Nobleo has collaborated with the research department of Emma Children’s Hospital in Amsterdam to develop a home breath monitoring device that could significantly improve the well-being of youngsters with lung diseases like ciliary dyskinesia (PCD) or cystic fibrosis.
“Our team specializes in lung disease, and particularly in the substances people exhale,” says Paul Brinkman, in-house biomedical engineer at Emma Children’s Hospital/Amsterdam University Medical Centre (UMC). “Our focus is on two chronic lung conditions in particular: PCD and cystic fibrosis. Both cause a buildup of mucus in the respiratory system that patients can struggle to get rid of. This frequently leads to secondary infections.”
Currently, the main method of testing for an infection in these patients is through a blood sample or lung function tests. “That’s not always convenient when children are involved,” he says. “And it isn’t predictive either: you only test when there’s an issue.”
That’s why Paul and his team have been working on revolutionizing the process. Testing kids at home, instead of in a clinic. Doing so by having them simply breathe out, rather than giving blood. And, if required, on a daily basis. “Like a police breathalyzer can check whether you have consumed alcohol, we’re working on an analysis system to detect exhaled particles that can indicate a virus, bacterial infection or an impending deterioration in your condition,” he says.
In basic terms, the solution, whose working title is Pheasant (Personalized Home monitoring of Exhaled Air using Swift And Non-invasive Technology), is a unit with an array of sensors for detecting many different types of exhaled particles, and which then captures and communicates this data to healthcare professionals. Nobleo was asked to advise on the most appropriate electronic hardware for the Pheasant unit, and also to develop the software that runs on it.
“I think the biggest challenge for Nobleo was that we were very vague in the beginning,” says Paul. “We wanted software that could communicate with sensors we hadn’t even specified yet.” Bas Caljouw, business developer at Nobleo, was absolutely fine with that. “Actually, we prefer to be involved at an early stage of a project like this,” he says. “We ask a lot of questions in the beginning – some customers may think we ask too many! – but it’s all to make sure that the requirements are correct. If you don’t spend enough time on requirement analysis, you might end up with something that doesn’t work the way your customer expects.”
“Flexibility was crucial,” he continues. “The software platform we developed had to cover all eventualities. Variables like the frequency with which different sensors make measurements, how often the patient uses the device, and transmitting data to the cloud through a secure connection had to be taken into consideration.” This project is part of a wider initiative by Nobleo to develop a new embedded software control platform which offers a stable and secure environment to run applications and algorithms while accelerating the development cycle. There are currently two pilot projects running in the field, of which Pheasant is one.
“The control software made for this system is an example of how our Nobleo embedded platform software can be used,” adds Gaston Muitjens, Nobleo software architect. “The embedded software runs on controller hardware which meets the requirements of our hardware supplier and Amsterdam UMC. This software controls the sensor array via another low-level peripheral driver board, which is connected directly to the sensors and controlled using the SCPI protocol. Our software then makes sure the data generated by the sensors is stored locally, and can be transmitted securely to the SURF Research Cloud once there’s a connection. The MQTT protocol is used for the communication between processes running on the control board, and also for communication with the cloud.” It’s important to note that the data must not only be transmitted over a secure connection, but also anonymized. This is the responsibility of Amsterdam UMC, and not Nobleo.
“We’re hoping to start a clinical trial with a prototype of Pheasant involving around 40 patients at the beginning of 2024,” says Paul. “If that’s successful, we can then see what’s required to turn this into a feasible product, together with external partners, and also look at possible improvements. Nobleo could play a role in that.” Bas agrees. “We’ve already discussed refinements for a next-generation version, such as a separate docking station for the breath monitoring device, a display with feedback for the user about how to use it, or maybe even an app. But first things first: let’s see how the clinical trial goes.”
Research into improving the well-being of sick children
The Emma Children’s Hospital is part of Amsterdam University Medical Centre (UMC). This hospital, which has been providing specialized pediatric care for over 150 years, is committed to innovative research aimed at improving the well-being of sick children. As part of this, it has an in-house team exploring various areas of interest, one of which is pulmonology (diseases and conditions of the chest). Paul Brinkman works as a research associate there, and is currently involved in the Pheasant project.