title: Linshom thermodynamic sensor is a reliable alternative to capnography for monitoring respiratory rate.
abstract: Monitoring ventilation accurately is a technically challenging, yet indispensable aspect of patient care in the intra- and post-procedural settings. A new prototypical device known as the Linshom Respiratory Monitoring Device (LRMD) has been recently designed to non-invasively, inexpensively, and portably measure respiratory rate. The purpose of this study was to measure the accuracy and variability of LRMD measurements of respiratory rate relative to the measurement of capnography. In this prospective study, participants were enrolled and individually fitted with a face mask monitored by the LRMD and capnography. With a baseline oxygen flow rate and digital metronome to pace their respiratory rate, the participants were instructed to breathe at 10 breaths per minute (bpm) for 3 min, 20 bpm for 3 min, 30 bpm for 3 min, 0 bpm for 30 s, and resume regular breathing for 30 s. Both sensors were connected to a computer for continuous temperature and carbon dioxide waveform recordings. The data were then retrospectively analyzed. Twenty-six healthy volunteers, mean (range) age 27.8 (23-37) and mean (range) BMI 23.1 (18.8-29.2) kg/m2were recruited. There were 15 males (57.7%) and 11 females (42.3%). After excluding 3 subjects for technical reasons, 13,800 s of breathing and 4,140 expiratory breaths were recorded. Throughout the protocol, the average standard deviation (SD) for the LRMD and capnography was 1.11 and 1.81 bpm, respectively. The overall mean bias (±2SD) between LRMD and capnography was -0.33 (±0.1.56) bpm. At the lowest and intermediate breathing rates reflective of hypoventilation and normal ventilation, the LRMD variance was 0.55 and 1.23 respectively, compared to capnography with 5.54 and 7.47, respectively. At higher breathing rates indicative of hyperventilation, the variance of the test device was 4.52, still less than that of capnography at 5.73. This study demonstrated a promising correlation between the LRMD and capnography for use as a respiratory rate monitor. The LRMD technology may be a significant addition to monitoring vital signs because it offers a minimally intrusive opportunity to detect respiratory rate and apnea, without expensive or complex anesthetic equipment, before the need for life-saving resuscitation arises.
authors.affiliation: Department of Anesthesiology, Perioperative and Pain Medicine, Harvard Medical School/Brigham and Women's Hospital, Boston, MA, 02115, USA.
authors.forename: David
authors.initials: D
authors.lastname: Preiss
authors.affiliation: Department of Anesthesiology, Naval Medical Center Portsmouth, Portsmouth, VA, 23704, USA.
authors.forename: Benjamin A
authors.initials: BA
authors.lastname: Drew
authors.affiliation: Department of Anesthesiology, Perioperative and Pain Medicine, Harvard Medical School/Brigham and Women's Hospital, Boston, MA, 02115, USA.
authors.forename: James
authors.initials: J
authors.lastname: Gosnell
authors.affiliation: Department of Anesthesiology, Perioperative and Pain Medicine, Harvard Medical School/Brigham and Women's Hospital, Boston, MA, 02115, USA.
authors.forename: Bhavani S
authors.initials: BS
authors.lastname: Kodali
authors.affiliation: Department of Anesthesiology, Perioperative and Pain Medicine, Harvard Medical School/Brigham and Women's Hospital, Boston, MA, 02115, USA.
authors.forename: James H
authors.initials: JH
authors.lastname: Philip
authors.affiliation: Department of Anesthesiology, Perioperative and Pain Medicine, Harvard Medical School/Brigham and Women's Hospital, Boston, MA, 02115, USA. rurman@partners.org.|Center for Perioperative Research, Brigham and Women's Hospital, Boston, MA, 02115, USA. rurman@partners.org.
authors.forename: Richard D
authors.initials: RD
authors.lastname: Urman
mesh_terms: D000328:Adult; D015992:Body Mass Index; D019296:Capnography / Q000295:instrumentation* / Q000379:methods; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008991:Monitoring, Physiologic / Q000295:instrumentation* / Q000379:methods; D010092:Oximetry / Q000379:methods; D010100:Oxygen / Q000378:metabolism*; D011446:Prospective Studies; D012119:Respiration; D056152:Respiratory Rate; D012189:Retrospective Studies; D013816:Thermodynamics; D013997:Time Factors; D055815:Young Adult
chemical_list: D010100:Oxygen
keywords: Apnea; End-tidal carbon dioxide; Monitoring; Post-operative; Respiratory rate; Ventilation