Wearability of Biosensors in Children

Animesh (Ashoo) Tandon, MD, MS; Sravani Avula, MD; Hoang Nguyen, MD; Colin Drummond, MD - Cleveland Clinic Children’s

There is an increase in both clinical and consumer use of wearable biosensors.  Many of these technologies are focused on adults, which means there are few devices designed specifically for children and how these devices should be designed is unclear.

The goal of this project is to determine how to define the concept of wearability in children – allowing for improved device design as well as improved usability for patients and families.  The plan is to call this the Pediatric Wearable Assessment Tool.   Wearability is the concept describing the characteristics of an effective wearable biosensor, spanning sensor accuracy, comfort, battery life, aesthetics, form factor, method of attachment and more.

Gut Microbiome Study

Drs. Stephanie Patterson, Buddy Creech & Fred Lamb - Monroe Carell Jr. Children’s Hospital at Vanderbilt

Feeding difficulties after cardiac surgery occur in 20% of infants with congenital heart disease (CHD). Optimizing nutrition for these infants is important for healing, development, and growth. A healthy gastrointestinal (GI) microbiome promotes growth and good nutrition; however, little is known about the GI microbiome in children with CHD and the contribution to feeding difficulties. Necrotizing enterocolitis (NEC) is one serious complication that occurs in approximately 5% of infants, contributing to poor feeding outcomes and in-hospital mortality (50-73%). Data suggest that preterm infants with NEC have decreased microbial diversity and increased prevalence of pathogenic bacteria that may contribute to this pathology. There are currently no data regarding the relationship between CHD and alterations in the GI microbiome that may contribute to NEC. Analysis of our current study has shown that in infants with CHD, chronic disease is associated with a delay in microbial diversification, when compared to the typical richness that develops in the first 2 months of life. Therefore, this biorepository will allow both a larger sample size to confirm these results and provide an infrastructure to study ways to repopulate the gastrointestinal microbiome in patients. Infants with CHD are also at higher risk for infections after surgery with a 13-30% risk of infection postoperatively. The GI microbiome is important for healthy immune function, which is essential in preventing infections in infants with CHD. No study has evaluated the influence of the GI microbiome and risk for infections in infants with CHD postoperatively.

Growth Accommodating Pediatric Valve Project (Autus Valve)

Sophie Hofferberth, MD & Pedro Del Nido, MD - Boston Children’s Hospital

Congenital heart valve disease has life-threatening consequences that warrant early valve replacement; however, the development of a growth-accommodating prosthetic valve has remained elusive. Thousands of children continue to face multiple high-risk open-heart operations to replace valves that they have outgrown. Here, we demonstrate a biomimetic prosthetic valve that is geometrically adaptable to accommodate somatic growth and structural asymmetries within the heart. Inspired by the human venous valve, whose geometry is optimized to preserve functionality across a wide range of constantly varying volume loads and diameters, our balloon-expandable synthetic bileaflet valve analog exhibits similar adaptability to dimensional and shape changes. Benchtop and acute in vivo experiments validated design functionality, and in vivo survival studies in growing sheep demonstrated that mechanical valve expansion accommodated growth. As illustrated in this work, dynamic size adaptability with preservation of unidirectional flow in prosthetic valves thus offers a paradigm shift in the treatment of heart valve disease.