Comparison of Postoperative Respiratory Monitoring by Acoustic and Transthoracic Impedance Technologies in Pediatric Patients at Risk of Respiratory Depression

Patiño, Mario; Kalin, Megan; Griffin, Allison; Minhajuddin, Abu; Ding, Lili; Williams, Timothy; Ishman, Stacey L.; Mahmoud, Mohamed; Kurth, C. Dean; Szmuk, Peter

doi:10.1213/ane.0000000000002062

Cited by 11 publications

(4 citation statements)

References 13 publications

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“…When applied to the acute setting thoracic impedance measurements of adults presenting to an emergency department showed poor agreement against criterion standard measurements of respiratory rate, [20] with the limits of agreement between -8.6 and 9.5 breaths/min. More recently acoustic methods of measuring RR have been trialed in children post-operatively [22]. When compared against capnography measurements, the limits of agreement were -7.3 to 6.6 breaths/min.…”

Section: Discussionmentioning

confidence: 99%

A Novel, Contactless, Portable “Spot-Check” Device Accurately Measures Respiratory Rate

Daw

Kingshott

Saatchi

et al. 2020

Journal of Medical Devices

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Respiratory rate (RR) is an important vital sign used in the initial and ongoing assessment of acutely ill patients. It is also used as a predictor of serious deterioration in a patient's clinical condition. Convenient electronic devices exist for measurement of pulse, blood pressure, oxygen saturation, and temperature. Although devices which measure RR exist, none has entered everyday clinical practice. We have developed a contactless portable respiratory rate monitor (CPRM) and evaluated the agreement in respiratory rate measurements between existing methods and our new device. The CPRM uses thermal anemometry to measure breath signals during inspiration and expiration. RR data were collected from 52 healthy adult volunteers using respiratory inductance plethysmography (RIP) bands (established contact method), visual counting of chest movements (established noncontact method), and the CPRM (new method), simultaneously. Two differently shaped funnel attachments to the CPRM were evaluated for each volunteer. Data showed a good agreement between measurements from the CPRM and the gold standard RIP, with intraclass correlation coefficient (ICC): 0.836, mean difference 0.46 and 95% limits of agreement of −5.90 to 6.83. When separate air inlet funnels of the CPRM were analyzed, stronger agreement was seen with an elliptical air inlet; ICC 0.908, mean difference 0.37 with 95% limits of agreement −4.35 to 5.08. A contactless device for accurately and quickly measuring respiratory rate will be an important triage tool in the clinical assessment of patients. More testing is needed to explore the reasons for outlying measurements and to evaluate in the clinical setting.

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Section: Discussionmentioning

confidence: 99%

A Novel, Contactless, Portable “Spot-Check” Device Accurately Measures Respiratory Rate

Daw

Kingshott

Saatchi

et al. 2020

Journal of Medical Devices

View full text Add to dashboard Cite

show abstract

“…Comparisons of these technologies to capnography to measure respiratory rate among patients in the PACU have raised concerns regarding their sensitivity49,50; however, the performance differences between bioacoustic monitoring and capnography are more modest (or even equivalent) than other technologies 49,51–53. One study found acoustic monitoring to be superior to impedance pneumography in detecting RD among posttonsillectomy pediatric patients 54…”

Section: Incidence Of Rd Among Hospitalized Patientsmentioning

confidence: 99%

“…49,[51][52][53] One study found acoustic monitoring to be superior to impedance pneumography in detecting RD among posttonsillectomy pediatric patients. 54 Ishikawa and Sakamoto 55 used a combination of acoustic respiratory rate monitor and pulse oximetry to detect RD on 1064 general care wards, adult postoperative patients and found an incidence of desaturation (SpO 2 <90% for > 10 s) of 12.1% and bradypnea (respiratory rate <8 breaths per minute for > 2 min) to be 5.1%. Although the rate of desaturation was much lower than that reported by Sun et al, 34 the rate was comparable to the PRODIGY trial (13%, albeit defined as SpO 2 ≤ 85% > 3 min); however, the rate of bradypnea was much lower than reported in PRODIGY (58%, defined as respiratory rate ≤ 5 breaths per minute > 3 min).…”

Section: Continuous Electronic Monitoringmentioning

confidence: 99%

An update on postoperative respiratory depression

Weingarten

Šprung

2022

International Anesthesiology Clinics

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“…The Masimo RRa product (Masimo Corporation, Irvine California USA) is a piezoelectric sticker that is placed on the neck to detect airflow acoustic signals. Two studies demonstrated the Masimo RRa product showed greater sensitivity and specificity than thoracic impedance pneumography or capnography by nasal cannula at detecting apneic events [16,17]. The Infant and Pediatric cap-ONE utilizes a mask with mainstream capnography (Nihon Kohden Corporation, Tokyo, Japan) and more accurately monitors carbon dioxide levels in patients without advanced airways when compared to capnography via nasal cannula [18].…”

Section: Monitoring and Equipmentmentioning

confidence: 99%

An update on pediatric sedation techniques in nonoperating room locations

Sobey

Tsai

Evans

2021

Current Opinion in Anaesthesiology

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Purpose of reviewTo review advancements in care for pediatric patients in nonoperating room settings. Recent findingsAdvances in patient monitoring technology, utilization of Child Life specialists, and alternative staffing models are helping anesthesia providers meet the rising demand for coverage of pediatric nonoperating room anesthesia (NORA) cases. The Wake Up Safe and Pediatric Sedation Research Consortium registries are exploring outcome measures regarding the safety of pediatric anesthesia in off-site locations and have reported an increased risk for severe respiratory and cardiac adverse events when compared to OR anesthesia sites. Additionally, malpractice claims for NORA have a higher proportion of claims for death than claims in operating rooms. SummaryPediatric NORA requires thorough preparation, flexibility, and vigilance to provide safe anesthesia care to children in remote locations. Emerging techniques to reduce anesthetic exposure, improve monitoring, and alternative staffing models are expanding the boundaries of pediatric NORA to provide a safer, more satisfying experience for diagnostic and interventional procedures.

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Comparison of Postoperative Respiratory Monitoring by Acoustic and Transthoracic Impedance Technologies in Pediatric Patients at Risk of Respiratory Depression

Cited by 11 publications

References 13 publications

A Novel, Contactless, Portable “Spot-Check” Device Accurately Measures Respiratory Rate

A Novel, Contactless, Portable “Spot-Check” Device Accurately Measures Respiratory Rate

An update on postoperative respiratory depression

An update on pediatric sedation techniques in nonoperating room locations

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