{"title":"Respiratory rate measurement by pressure variation in the high flow nasal cannula-system in healthy volunteers.","authors":"Jeffrey Miechels, Mark V Koning","doi":"10.1007/s10877-024-01185-8","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>This study tests if the pressure variation in the HFNC-system may allow for monitoring of respiratory rate and the pressure difference during breathing may be a marker of respiratory effort.</p><p><strong>Methods: </strong>A HFNC system (Fisher & Paykel Optiflow Thrive 950) was modified by adding a GE Healthcare D-Lite spirometry sensor attached to a respiratory module and a pressure transducer. Participants were instructed to breathe regularly, quickly and slowly during 4 different conditions (HFNC flow 30 l/min and 70 l/min and with an open and closed mouth). Respiratory rate was counted based on pressure variation shown on the monitor graphs and compared with the count by observation of the participant. The pressure difference between inspiration and expiration was tested for correlation with the respiratory rate, as a surrogate marker for respiratory effort.</p><p><strong>Results: </strong>Twenty five participants were included in this study. False detection of apnea in pressure-based measurements occurred in 10% and 11% of the measurements with open mouth position at 30 l/min and 70 l/min HFNC-flow, respectively, but not with a closed mouth. The 95% Limits of Agreement were - 1.85;1.91, -13.72;9,88, -2.25;2.47, -30.32;19.93 for the conditions of 30 l/min -closed mouth, 30 l/min - open mouth, 70 l/min - closed mouth and 70 l/min - open mouth, respectively. There was a correlation between pressure difference and respiratory effort, except for the condition of 30 l/min with open mouth.</p><p><strong>Conclusions: </strong>The pressure variation in the HFNC system allows for respiratory rate and effort monitoring, but requires further development to increase precision.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov (NCT05991843).</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"1397-1404"},"PeriodicalIF":2.0000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Clinical Monitoring and Computing","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10877-024-01185-8","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/6/12 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: This study tests if the pressure variation in the HFNC-system may allow for monitoring of respiratory rate and the pressure difference during breathing may be a marker of respiratory effort.
Methods: A HFNC system (Fisher & Paykel Optiflow Thrive 950) was modified by adding a GE Healthcare D-Lite spirometry sensor attached to a respiratory module and a pressure transducer. Participants were instructed to breathe regularly, quickly and slowly during 4 different conditions (HFNC flow 30 l/min and 70 l/min and with an open and closed mouth). Respiratory rate was counted based on pressure variation shown on the monitor graphs and compared with the count by observation of the participant. The pressure difference between inspiration and expiration was tested for correlation with the respiratory rate, as a surrogate marker for respiratory effort.
Results: Twenty five participants were included in this study. False detection of apnea in pressure-based measurements occurred in 10% and 11% of the measurements with open mouth position at 30 l/min and 70 l/min HFNC-flow, respectively, but not with a closed mouth. The 95% Limits of Agreement were - 1.85;1.91, -13.72;9,88, -2.25;2.47, -30.32;19.93 for the conditions of 30 l/min -closed mouth, 30 l/min - open mouth, 70 l/min - closed mouth and 70 l/min - open mouth, respectively. There was a correlation between pressure difference and respiratory effort, except for the condition of 30 l/min with open mouth.
Conclusions: The pressure variation in the HFNC system allows for respiratory rate and effort monitoring, but requires further development to increase precision.
期刊介绍：
The Journal of Clinical Monitoring and Computing is a clinical journal publishing papers related to technology in the fields of anaesthesia, intensive care medicine, emergency medicine, and peri-operative medicine.
The journal has links with numerous specialist societies, including editorial board representatives from the European Society for Computing and Technology in Anaesthesia and Intensive Care (ESCTAIC), the Society for Technology in Anesthesia (STA), the Society for Complex Acute Illness (SCAI) and the NAVAt (NAVigating towards your Anaestheisa Targets) group.
The journal publishes original papers, narrative and systematic reviews, technological notes, letters to the editor, editorial or commentary papers, and policy statements or guidelines from national or international societies. The journal encourages debate on published papers and technology, including letters commenting on previous publications or technological concerns. The journal occasionally publishes special issues with technological or clinical themes, or reports and abstracts from scientificmeetings. Special issues proposals should be sent to the Editor-in-Chief. Specific details of types of papers, and the clinical and technological content of papers considered within scope can be found in instructions for authors.
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