Charlton Peter H, Bonnici Timothy, Tarassenko Lionel, Clifton David A, Beale Richard, Watkinson Peter J, Alastruey Jordi
Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, King's Health Partners, London SE1 7EH, UK.
Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford OX3 7DQ, UK.
Biomed Signal Process Control. 2021 Mar 1;65:102339. doi: 10.1016/j.bspc.2020.102339.
Impedance pneumography (ImP) is widely used for respiratory rate (RR) monitoring. However, ImP-derived RRs can be imprecise. The aim of this study was to develop a signal quality index (SQI) for the ImP signal, and couple it with a RR algorithm, to improve RR monitoring. An SQI was designed which identifies candidate breaths and assesses signal quality using: the variation in detected breath durations, how well peaks and troughs are defined, and the similarity of breath morphologies. The SQI categorises 32 s signal segments as either high or low quality. Its performance was evaluated using two critical care datasets. RRs were estimated from high-quality segments using a RR algorithm, and compared with reference RRs derived from manual annotations. The SQI had a sensitivity of 77.7 %, and specificity of 82.3 %. RRs estimated from segments classified as high quality were accurate and precise, with mean absolute errors of 0.21 and 0.40 breaths per minute (bpm) on the two datasets. Clinical monitor RRs were significantly less precise. The SQI classified 34.9 % of real-world data as high quality. In conclusion, the proposed SQI accurately identifies high-quality segments, and RRs estimated from those segments are precise enough for clinical decision making. This SQI may improve RR monitoring in critical care. Further work should assess it with wearable sensor data.
阻抗式肺量计(ImP)被广泛用于呼吸频率(RR)监测。然而,通过ImP得出的RR可能并不精确。本研究的目的是为ImP信号开发一种信号质量指数(SQI),并将其与RR算法相结合,以改善RR监测。设计了一种SQI,它通过以下方式识别候选呼吸并评估信号质量:检测到的呼吸持续时间的变化、峰谷的定义程度以及呼吸形态的相似性。该SQI将32秒的信号段分类为高质量或低质量。使用两个重症监护数据集对其性能进行了评估。使用RR算法从高质量段估计RR,并与通过人工标注得出的参考RR进行比较。该SQI的灵敏度为77.7%,特异性为82.3%。从分类为高质量的段估计出的RR准确且精确,在两个数据集上的平均绝对误差分别为每分钟0.21次呼吸和0.40次呼吸(bpm)。临床监测仪得出的RR精确性明显较低。该SQI将34.9%的实际数据分类为高质量。总之,所提出的SQI能够准确识别高质量段,并且从这些段估计出的RR精确到足以用于临床决策。这种SQI可能会改善重症监护中的RR监测。进一步的工作应该使用可穿戴传感器数据对其进行评估。
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