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林肖姆热力学传感器是用于监测呼吸频率的可靠的二氧化碳监测仪替代品。

Linshom thermodynamic sensor is a reliable alternative to capnography for monitoring respiratory rate.

作者信息

Preiss David, Drew Benjamin A, Gosnell James, Kodali Bhavani S, Philip James H, Urman Richard D

机构信息

Department of Anesthesiology, Perioperative and Pain Medicine, Harvard Medical School/Brigham and Women's Hospital, Boston, MA, 02115, USA.

Department of Anesthesiology, Naval Medical Center Portsmouth, Portsmouth, VA, 23704, USA.

出版信息

J Clin Monit Comput. 2018 Feb;32(1):133-140. doi: 10.1007/s10877-017-0004-4. Epub 2017 Feb 22.

Abstract

Monitoring ventilation accurately is a technically challenging, yet indispensable aspect of patient care in the intra- and post-procedural settings. A new prototypical device known as the Linshom Respiratory Monitoring Device (LRMD) has been recently designed to non-invasively, inexpensively, and portably measure respiratory rate. The purpose of this study was to measure the accuracy and variability of LRMD measurements of respiratory rate relative to the measurement of capnography. In this prospective study, participants were enrolled and individually fitted with a face mask monitored by the LRMD and capnography. With a baseline oxygen flow rate and digital metronome to pace their respiratory rate, the participants were instructed to breathe at 10 breaths per minute (bpm) for 3 min, 20 bpm for 3 min, 30 bpm for 3 min, 0 bpm for 30 s, and resume regular breathing for 30 s. Both sensors were connected to a computer for continuous temperature and carbon dioxide waveform recordings. The data were then retrospectively analyzed. Twenty-six healthy volunteers, mean (range) age 27.8 (23-37) and mean (range) BMI 23.1 (18.8-29.2) kg/m were recruited. There were 15 males (57.7%) and 11 females (42.3%). After excluding 3 subjects for technical reasons, 13,800 s of breathing and 4,140 expiratory breaths were recorded. Throughout the protocol, the average standard deviation (SD) for the LRMD and capnography was 1.11 and 1.81 bpm, respectively. The overall mean bias (±2SD) between LRMD and capnography was -0.33 (±0.1.56) bpm. At the lowest and intermediate breathing rates reflective of hypoventilation and normal ventilation, the LRMD variance was 0.55 and 1.23 respectively, compared to capnography with 5.54 and 7.47, respectively. At higher breathing rates indicative of hyperventilation, the variance of the test device was 4.52, still less than that of capnography at 5.73. This study demonstrated a promising correlation between the LRMD and capnography for use as a respiratory rate monitor. The LRMD technology may be a significant addition to monitoring vital signs because it offers a minimally intrusive opportunity to detect respiratory rate and apnea, without expensive or complex anesthetic equipment, before the need for life-saving resuscitation arises.

摘要

在手术中和术后护理中,准确监测通气是一项技术上具有挑战性但又不可或缺的工作。最近设计了一种名为林肖姆呼吸监测设备(LRMD)的新型原型设备,用于以非侵入性、低成本和便携的方式测量呼吸频率。本研究的目的是测量LRMD测量呼吸频率相对于二氧化碳描记法测量的准确性和变异性。在这项前瞻性研究中,招募了参与者,并为他们分别佩戴由LRMD和二氧化碳描记法监测的面罩。在设定基线氧气流速和数字节拍器以设定呼吸频率的情况下,指导参与者每分钟呼吸10次(bpm)持续3分钟、每分钟呼吸20次持续3分钟、每分钟呼吸30次持续3分钟、停止呼吸30秒,然后恢复正常呼吸30秒。两个传感器都连接到计算机以进行连续的温度和二氧化碳波形记录。然后对数据进行回顾性分析。招募了26名健康志愿者,平均(范围)年龄27.8(23 - 37)岁,平均(范围)体重指数23.1(18.8 - 29.2)kg/m²。其中有15名男性(57.7%)和11名女性(42.3%)。因技术原因排除3名受试者后,记录了13800秒的呼吸和4140次呼气。在整个方案过程中,LRMD和二氧化碳描记法的平均标准差(SD)分别为1.11和1.81 bpm。LRMD和二氧化碳描记法之间的总体平均偏差(±2SD)为 -0.33(±0.156)bpm。在反映通气不足和正常通气的最低和中等呼吸频率下,LRMD的方差分别为0.55和1.23,而二氧化碳描记法的方差分别为5.54和7.47。在表明通气过度的较高呼吸频率下,测试设备的方差为4.52,仍低于二氧化碳描记法的5.73。本研究表明,LRMD和二氧化碳描记法在用作呼吸频率监测方面具有良好的相关性。LRMD技术可能是对生命体征监测的一项重要补充,因为在需要进行挽救生命的复苏之前,它提供了一种侵入性最小的机会来检测呼吸频率和呼吸暂停,且无需昂贵或复杂的麻醉设备。

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