Progress in non-invasive respiratory monitoring using uncalibrated breathing movement components.
The theory for optimal linear combination of uncalibrated breathing movements was developed and applied in non-invasive respiratory monitoring situations for assessment. 16 patients were monitored overnight for respiratory depression during postoperative pain treatment. Intranasal/extra-oral airway pressure monitoring and pulse oximetry signals were recorded at 50 Hz. Respiratory inductive plethysmography (RIP) provided guidance to nurses regarding sensitivity settings of the pressure device during slow, shallow breathing, and vital information about breathing movements to help distinguish central from obstructive apnoeas. Subsequent analysis showed that the principal components of the standardized RIP signals would be helpful in any automated identification of pressure indicator false alarms and could provide a simple means for supplementary breath classification. The sum and difference of the scaled RIP values tracked changes in tidal volume and indicated any breathing movement asynchrony or paradox associated with obstructions. A construction was developed for emulating RIP calibration predictions of relative changes in tidal volume to within about 1%, so that invasive or demanding monitoring preparations could be by-passed altogether. The necessary signal combination and linearcalibration model background is reviewed for this simple formulation, which arises from component analysis and least squares regression. The methods are illustrated for definitive non-invasive postoperative monitoring and calibration situations. Theoretical and physiological reasons for preferring the use of balanced ribcage and abdomen contributions to overall tidal volume are presented that also help clarify the greater limitations of traditional RIP monitoring practices.
Department of Anaesthetics, University of Bristol, UK.
A M
AM
Black
A
A
Bambridge
G
G
Kunst
R K
RK
Millard
D000701:Analgesics, Opioid / Q000009:adverse effects; D001049:Apnea / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D008875:Middle Aged; D008954:Models, Biological; D008991:Monitoring, Physiologic / Q000379:methods*; D010149:Postoperative Pain / Q000188:drug therapy / Q000503:physiopathology; D010991:Plethysmography / Q000379:methods; D015656:Respiratory Mechanics / Q000502:physiology*
D000701:Analgesics, Opioid