title: Real-time detection, classification, and quantification of apneic episodes using miniature surface motion sensors in rats.
abstract: BACKGROUND
  Real-time detection and classification of apneic episodes remain significant challenges. This study explores the applicability of a novel method of monitoring the respiratory effort and dynamics for rapid detection and classification of apneic episodes.
  
  
  METHODS
  Obstructive apnea (OA) and hypopnea/central apnea (CA) were induced in nine tracheostomized rats, by short-lived airway obstruction and administration of succinylcholine, respectively. Esophageal pressure (EP), EtCO2, arterial O2 saturation (SpO2), heart rate, and blood pressure were monitored. Respiratory dynamics were monitored utilizing three miniature motion sensors placed on the chest and epigastrium. Three indices were derived from these sensors: amplitude of the tidal chest wall displacement (TDi), breath time length (BTL), that included inspiration and rapid expiration phases, and amplitude time integral (ATI), the integral of breath amplitude over time.
  
  
  RESULTS
  OA induced a progressive 6.42 ± 3.48-fold increase in EP from baseline, which paralleled a 3.04 ± 1.19-fold increase in TDi (P < 0.0012), a 1.39 ± 0.22-fold increase in BTL (P < 0.0002), and a 3.32 ± 1.40-fold rise in the ATI (P < 0.024). During central hypopneic/apneic episodes, each sensor revealed a gradual decrease in TDi, which culminated in absence of breathing attempts.
  
