Fischer Tobit, Eggert Torsten, Wildenauer Alina, Dietz-Terjung Sarah, Voisard Rainer, Schöbel Christoph
Medizinische Fakultät, Universität Ulm, Ulm, Germany.
Pneumologie, Ruhrlandklinik, Universitätsmedizin Essen, Essen, Germany.
Pneumologie. 2025 Aug;79(8):557-566. doi: 10.1055/a-2542-5101. Epub 2025 May 9.
Long-term monitoring of respiratory rate (RR) is an important component in the management of chronic respiratory diseases (CRDs). Specifically, predicting acute exacerbations of chronic obstructive pulmonary disease (AECOPD) is of significant scientific and clinical interest. This study aimed to evaluate the long-term validity of a novel contactless sleep monitor (CSM) in the home environment of CRD patients receiving ventilatory support. Additionally, we assessed patient acceptance, device usability, and RR fluctuations associated with AECOPD to establish a robust foundation for future research.In this prospective proof-of-concept study, nineteen patients requiring non-invasive ventilation (NIV) were provided with the CSM in their home environment for six months and seven patients requiring invasive mechanical ventilation (IMV) for one month. The primary indication for NIV therapy was chronic obstructive pulmonary disease (COPD).The CSM was validated under real-life conditions by comparing its nocturnal RR values with software data from both types of ventilators. Acceptability and usability of the sensor were assessed using a questionnaire. Additionally, COPD exacerbations occurring during the study period were analyzed for potential RR fluctuations preceding these events.Mean absolute error (MAE) of median RR between the NIV device and the CSM, based on 2326 nights, was 0.78 (SD: 1.96) breaths per minute (brpm). MAE between the IMV device and the CSM was 0.12 brpm (SD: 0.52) for 215 nights. The non-contact device was accepted by the patients and proved to be easy in use. In some of the overall only 13 cases of AECOPD, RR time courses showed variations of increased nocturnal respiratory activity a few days before the occurrence of such events.The present CSM is suitable for valid long-term monitoring of nocturnal RR in patients' home environment and is well accepted by the patients. The exploratory findings related to AECOPD events may serve as a starting point for larger studies aimed at developing robust prediction rules.
长期监测呼吸频率(RR)是慢性呼吸系统疾病(CRD)管理的重要组成部分。具体而言,预测慢性阻塞性肺疾病急性加重(AECOPD)具有重大的科学和临床意义。本研究旨在评估一种新型非接触式睡眠监测仪(CSM)在接受通气支持的CRD患者家庭环境中的长期有效性。此外,我们评估了患者的接受度、设备可用性以及与AECOPD相关的RR波动情况,为未来的研究奠定坚实基础。
在这项前瞻性概念验证研究中,19名需要无创通气(NIV)的患者在其家庭环境中使用CSM达6个月,7名需要有创机械通气(IMV)的患者使用1个月。NIV治疗的主要适应症为慢性阻塞性肺疾病(COPD)。
通过将CSM的夜间RR值与两种呼吸机的软件数据进行比较,在实际生活条件下对CSM进行了验证。使用问卷评估传感器的可接受性和可用性。此外,分析了研究期间发生的COPD加重事件,以寻找这些事件之前潜在的RR波动情况。
基于2326个夜晚,NIV设备与CSM之间RR中位数的平均绝对误差(MAE)为每分钟0.78次呼吸(SD:1.96)(brpm)。对于215个夜晚,IMV设备与CSM之间的MAE为0.12 brpm(SD:0.52)。这种非接触式设备为患者所接受,且使用方便。在总共仅13例AECOPD病例中,RR时间进程显示在这些事件发生前几天夜间呼吸活动增加。
目前的CSM适用于在患者家庭环境中对夜间RR进行有效的长期监测,并且患者接受度良好。与AECOPD事件相关的探索性发现可能作为旨在制定可靠预测规则的更大规模研究的起点。