Calibration of respiratory inductive plethysmograph during natural breathing

Sackner, Marvin A.; Watson, Herman; Belsito, Anne; Feinerman, Drew; Suarez, Martin A.; G, González Díaz; Bizousky, F.; Krieger, Bruce P.

doi:10.1152/jappl.1989.66.1.410

Cited by 337 publications

(253 citation statements)

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“…However, this requires prior calibration with airflow measured at a facemask if absolute volumes are to be measured 8 , which negates most of the advantage of the technique. Using uncalibrated RIP has been advocated 9 , but the accuracy of tidal parameters measured in this way has been questioned 10 .…”

Section: Discussionmentioning

confidence: 99%

Measuring tidal breathing parameters using a volumetric vest in neonates with and without lung disease

Olden

Symes

Seddon

2010

Pediatric Pulmonology

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. Measuring tidal breathing parameters using a volumetric vest in neonates with and without lung disease. Pediatric Pulmonology, Wiley, 2010, 45 (11) Lung function measurement is difficult in unsedated infants; tidal breathing parameters are a useful non-invasive surrogate, but even these measurements cause disturbance from applying a facemask. We investigated a novel volumetric vest system (FloRight), which measures volume changes of the respiratory system from changes in the magnetic fields induced by current-carrying coils around the entire chest and abdomen.Using a facemask and ultrasonic flowmeter as comparator, we assessed the validity and repeatability of tidal breathing parameters measured by FloRight in 10 healthy newborn infants during natural sleep. We also assessed the effect of a facemask on tidal volume and tidal expiratory flow parameters. To assess the ability of the FloRight system to detect disease, we compared the healthy infants with 11 infants suffering from bronchopulmonary dysplasia.Tidal parameters with the FloRight vest corresponded closely with facemask measurements.Mean difference, mask minus vest, for tidal volume was 0.096mL (p<0.05), with limits of agreement +4.5 to -4.3mL. Coefficient of repeatability was similar for mask and vest measurements. Tidal volume measured by FloRight with mask in place (20.6mL) was significantly higher than without mask (16.1mL), but tidal expiratory flow parameters were not altered. FloRight measurements of tidal parameters were markedly different between the two groups of infants, with tidal volume per Kg sigificantly higher and tidal expiratory flow parameters significantly lower.Our findings suggest that the FloRight system is able to measure tidal breathing parameters accurately, in healthy newborn infants, without prior calibration on the infant. It appears to have at least sufficient sensitivity to detect severe respiratory disease.

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Section: Discussionmentioning

confidence: 99%

Measuring tidal breathing parameters using a volumetric vest in neonates with and without lung disease

Olden

Symes

Seddon

2010

Pediatric Pulmonology

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“…The bands provide voltage changes that are proportional to the changes in their cross-sectional area and thus reflect the volume changes in the rib cage and abdominal compartments. Calibration was achieved by the built-in qualitative diagnostic calibration procedure that determines the relative electrical gains for the two signals (20,21). This procedure takes approximately 5 min and was done while the infants were in the supine position, lying quietly in their incubators.…”

Section: Methodsmentioning

confidence: 99%

Proportional Assist Ventilation Decreases Thoracoabdominal Asynchrony and Chest Wall Distortion in Preterm Infants

et al. 2001

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Thoracoabdominal asynchrony (TAA) and chest wall distortion (CWD) are commonly seen in preterm infants secondary to a highly compliant rib cage and poor compensation of distorting forces by inspiratory rib cage muscles. Continuous positive airway pressure (CPAP) reduces TAA and CWD by stenting the chest wall. We hypothesized that application of positive airway pressure only during inspiration and in proportion to an infant's inspiratory effort should have a similar but more pronounced effect than CPAP alone. A ventilator providing airway pressure changes in proportion to flow and volume generated by an infant (proportional assist ventilation) was used to unload the respiratory pump during inspiration. Ten preterm infants were studied [birth weight, 745 (635-1175) g; gestational age, 26.5 (24 -31) wk; postnatal age 3 (1-7) d; medium (range)]. TAA and CWD were determined by respiratory inductive plethysmography. TAA was expressed as the phase angle between the rib cage and abdominal motion and CWD as the total compartmental displacement ratio. In addition, we measured tidal volume with a pneumotachograph and esophageal and airway pressure deflections with pressure transducers. Measurements were obtained during alternating periods of CPAP and two different degrees of support (Gain 1 ϭ 1.09 Ϯ 0.68, Gain 2 ϭ 1.84 Ϯ 0.84 cm H 2 O/mL) that were provided by a proportional assist ventilator. Phase angle and the total compartmental displacement ratio decreased with increasing gain compared with CPAP alone. Peak airway pressure increased from 0.6 to 3.8 to 7.6 cm H 2 O above positive end-expiratory pressure (PEEP) with CPAP, Gain 1, and Gain 2, respectively, as tidal volume increased from 2.8 to 4.1 to 4.7 mL/kg. Esophageal pressure changes decreased only little with increasing gain. Chest wall excursion increased and abdominal movement decreased, indicating a redistribution of tidal volume between chest and abdomen. We conclude that proportional assist ventilation reduces TAA and CWD by generating a small increase in airway pressure that occurs in synchrony and in proportion to each inspiratory effort. TAA, in which the rib cage and abdomen move out of phase due to inward CWD, are commonly seen in spontaneously breathing preterm infants. TAA and CWD are more pronounced in the presence of decreased lung compliance or increased airway resistance but can also be seen in preterm infants without lung disease or in term infants during REM sleep (1-4). The phenomenon is caused by mainly two factors: the negativity of the pleural pressure generated during inspiration and the compliance of the chest wall (5-7). For the chest wall to move along the pressure/volume curve seen during passive inflation of the respiratory system, active compensation from the inspiratory chest wall muscles, counteracting the distorting pleural force, is necessary (8). It has been shown that the more immature the infants are, the less well developed is their active compensation (9). It may be completely absent in very immature infants, leading to a 180...

