title: Measurement of CO2 response with the breath-by-breath automatic acquisition of the breathing pattern and occlusion pressure.
abstract: OBJECTIVE
  Our objective is to present a methodology for the automated acquisition and storage of BP and P0.1 during a CO2 rebreathing test.
  
  
  METHODS
  The system consists of a microcomputer with additional circuits and an automatic electronically controlled valve to occlude the inspiratory airway. Data collection and data processing are separate programs. Airway pressure and flow are digitized at a 100-Hz rate, while PETCO2 is determined and P0.1 is measured on a breath-by-breath basis. Off-line processing calculates the BP variables, generates a correlation matrix (VE/PETCO2, TTOT/PETCO2, TI/PETCO2, TE/PETCO2, [VT/TI]/PETCO2, [TI/TTOT]/PETCO2, P0.1/PETCO2), and edits graphic data. The accuracy of the volume and pressure measurements was tested by comparing known volumes provided by a syringe (n = 100) and a series of pressures controlled by a water manometer (n = 41) on the one hand, with volumes and pressures measured by the device. The accuracy of the time intervals and P0.1 was assessed by comparing in 10 healthy subjects the values measured manually on a graphic recording with those provided by the device (n = 170).
  
  
  RESULTS
  Volumes:Vmeasured = 0.99 x Vcontrolled, r = 0.99, p < 0.001. Pressures:Pmeasured = 0.97 x Pcontrolled + 0.09, r = 0.98, p < 0.001. Inspiratory time:TIautomatic = 0.91 x TIgraphic + 0.22, r = 0.93, p < 0.001. Expiratory time:TEautomatic = 0.93 x TEgraphic + 0.34, r = 0.95, p < 0.001. Occlusion pressure:P0.1automatic = 0.95 x P0.1graphic + 0.62, r = 0.94, p < 0.001. Reproducibility was assumed to be represented by the intraindividual coefficient of variation of the CO2 response. The comparison of an automatic breath-to-breath method with a graphic manual recording revealed significantly less variability with the former (VE/PETCO2: 15.2 +/- 4.5% vs 22.5 +/- 6.3%, p < 0.01; P0.1/PETCO2:8.3 +/- 4.3% vs 19.7 +/- 7.2%, p < 0.001; [VT/TI]/PETCO2:9.1 +/- 3.5% vs 14.5 +/- 5.3%, p < 0.05).
  
  
  CONCLUSIONS
  Our automated acquisition and storage of waveforms and breath-by-breath determination of BP and P0.1 provide an easy and thorough analysis of the respiratory response to CO2 and decrease the variability of the results.
authors.affiliation: Département d'Anesthésie-Réanimation, CHU Jean Verdier, Bondy, France.
authors.forename: J L
authors.initials: JL
authors.lastname: Pourriat
authors.forename: M
authors.initials: M
authors.lastname: Baud
authors.forename: C
authors.initials: C
authors.lastname: Lamberto
authors.forename: J L
authors.initials: JL
authors.lastname: Fournier
authors.forename: M
authors.initials: M
authors.lastname: Cupa
mesh_terms: D000764:Anesthesia, Closed-Circuit; D002245:Carbon Dioxide / Q000502:physiology*; D006801:Humans; D012119:Respiration / Q000502:physiology*; D012984:Software
chemical_list: D002245:Carbon Dioxide