  
  CONCLUSIONS
  Noninvasive monitoring of chest wall dynamics enables detection and classification of central and obstructive apneic episodes, which tightly correlates with the EP.
authors.affiliation: 1] Department of Neonatology, Carmel Medical Center, Haifa, Israel [2] Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
authors.forename: Dan
authors.initials: D
authors.lastname: Waisman
authors.affiliation: 1] Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel [2] Faculty of Biomedical Engineering, Technion-IIT, Haifa, Israel.
authors.forename: Lior
authors.initials: L
authors.lastname: Lev-Tov
authors.affiliation: 1] Faculty of Biomedical Engineering, Technion-IIT, Haifa, Israel [2] Department of Neonatology, Mayer Children's Hospital, Haifa, Israel [3] Pneumedicare Ltd., Yokneam, Israel.
authors.forename: Carmit
authors.initials: C
authors.lastname: Levy
authors.affiliation: Faculty of Biomedical Engineering, Technion-IIT, Haifa, Israel.
authors.forename: Anna
authors.initials: A
authors.lastname: Faingersh
authors.affiliation: 1] Department of Neonatology, Mayer Children's Hospital, Haifa, Israel [2] Pneumedicare Ltd., Yokneam, Israel.
authors.forename: Ifat
authors.initials: I
authors.lastname: Colman Klotzman
authors.affiliation: Department of Pediatrics, Barzilai Medical Center, Ashkelon, Israel.
authors.forename: Haim
authors.initials: H
authors.lastname: Bibi
authors.affiliation: 1] Department of Neonatology, Carmel Medical Center, Haifa, Israel [2] Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
authors.forename: Avi
authors.initials: A
authors.lastname: Rotschild
authors.affiliation: Faculty of Biomedical Engineering, Technion-IIT, Haifa, Israel.
authors.forename: Amir
authors.initials: A
authors.lastname: Landesberg
mesh_terms: D000818:Animals; D001794:Blood Pressure; D004195:Disease Models, Animal; D006339:Heart Rate; D008297:Male; D008991:Monitoring, Physiologic / Q000295:instrumentation* / Q000379:methods; D009038:Motion; D010092:Oximetry; D010100:Oxygen / Q000737:chemistry; D011312:Pressure; D051381:Rats; D017207:Rats, Sprague-Dawley; D012119:Respiration; D020182:Sleep Apnea, Central / Q000175:diagnosis; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis*; D013390:Succinylcholine / Q000737:chemistry; D013990:Tidal Volume; D013997:Time Factors; D014139:Tracheostomy
chemical_list: D013390:Succinylcholine; D010100:Oxygen
references.citation: Pediatrics. 2011 Nov;128(5):e1341-67
references.pmid: 22007003
references.citation: Front Neurol. 2011 Nov 29;2:73
references.pmid: 22144976
references.citation: J Appl Physiol (1985). 2004 Nov;97(5):2020-5
references.pmid: 15258129
references.citation: Pediatr Pulmonol. 2008 Oct;43(10):937-44
references.pmid: 18780339
references.citation: J Perinatol. 2004 Dec;24(12):763-8
references.pmid: 15329741
references.citation: Am J Respir Crit Care Med. 2012 Apr 15;185(8):805-16
references.pmid: 22135346
references.citation: Intensive Care Med. 2012 Jan;38(1):120-7
references.pmid: 22105962
references.citation: Pediatr Rev. 2007 Jun;28(6):203-8
references.pmid: 17545331
references.citation: J Mol Cell Cardiol. 2009 Oct;47(4):544-51
references.pmid: 19463830
references.citation: J Sleep Res. 2002 Jun;11(2):161-8
references.pmid: 12028481
references.citation: Early Hum Dev. 1993 Mar;32(2-3):197-206
references.pmid: 8486121
references.citation: Neonatology. 2007;91(3):155-61
references.pmid: 17377399
references.citation: Intensive Care Med. 2011 Jul;37(7):1174-81
references.pmid: 21528388
references.citation: Sleep Med. 2013 Feb;14(2):177-82
references.pmid: 23266107
references.citation: J Appl Physiol (1985). 1997 Aug;83(2):485-94
references.pmid: 9262444
references.citation: Sleep Med. 2002 Mar;3(2):163-73
references.pmid: 14592238
references.citation: Eur J Pediatr. 2011 Sep;170(9):1097-105
references.pmid: 21301866
references.citation: Chest. 2009 May;135(5):1133-41
references.pmid: 19118271
references.citation: Paediatr Respir Rev. 2009 Jun;10(2):75-80
references.pmid: 19410206
references.citation: J Appl Physiol (1985). 2009 Oct;107(4):1017-27
references.pmid: 19608934
references.citation: J Appl Physiol (1985). 2012 Oct;113(7):988-95
references.pmid: 22837173
references.citation: Neonatology. 2013;103(2):98-102
references.pmid: 23172040
references.citation: Pediatr Res. 1999 Mar;45(3):350-4
references.pmid: 10088653
references.citation: IEEE Trans Inf Technol Biomed. 2012 May;16(3):463-8
references.pmid: 22287247
references.citation: JAMA. 2012 Jan 18;307(3):275-82
references.pmid: 22253394
references.citation: Chest. 2003 Oct;124(4):1543-79
references.pmid: 14555592
references.citation: Neonatology. 2011;100(3):303-10
references.pmid: 21986336
references.citation: Chest. 2003 Nov;124(5):1702-8
references.pmid: 14605038
references.citation: Pediatr Clin North Am. 2005 Aug;52(4):1127-46, ix
references.pmid: 16009260
references.citation: J Clin Sleep Med. 2012 Apr 15;8(2):177-85
references.pmid: 22505863
references.citation: Am J Respir Crit Care Med. 1994 Jul;150(1):83-9
references.pmid: 8025778
references.citation: Pediatr Res. 2000 Aug;48(2):140-2
references.pmid: 10926286
references.citation: Pediatrics. 2009 Feb;123(2):533-9
references.pmid: 19171619
references.citation: Am J Respir Crit Care Med. 2000 Jul;162(1):87-93
references.pmid: 10903225
references.citation: Am J Respir Crit Care Med. 2000 Aug;162(2 Pt 1):471-80
references.pmid: 10934073
references.citation: Paediatr Respir Rev. 2004;5 Suppl A:S383-6
references.pmid: 14980301