Use of Pulse Transit Time To Distinguish Respiratory Events From Tidal Breathing in Sleeping Children

Foo, Jong Yong Abdiel; Wilson, Stephen J.; Bradley, Andrew P.; Williams, Gordon R.; Harris, Margaret; Cooper, David M.

doi:10.1378/chest.128.4.3013

Cited by 28 publications

(36 citation statements)

References 28 publications

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“…This suggests that recruitment of muscular activity determining mandible position is more pronounced when RE is increased. 16,31,32 MM during OAH is accompanied by mean changes in PTT ≥ 15 ms.…”

Section: Discussionmentioning

confidence: 99%

Mandibular Movements Identify Respiratory Effort in Pediatric Obstructive Sleep Apnea

Martinot¹,

Senny

Denison³

et al. 2015

Journal of Clinical Sleep Medicine

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Study Objectives: Obstructive sleep apnea-hypopnea (OAH) diagnosis in children is based on the quantifi cation of fl ow and respiratory effort (RE). Pulse transit time (PTT) is one validated tool to recognize RE. Pattern analysis of mandibular movements (MM) might be an alternative method to detect RE. We compared several patterns of MM to concomittant changes in PTT during OAH in children with adenotonsillar hypertrophy. Methods: Participants: 33 consecutive children with snoring and symptoms/signs of OAH. Measurements:MMs were measured during polysomnography with a magnetometer device (Brizzy Nomics, Liege, Belgium) placed on the chin and forehead. Patterns of MM were evaluated representing peak to peak fl uctuations > 0.3 mm in mandibular excursion (MML), mandibular opening (MMO), and sharp MM (MMS), which closed the mouth on cortical arousal (CAr). Results: The median (95% CI) hourly rate of at least 1 MM (MML, or MMO, or MMS) was 18.1 (13.2-36.3) and strongly correlated with OAHI (p = 0.003) but not with central apnea-hypopnea index (CAHI; p = 0.292). The durations when the MM amplitude was > 0.4 mm and PTT > 15 ms were strongly correlated (p < 0.001). The mean (SD) of MM peak to peak amplitude was larger during OAH than CAH (0.9 ± 0.7 mm and 0.2 ± 0.3 mm; p < 0.001, respectively). MMS at the termination of OAH had larger amplitude compared to MMS with CAH (1.5 ± 0.9 mm and 0.5 ± 0.7 mm, respectively, p < 0.001). Conclusions: MM > 0.4 mm occurred frequently during periods of OAH and were frequently terminated by MMS corresponding to mouth closure on CAr. The MM fi ndings strongly correlated with changes in PTT. MM analysis could be a simple and accurate promising tool for RE characterization and optimization of OAH diagnosis in children.

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Section: Discussionmentioning

confidence: 99%

Mandibular Movements Identify Respiratory Effort in Pediatric Obstructive Sleep Apnea

Martinot¹,

Senny

Denison³

et al. 2015

Journal of Clinical Sleep Medicine

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“…6,7 Third, PTT measurements were acquired from the recruited children in the sitting rather than supine position. Further research is required to fully understand the potential PTTR differences between the two said postures.…”

Section: Research Lettermentioning

confidence: 99%

“…5 A simple non-invasive physiological measure termed as PTT has shown its usefulness in clinical studies. 6,7 PTT is generally used as an indirect measure associated with changes in the arterial wall stiffness that is in turn affected by BP changes. It can be defined as the time delay between the R-wave of an electrocardiogram (ECG) and the corresponding pulsation at a selected periphery detected by photoplethysmography (PPG) of a pulse oximeter.…”

mentioning

confidence: 99%

“…6 Institutional ethical approval and informed consent from the child and/or parent were obtained. A standalone PTT device previously described (with a 1 ms resolution) 6,7 was used in conjunction with an ECG monitor (S&W Medico, Teknik, Denmark) and a pulse oximeter (Novametrix Medical Systems Inc., Wallingford, CT, USA). As the PTT technique can be highly temperature sensitive, all measurements in the study were performed in a typical sleep laboratory at a controlled ambient temperature of 251C and between 0900 and 1100 h.…”

mentioning

confidence: 99%

“…11 Thereby, any variations in respiratory effort or breath-based BP changes can then be better reflected by the PTT parameter. 7 Moreover, BP and HR variances in either sitting or standing can be considered equivalent or close so that values attained in either posture can be handy for deriving values in situations in which the other cannot be readily adopted. 11 A minimum of 30 PTT estimates from each periphery and free from motion artefacts were obtained.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Pulse transit time ratio as a potential marker for paediatric crural and brachial blood pressure index

et al. 2007

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Pulse Transit Time as a Screening Test for Pediatric Sleep-Related Breathing Disorders

Brietzke¹,

Katz²,

Roberson³

2007

Arch Otolaryngol Head Neck Surg

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To evaluate a noninvasive measure of arousal, the pulse transit time (PTT), as a screening tool for obstructive sleep apnea/hypopnea syndrome (OSAHS) in an unselected population of symptomatic children, compared with overnight polysomnography (PSG). A secondary objective included comparing the diagnostic performance of PTT with continuous pulse oximetry recorded during PSG.Design: Prospective, blinded diagnostic comparison study using the gold standard of overnight PSG.

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Use of Pulse Transit Time To Distinguish Respiratory Events From Tidal Breathing in Sleeping Children

Cited by 28 publications

References 28 publications

Mandibular Movements Identify Respiratory Effort in Pediatric Obstructive Sleep Apnea

Mandibular Movements Identify Respiratory Effort in Pediatric Obstructive Sleep Apnea

Pulse transit time ratio as a potential marker for paediatric crural and brachial blood pressure index

Pulse Transit Time as a Screening Test for Pediatric Sleep-Related Breathing Disorders

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