*Article* **Non-Contact Video-Based Neonatal Respiratory Monitoring**

### **Scott L. Rossol 1,\*, Je**ff**rey K. Yang 1, Caroline Toney-Noland 1, Janine Bergin 1, Chandan Basavaraju 2, Pavan Kumar 2 and Henry C. Lee 1**


Received: 16 September 2020; Accepted: 3 October 2020; Published: 6 October 2020

**Abstract:** Respiratory rate (RR) has been shown to be a reliable predictor of cardio-pulmonary deterioration, but standard RR monitoring methods in the neonatal intensive care units (NICU) with contact leads have been related to iatrogenic complications. Video-based monitoring is a potential non-contact system that could improve patient care. This iterative design study developed a novel algorithm that produced RR from footage analyzed from stable NICU patients in open cribs with corrected gestational ages ranging from 33 to 40 weeks. The final algorithm used a proprietary technique of micromotion and stationarity detection (MSD) to model background noise to be able to amplify and record respiratory motions. We found significant correlation—*r* equals 0.948 (*p* value of 0.001)—between MSD and the current hospital standard, electrocardiogram impedance pneumography. Our video-based system showed a bias of negative 1.3 breaths and root mean square error of 6.36 breaths per minute compared to standard continuous monitoring. Further work is needed to evaluate the ability of video-based monitors to observe clinical changes in a larger population of patients over extended periods of time.

**Keywords:** neonatal monitoring; respiratory rate; clinical alarms; video recording; biomedical technology
