Department of Anesthesiology and Pain Medicine, Kyung Hee University, Seoul, Korea.
Department of Biomedical Engineering, College of Medicine, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Korea.
Sci Rep. 2021 Dec 21;11(1):24312. doi: 10.1038/s41598-021-03639-4.
The importance of perioperative respiration monitoring is highlighted by high incidences of postoperative respiratory complications unrelated to the original disease. The objectives of this pilot study were to (1) simultaneously acquire respiration rate (RR), tidal volume (TV), minute ventilation (MV), SpO and PETCO from patients in post-anesthesia care unit (PACU) and (2) identify a practical continuous respiration monitoring method by analyzing the acquired data in terms of their ability and reliability in assessing a patient's respiratory status. Thirteen non-intubated patients completed this observational study. A portable electrical impedance tomography (EIT) device was used to acquire RR, TV and MV, while PETCO, RR and SpO were measured by a Capnostream35. Hypoventilation and respiratory events, e.g., apnea and hypopnea, could be detected reliably using RR, TV and MV. PETCO and SpO provided the gas exchange information, but were unable to detect hypoventilation in a timely fashion. Although SpO was stable, the sidestream capnography using the oronasal cannula was often unstable and produced fluctuating PETCO values. The coefficient of determination (R) value between RR and RR was 0.65 with a percentage error of 52.5%. Based on our results, we identified RR, TV, MV and SpO as a set of respiratory parameters for robust continuous respiration monitoring of non-intubated patients. Such a respiration monitor with both ventilation and gas exchange parameters would be reliable and could be useful not only for respiration monitoring, but in making PACU discharge decisions and adjusting opioid dosage on general hospital floor. Future studies are needed to evaluate the potential clinical utility of such an integrated respiration monitor.
术后呼吸并发症的发生率与原发疾病无关，但却很高，这凸显了围手术期呼吸监测的重要性。本初步研究的目的是：(1) 同时从麻醉后监护病房（PACU）的患者身上获取呼吸频率（RR）、潮气量（TV）、分钟通气量（MV）、SpO2 和 PETCO2；(2) 通过分析所获取的数据，评估患者呼吸状况的能力和可靠性，从而确定一种实用的连续呼吸监测方法。十三名非插管患者完成了这项观察性研究。便携式电阻抗断层扫描（EIT）设备用于获取 RR、TV 和 MV，而 Capnostream35 则用于测量 PETCO2、RR 和 SpO2。RR、TV 和 MV 可可靠地检测到低通气和呼吸事件，如呼吸暂停和呼吸不足。PETCO2 和 SpO2 提供气体交换信息，但无法及时检测到低通气。尽管 SpO2 稳定，但经口鼻插管的旁流二氧化碳描记术往往不稳定，产生波动的 PETCO2 值。RR 和 RR 之间的决定系数（R）值为 0.65，百分比误差为 52.5%。根据我们的结果，我们确定 RR、TV、MV 和 SpO2 是一组非插管患者进行连续呼吸监测的呼吸参数。这种具有通气和气体交换参数的呼吸监测器将是可靠的，不仅可用于呼吸监测，还可用于 PACU 出院决策和调整综合医院病房的阿片类药物剂量。需要进一步研究来评估这种集成呼吸监测器的潜在临床应用价值。
