be minimal over the course of nine weeks. In the second part, the reproducibility of cardiovascular response to three successive administration of sotalol, an antihypertensive agent, was studied. In the last part, cardiovascular parameters determined by telemetry were compared to those obtained by direct arterial catheterization and showed a good linear correlation between those two methods.

Telemetry system for heart-rate and blood temperature using a microcomputer

A radio-telemetry system using a microcomputer has been constructed to measure both the heart-rate (HR) and right atrial blood-temperature in dogs. The telemeter incorporates a thermistor temperature probe, which allows blood-temperature measurements in the range of 35 degrees-42 degrees C with an available resolution of +/- 0.02 degree C. The output of the receiver is connected to active filters, a frequency counter and an HR meter, and finally to a microcomputer, through an appropriate interface circuit, for data linearization and storage.