Dan Waisman1, Lior Lev-Tov2, Carmit Levy3, Anna Faingersh4, Ifat Colman Klotzman5, Haim Bibi6, Avi Rotschild1, Amir Landesberg4. 1. 1] Department of Neonatology, Carmel Medical Center, Haifa, Israel [2] Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. 2. 1] Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel [2] Faculty of Biomedical Engineering, Technion-IIT, Haifa, Israel. 3. 1] Faculty of Biomedical Engineering, Technion-IIT, Haifa, Israel [2] Department of Neonatology, Mayer Children's Hospital, Haifa, Israel [3] Pneumedicare Ltd., Yokneam, Israel. 4. Faculty of Biomedical Engineering, Technion-IIT, Haifa, Israel. 5. 1] Department of Neonatology, Mayer Children's Hospital, Haifa, Israel [2] Pneumedicare Ltd., Yokneam, Israel. 6. Department of Pediatrics, Barzilai Medical Center, Ashkelon, Israel.
Abstract
BACKGROUND: Real-time detection and classification of apneic episodes remain significant challenges. This study explores the applicability of a novel method of monitoring the respiratory effort and dynamics for rapid detection and classification of apneic episodes. METHODS: Obstructive apnea (OA) and hypopnea/central apnea (CA) were induced in nine tracheostomized rats, by short-lived airway obstruction and administration of succinylcholine, respectively. Esophageal pressure (EP), EtCO2, arterial O2 saturation (SpO2), heart rate, and blood pressure were monitored. Respiratory dynamics were monitored utilizing three miniature motion sensors placed on the chest and epigastrium. Three indices were derived from these sensors: amplitude of the tidal chest wall displacement (TDi), breath time length (BTL), that included inspiration and rapid expiration phases, and amplitude time integral (ATI), the integral of breath amplitude over time. RESULTS: OA induced a progressive 6.42 ± 3.48-fold increase in EP from baseline, which paralleled a 3.04 ± 1.19-fold increase in TDi (P < 0.0012), a 1.39 ± 0.22-fold increase in BTL (P < 0.0002), and a 3.32 ± 1.40-fold rise in the ATI (P < 0.024). During central hypopneic/apneic episodes, each sensor revealed a gradual decrease in TDi, which culminated in absence of breathing attempts. CONCLUSION: Noninvasive monitoring of chest wall dynamics enables detection and classification of central and obstructive apneic episodes, which tightly correlates with the EP.
BACKGROUND: Real-time detection and classification of apneic episodes remain significant challenges. This study explores the applicability of a novel method of monitoring the respiratory effort and dynamics for rapid detection and classification of apneic episodes. METHODS: Obstructive apnea (OA) and hypopnea/central apnea (CA) were induced in nine tracheostomized rats, by short-lived airway obstruction and administration of succinylcholine, respectively. Esophageal pressure (EP), EtCO2, arterial O2 saturation (SpO2), heart rate, and blood pressure were monitored. Respiratory dynamics were monitored utilizing three miniature motion sensors placed on the chest and epigastrium. Three indices were derived from these sensors: amplitude of the tidal chest wall displacement (TDi), breath time length (BTL), that included inspiration and rapid expiration phases, and amplitude time integral (ATI), the integral of breath amplitude over time. RESULTS: OA induced a progressive 6.42 ± 3.48-fold increase in EP from baseline, which paralleled a 3.04 ± 1.19-fold increase in TDi (P < 0.0012), a 1.39 ± 0.22-fold increase in BTL (P < 0.0002), and a 3.32 ± 1.40-fold rise in the ATI (P < 0.024). During central hypopneic/apneic episodes, each sensor revealed a gradual decrease in TDi, which culminated in absence of breathing attempts. CONCLUSION: Noninvasive monitoring of chest wall dynamics enables detection and classification of central and obstructive apneic episodes, which tightly correlates with the EP.
Authors: Dan Waisman; Anna Faingersh; Carmit Levy; Eugene Konyukhov; Fatmi Ifat Colman Klotzman; Avi Rotschild; Amir Landesberg Journal: Intensive Care Med Date: 2011-11-22 Impact factor: 17.440
Authors: Jan A Gorter; Erwin A van Vliet; Stefanie Dedeurwaerdere; Gordon F Buchanan; Daniel Friedman; Karin Borges; Heidi Grabenstatter; Katarzyna Lukasiuk; Helen E Scharfman; Astrid Nehlig Journal: Epilepsia Open Date: 2018-10-11