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“…(4,8,9) Although ISOCAL is considered the gold standard for RIP calibration, the vast majority of studies employ QDC because the method requires no specific respiratory maneuvers. (10)(11)(12)(13) We are unaware of any studies comparing the two methods of RIP calibration regarding the values of the constant K when different positions are employed.…”

Section: Introductionmentioning

confidence: 99%

“…(3,4) Respiratory inductive plethysmographs are generally composed of two elastic bands that are placed around the rib cage and abdomen for movement transduction. These bands generate electrical signals that are proportional to the movements of the thoracic and abdominal compartments.…”

Section: Introductionmentioning

confidence: 99%

“…Chief among the various methods for calibrating respiratory inductive plethysmographs are isovolume maneuver calibration (ISOCAL), (3) which is considered the gold standard, and qualitative diagnostic calibration (QDC). (4) For ISOCAL, the subject is instructed to shift volumes between the rib cage and abdomen voluntarily and with occluded airways. This respiratory maneuver causes the ∆V AO value to be zero, therefore establishing the following equation:…”

Section: Introductionmentioning

confidence: 99%

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Pletismografia respiratória por indutância: estudo comparativo entre calibração por manobra de isovolume e calibração qualitativa diagnóstica em voluntários saudáveis avaliados em diferentes posturas

2012

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Objective: To compare two methods of respiratory inductive plethysmography (RIP) calibration in three different positions. Methods: We evaluated 28 healthy subjects (18 women and 10 men), with a mean age of 25.4 ± 3.9 years. For all of the subjects, isovolume maneuver calibration (ISOCAL) and qualitative diagnostic calibration (QDC) were used in the orthostatic, sitting, and supine positions. In order to evaluate the concordance between the two calibration methods, we used ANOVA and Bland-Altman plots. Results: The values of the constant of proportionality (K) were significantly different between ISOCAL and QDC in the three positions evaluated: 1.6 ± 0.5 vs. ResumoObjetivo: Comparar dois métodos de calibração da pletismografia respiratória por indutância (PRI) em três posturas diferentes. Métodos: Foram avaliados 28 indivíduos saudáveis (18 mulheres e 10 homens), com média de idade de 25,4 ± 3,9 anos. Todos os indivíduos foram submetidos a isovolume maneuver calibration (ISOCAL, calibração por manobra de isovolume) e qualitative diagnostic calibration (QDC, calibração diagnóstica qualitativa) em ortostatismo, sedestação e decúbito dorsal. Foi utilizada ANOVA e a disposição gráfica de Bland-Altman para a avaliação da concordância dos métodos de calibração. Resultados: Os valores da constante de proporcionalidade (K) foram significativamente distintos entre ISOCAL e QDC nas três posturas avaliadas: 1,6 ± 0,5 vs. 2,0 ± 1,2, em decúbito dorsal; 2,5 ± 0,8 vs. 0,6 ± 0,3, em sedestação; e 2,0 ± 0,8 vs. 0,6 ± 0,3, em ortostatismo (p < 0,05 para todos). Conclusões: Nossos resultados sugerem que QDC não é um método acurado para a calibração da PRI. Os valores de K obtidos por ISOCAL mostram que a PRI deve ser calibrada para cada postura avaliada.Descritores: Pletismografia; Mecânica respiratória; Postura; Calibragem. where SD(∆ U V AB ) and SD(∆ U V CT ) are the standard deviations of the electrical signals related to the abdomen and rib cage, respectively. (4,8,9) Although ISOCAL is considered the gold standard for RIP calibration, the vast majority of studies employ QDC because the method requires no specific respiratory maneuvers. (10)(11)(12)(13) We are unaware of any studies comparing the two methods of RIP calibration regarding the values of the constant K when different positions are employed.

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Calibration of respiratory inductive plethysmograph during natural breathing

Cited by 337 publications

References 0 publications

Measuring tidal breathing parameters using a volumetric vest in neonates with and without lung disease

Measuring tidal breathing parameters using a volumetric vest in neonates with and without lung disease

Proportional Assist Ventilation Decreases Thoracoabdominal Asynchrony and Chest Wall Distortion in Preterm Infants

Pletismografia respiratória por indutância: estudo comparativo entre calibração por manobra de isovolume e calibração qualitativa diagnóstica em voluntários saudáveis avaliados em diferentes posturas

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