East K A, East T D, Mathews V J, Waterfall B T
Department of Anesthesiology, University of Utah, Salt Lake City 84132.
J Clin Monit. 1989 Jul;5(3):170-6. doi: 10.1007/BF01627449.
Ventilatory inductive plethysmography allows noninvasive monitoring of patient ventilation. Patient movements unrelated to breathing introduce severe errors in ventilator inductive plethysmographic measurements and restrict its usefulness. The purpose of this research was to develop and test a microprocessor-based real-time digital signal processor that uses an adaptive filter to detect patient movements unrelated to breathing. The adaptive filter processor was tested for retrospective identification of artifacts in 20 male volunteers who performed the following specific movements between epochs of quiet, supine breathing: raising arms and legs (slowly, quickly, once, and several times), sitting up, breathing deeply and rapidly, and rolling from a supine to a lateral decubitus position. Flow was simultaneously measured directly with a pneumotachography attached to a mouthpiece. A multilinear regression was used to continuously calculate the calibration constants that relate the pneumotachographic and ventilatory inductive plethysmographic signals. Ventilatory inductive plethysmographic data were then processed, and results scored. There were a total of 166 movements. The calibration coefficients changed dramatically in 146 (88%) of the 166 movements. These movements would have significant errors on ventilatory inductive plethysmographic flow calculation. The changes lasted for the duration of the movements and returned to baseline within two to three breaths. The changes in the coefficients were five or more times larger than the variability around baseline during quiet, supine breathing. All of the total body movements and changes in breathing patterns were detected accurately. The filter detected 46 of 53 upper body movements, 34 of 36 lower body movements, 38 of 38 total body movements, and 19 of 19 breathing pattern changes where the calibration changed.(ABSTRACT TRUNCATED AT 250 WORDS)
通气感应体积描记法可对患者通气进行无创监测。与呼吸无关的患者运动在通气感应体积描记测量中会引入严重误差,限制了其用途。本研究的目的是开发并测试一种基于微处理器的实时数字信号处理器,该处理器使用自适应滤波器来检测与呼吸无关的患者运动。对20名男性志愿者进行了测试,以回顾性识别伪影,这些志愿者在安静仰卧呼吸的各时段之间进行了以下特定运动:缓慢、快速、一次和多次举起手臂和腿部、坐起、深呼吸和快速呼吸,以及从仰卧位翻滚到侧卧位。同时使用连接在口件上的呼吸速度描记器直接测量流量。使用多元线性回归连续计算将呼吸速度描记信号与通气感应体积描记信号相关联的校准常数。然后对通气感应体积描记数据进行处理并对结果评分。总共进行了166次运动。在166次运动中的146次(88%)中,校准系数发生了显著变化。这些运动会在通气感应体积描记流量计算中产生重大误差。这些变化在运动期间持续存在,并在两到三次呼吸内恢复到基线。系数的变化比安静仰卧呼吸时基线周围的变异性大五倍或更多。所有全身运动和呼吸模式变化均被准确检测到。该滤波器检测到53次上身运动中的46次、36次下身运动中的34次、38次全身运动中的38次以及校准发生变化的19次呼吸模式变化中的19次。(摘要截短于250字)