Changes in tidal volume, frequency, and ventilation induced by their measurement.

Gilbert, Robert; Auchincloss, J. Howland; Brodsky, Jay B.; Boden, William E.

doi:10.1152/jappl.1972.33.2.252

Cited by 318 publications

(168 citation statements)

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“…On the other hand, the progressive decline of FET,CO 2 starting from an initially normal value, observed in patients during mouthpiece breathing, was not observed during Respitrace recording nor during the following period of mouthpiece breathing: from the onset, FET,CO 2 was lower than in normal subjects and did not vary significantly during the recordings. Taking in the mouthpiece resulted, as expected [29], in an increase in VT, similar in normal subjects and in patients, however without modification of FET,CO 2 . Apparently, when preceded by a period of breathing recording by the Respitrace, the mouthpiece did not represent any further challenge for the patients.…”

Section: Discussionsupporting

confidence: 81%

Unsteadiness of breathing in patients with hyperventilation syndrome and anxiety disorders

Han

Stegen²,

Simkens³

et al. 1997

Eur Respir J

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Simply breathing via a mouthpiece and pneumotachograph made end-tidal CO 2 fractional concentration (FET,CO 2 ) decrease progressively both in hyperventilators and in patients with anxiety disorders, but not in normals. At the start of the measurement the FET,CO 2 was not different between patients and healthy subjects. In patients ≤28 yrs, the decrease of FET,CO 2 resulted from a higher tidal volume, and in patients ≥29 years from an increase in frequency. After voluntary hyperventilation, the recovery of FET,CO 2 was delayed in patients, due to a slower normalization of respiratory frequency in females and in older males, and of tidal volume in younger males, and also due to less frequent end-expiratory pauses. When breathing was recorded first by means of inductive plethysmography (Respitrace), the progressive decline of FET,CO 2 seen in patients was not observed: from the onset of the recording, FET,CO 2 was reduced in patients. It did not change further when, immediately afterwards, the subject switched to mouthpiece breathing.The finding that breathing through a mouthpiece induces hyperventilation in patients and that recovery of FET,CO 2 is delayed after voluntary hyperventilation, suggests that the respiratory control system is less resistant to challenges (mouthpiece or voluntary hyperventilation) in those patients. On the other hand, the lower values of FET,CO 2 measured during recording by means of a Respitrace probably result from a challenge, prior to the recordings, induced by the fitting of the measuring device to the patient. This unsteadiness of breathing characterizes patients with hyperventilation syndrome and those with anxiety disorders, but is not sufficiently sensitive to be used for individual diagnosis.

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Section: Discussionsupporting

confidence: 81%

Unsteadiness of breathing in patients with hyperventilation syndrome and anxiety disorders

Han

Stegen²,

Simkens³

et al. 1997

Eur Respir J

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“…Inaccurate rates may mislead physicians in their respiratory assessments and magnify the utility of pulse oximetry. Respiratory rate measurements are notoriously sensitive to measurement techniques 2,22 and are often assessed inaccurately. 23 We made extensive efforts to ensure that clinicians received reliable respiratory rate measurements, and the counting of respiratory rates was the most tedious aspect of this study.…”

Section: Discussionmentioning

confidence: 99%

Pulse Oximetry as a Fifth Pediatric Vital Sign

Mower¹,

et al. 1997

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ABSTRACT. Purpose. To determine the utility of pulse oximetry as a routine fifth vital sign in acute pediatric assessment.Design. Prospective study using pulse oximetry to measure oxygen saturation in children presenting to emergency department triage. Saturation values were disclosed to clinicians only after they had completed medical evaluations and were ready to discharge or admit each child. We measured changes in medical treatment and diagnoses initiated after the disclosure of pulse oximetry values.Setting and Participants. The study included 2127 consecutive children presenting to triage at a university emergency department.Measurements. Changes in select diagnostic tests: chest radiography, complete blood count, spirometry, arterial blood gases, pulse oximetry, and ventilation-perfusion scans; treatments: antibiotics, ␤-agonists, supplemental oxygen; and hospital admission and final diagnoses that occurred after disclosure of triage pulse oximetry values.Results. Of 305 children having triage pulse oximetry values less than 95%, physicians ordered second oximetry for 49, additional chest radiography for 16, complete blood counts for 7, arterial blood gas measurements for 4, spirometry for 2, and ventilation-perfusion scans for 2. Physicians ordered 39 new therapies for 33 patients, including antibiotics for 15, supplemental oxygen for 11, and ␤-agonists for 8. Five patients initially scheduled for hospital discharge were subsequently admitted. Physicians changed or added diagnoses in 25 patients.Conclusions. Using pulse oximetry as a routine fifth vital sign resulted in important changes in the treatment of a small proportion of pediatric patients. Pediatrics 1997;99:681-686; oximetry, vital signs, triage, oxygen saturation.ABBREVIATIONS. Sao 2 , arterial oxygen saturation; ED, emergency department.Simple clinical signs, including respiratory rate, presence of retractions or nasal flaring, grunting, cyanosis, pallor, and general appearance, are used to assess the cardiorespiratory status of infants and children. Previous investigators have found that although these clinical signs are frequently present, their absence does not reliably exclude the possibility of serious cardiopulmonary disease or lower respiratory tract infections.

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“…It is widely recognized that the amount and pattern of ventilation may be altered by the method of measurement, which usually involves breathing through a mouth piece and valve box while wearing a nose clip and sitting in a pulmonary laboratory, all of which are unnatural practices (Gilbert, Auchincloss, Brodsky & Boden, 1972). As a result, several indirect ways of measuring ventilation have been developed.…”

Section: Gm Sterlingmentioning

confidence: 99%

Ventilation.

Sterling¹

1979

Brit J Clinical Pharma

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Changes in tidal volume, frequency, and ventilation induced by their measurement.

Cited by 318 publications

References 0 publications

Unsteadiness of breathing in patients with hyperventilation syndrome and anxiety disorders

Unsteadiness of breathing in patients with hyperventilation syndrome and anxiety disorders

Pulse Oximetry as a Fifth Pediatric Vital Sign

Ventilation.

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