Foundational Research & Global Recognition

 

The Science Behind the Innovation

Makani Science was founded on high-impact, peer-reviewed research that redefines how we monitor respiratory health. Our core sensing technology is backed by a landmark study published in Nature, currently ranked in the top 5% of all global research outputs (Altmetric Score).

• Foundational Paper: Respiration rate and volume measurements using wearable strain sensors.

• Impact Score: Nature Altmetric Top 5%

• The Technology: Our founder's research introduced the high-fidelity sensing methodology that allows for continuous, non-invasive monitoring of respiratory dynamics, solving the "monitoring gap" inherent in traditional pulse oximetry.

 

Featured Clinical Commentary: MedCram

Independent medical educators have recognized the significance of this technology. MedCram, a leading authority in medical education, featured our underlying science in their deep-dive into advanced respiratory monitoring.

• Watch: Independent Review of Makani Science Technology by MedCram

• Key Insight: The segment highlights how our sensor captures real-time breathing mechanics, providing clinicians with data that is often missed by standard peripheral saturation (SpO2) monitors.

 

Clinical Evidence: The 2026 Lancet Series on PLD

The following summaries outline the groundbreaking research published in The Lancet Respiratory Medicine (January 2026). This series introduces Prematurity-Associated Lung Disease (PLD) as a unifying framework for the lifelong respiratory consequences of preterm birth.

 

1. Defining PLD: Beyond the NICU Diagnosis

Source: Course CW, et al. Looking beyond bronchopulmonary dysplasia: prematurity-associated lung disease and its phenotypes. * Key Insight: This paper moves the medical community beyond the traditional neonatal diagnosis of Bronchopulmonary Dysplasia (BPD) to a life-course framework called Prematurity-Associated Lung Disease (PLD).

• Clinical Significance: PLD affects not only extremely preterm infants but also those born moderate and late preterm (32–36 weeks), who often experience chronic respiratory symptoms despite not having a BPD diagnosis in the NICU.

• Implications for Monitoring: Identifying the specific PLD phenotype—such as obstructive disease or dysanapsis (a developmental mismatch where the airways are undersized relative to overall lung volume)—is essential for personalized care. Early identification of breathing instability is a critical first step in this framework.

• Read Full Article at The Lancet

 

2. Lifelong Trajectories: Protecting the First 1,000 Days

Source: Du Berry C, et al. Trajectories of prematurity-associated lung disease: lifelong lung health. * Key Insight: Preterm birth alters lung function trajectories from birth through adulthood. If an infant starts on a "suboptimal" trajectory, they are at significantly higher risk for early-onset COPD (before age 50).

• AOP Connection: Physiological stressors in early life, including episodes of immature breathing control, can signal or contribute to a declining trajectory.

• Clinical Significance: The first years of life are a critical window for intervention. Accurate monitoring of respiratory events during this period is vital to ensure the child remains on a healthy lung-growth path.

• Read Full Article at The Lancet

 

3. Management and "Treatable Traits" of Respiratory Control

Source: Duijts L, et al. Management of prematurity-associated lung disease from infancy through to adulthood. * Key Insight: The series identifies "abnormal respiratory control" and "neuromuscular immaturity" as key Treatable Traits of PLD that require active management.

• Clinical Significance: Effective management of PLD requires "longitudinal assessment" and "early identification" of breathing instability. The authors advocate for structured follow-up that transitions from the NICU into childhood and beyond.

• Monitoring Recommendation: There is an urgent clinical need for reliable monitoring tools to track respiratory control traits, especially during the "uncertain" transition period after hospital discharge.

• Read Full Article at The Lancet

 

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Clinical Evidence: The Link Between AOP and Long-Term Outcomes

Effective management of Apnea of Prematurity (AOP) is increasingly recognized as a critical intervention point for preventing lifelong respiratory and neurological impairment. Below is the foundational evidence linking early-life breathing stability to long-term health trajectories.

 

1. AOP and Respiratory Health: The PLD Connection

Recent research has established that intermittent hypoxemia (IH) associated with apnea is not just a symptom, but a primary driver of lung injury.

• The 20-Fold Risk Factor: A landmark study of 1,018 infants found that the probability of developing severe Bronchopulmonary Dysplasia (BPD)—now part of the PLD framework—increased 20-fold for infants with high exposure to hypoxemic episodes (Jensen et al., 2022).

• Predicting Mortality: In extremely preterm infants, the duration of hypoxemic events below 70% SpO₂ is a significant predictor of both pulmonary hypertension (BPD-PH) and mortality (Gentle et al., 2023).

• Early Intervention Success: The CAP Trial demonstrated that when apnea is proactively managed (e.g., with caffeine therapy), the incidence of BPD and neurodevelopmental delay is significantly reduced (Williamson et al., 2021).

 

2. AOP and Brain Health: Impact of Cerebral Hypoxia

Apneic episodes cause immediate and measurable deficits in brain oxygenation, even when peripheral oxygen levels appear stable.

• Cerebral Oxygen Deficits: Research indicates that apneic episodes cause a direct decrease in cerebral oxygenation. Post-hypoxic "overshoots" reflect dangerous vasodilation and reperfusion stress (Choi et al., 2021). 

• The Bradycardia Threshold: When apnea-related bradycardia falls below 80 bpm, there is a significant reduction in cerebral blood flow velocity, which is strongly linked to poor neurodevelopmental scores in later childhood (Pfurtscheller et al., 2023).

• Long-term Impairment: Even in "clinically stable" infants, the total time spent in respiratory events (apneas and periodic breathing) predicts reduced language and motor scores at 6 months of age (Yee et al., 2023). 

 

3. The Call for Advanced Monitoring

Leading experts now argue that traditional pulse oximetry histograms are insufficient for modern care.

• Frequency vs. Duration: Research suggests that the frequency of intermittent hypoxemia events is a more accurate predictor of BPD risk than the total time spent in hypoxemia (Di Fiore et al., 2021).

• The Monitoring Gap: There is a direct call in the literature for "improved measurement of apnea and respiratory dynamics" to better stratify infants based on their risk of poor long-term outcomes (Di Fiore et al., 2021).

 

Our Perspective

At Makani Science Inc, our monitoring systems are specifically engineered to address the 'Monitoring Gap' identified by Di Fiore et al. (2021) and the 'Longitudinal Assessment' needs highlighted in the 2026 Lancet Series."