SU-E-J-211: Design and Study of In-House Software Based Respiratory Motion Monitoring, Controlling and Breath-Hold Device for Gated Radiotherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Shanmugam, Senthilkumar

Purpose: The purpose of this present work was to fabricate an in-house software based respiratory monitoring, controlling and breath-hold device using computer software programme which guides the patient to have uniform breath hold in response to request during the gated radiotherapy. Methods: The respiratory controlling device consists of a computer, inhouse software, video goggles, a highly sensitive sensor for measurement of distance, mounting systems, a camera, a respiratory signal device, a speaker and a visual indicator. The computer is used to display the respiratory movements of the patient with digital as well as analogue respiration indicators during the respiration cycle,more » to control, breath-hold and analyze the respiratory movement using indigenously developed software. Results: Studies were conducted with anthropomophic phantoms by simulating the respiratory motion on phantoms and recording the respective movements using the respiratory monitoring device. The results show good agreement between the simulated and measured movements. Further studies were conducted for 60 cancer patients with several types of cancers in the thoracic region. The respiratory movement cycles for each fraction of radiotherapy treatment were recorded and compared. Alarm indications are provided in the system to indicate when the patient breathing movement exceeds the threshold level. This will help the patient to maintain uniform breath hold during the radiotherapy treatment. Our preliminary clinical test results indicate that our device is highly reliable and able to maintain the uniform respiratory motion and breathe hold during the entire course of gated radiotherapy treatment. Conclusion: An indigenous respiratory monitoring device to guide the patient to have uniform breath hold device was fabricated. The alarm feature and the visual waveform indicator in the system guide the patient to have normal respiration. The signal from the device can be connected to the radiation unit in near future to carry out the gated radiotherapy treatment.« less

A wearable textile for respiratory monitoring: Feasibility assessment and analysis of sensors position on system response.

PubMed

Lo Presti, D; Massaroni, C; Saccomandi, P; Caponero, M A; Formica, D; Schena, E

2017-07-01

The interest on wearable textiles to monitor vital signs is growing in the research field and clinical scenario related to the increasing demands of long-term monitoring. Despite several smart textile-based solutions have been proposed for assessing the respiratory status, only a limited number of devices allow the respiratory monitoring in a harsh environment or in different positions of the human body. In this paper, we investigated the performances of a smart textile for respiratory rate monitoring characterized by 12 fiber optic sensors (i.e., fiber Bragg grating) placed on specific landmarks for compartmental analysis of the chest wall movements during quiet breathing. We focused on the analysis of the influence of sensor position on both peak-to-peak amplitude of sensors output and accuracy of respiratory rate measurements. This analysis was performed on two participants, who wore the textile in two positions (i.e., standing and supine). Bland-Altman analysis on respiratory rate showed promising results (better than 0.3 breaths per minute). Referring to the peak-to-peak output amplitude, the abdomen compartment showed the highest excursions in both the enrolled participants and positions. Our findings open up new approaches to design and develop smart textile for respiratory rate monitoring.

Verification and compensation of respiratory motion using an ultrasound imaging system

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chuang, Ho-Chiao, E-mail: hchuang@mail.ntut.edu.tw; Hsu, Hsiao-Yu; Chiu, Wei-Hung

Purpose: The purpose of this study was to determine if it is feasible to use ultrasound imaging as an aid for moving the treatment couch during diagnosis and treatment procedures associated with radiation therapy, in order to offset organ displacement caused by respiratory motion. A noninvasive ultrasound system was used to replace the C-arm device during diagnosis and treatment with the aims of reducing the x-ray radiation dose on the human body while simultaneously being able to monitor organ displacements. Methods: This study used a proposed respiratory compensating system combined with an ultrasound imaging system to monitor the compensation effectmore » of respiratory motion. The accuracy of the compensation effect was verified by fluoroscopy, which means that fluoroscopy could be replaced so as to reduce unnecessary radiation dose on patients. A respiratory simulation system was used to simulate the respiratory motion of the human abdomen and a strain gauge (respiratory signal acquisition device) was used to capture the simulated respiratory signals. The target displacements could be detected by an ultrasound probe and used as a reference for adjusting the gain value of the respiratory signal used by the respiratory compensating system. This ensured that the amplitude of the respiratory compensation signal was a faithful representation of the target displacement. Results: The results show that performing respiratory compensation with the assistance of the ultrasound images reduced the compensation error of the respiratory compensating system to 0.81–2.92 mm, both for sine-wave input signals with amplitudes of 5, 10, and 15 mm, and human respiratory signals; this represented compensation of the respiratory motion by up to 92.48%. In addition, the respiratory signals of 10 patients were captured in clinical trials, while their diaphragm displacements were observed simultaneously using ultrasound. Using the respiratory compensating system to offset, the diaphragm displacement resulted in compensation rates of 60%–84.4%. Conclusions: This study has shown that a respiratory compensating system combined with noninvasive ultrasound can provide real-time compensation of the respiratory motion of patients.« less

Field Programmable Gate Array (FPGA) Respiratory Monitoring System Using a Flow Microsensor and an Accelerometer

NASA Astrophysics Data System (ADS)

Mellal, Idir; Laghrouche, Mourad; Bui, Hung Tien

2017-04-01

This paper describes a non-invasive system for respiratory monitoring using a Micro Electro Mechanical Systems (MEMS) flow sensor and an IMU (Inertial Measurement Unit) accelerometer. The designed system is intended to be wearable and used in a hospital or at home to assist people with respiratory disorders. To ensure the accuracy of our system, we proposed a calibration method based on ANN (Artificial Neural Network) to compensate the temperature drift of the silicon flow sensor. The sigmoid activation functions used in the ANN model were computed with the CORDIC (COordinate Rotation DIgital Computer) algorithm. This algorithm was also used to estimate the tilt angle in body position. The design was implemented on reconfigurable platform FPGA.

A comparative study of a new wireless continuous cardiorespiratory monitor for the diagnosis and management of patients with congestive heart failure at home.

PubMed

Andrews, D; Gouda, M S; Higgins, S; Johnson, P; Williams, A; Vandenburg, M

2002-01-01

Congestive heart failure (CHF) is a major and increasing chronic disease in Western society, with a high mortality, morbidity and cost for unplanned hospital admissions. Continuous cardiorespiratory monitoring is required to detect Cheyne-Stokes respiration (CSR). We have tested a new wireless monitoring system and compared it with polysomnography (PSG) and respiratory inductance plethysmography (RIP) in six CHF patients with CSR in a sleep laboratory. The wireless system compared well with RIP for the detection of CSR but less well with PSG, which had unexpected but significant respiratory sensing errors that led to misclassification of the respiratory disorder present. The wireless system could be used to select CHF patients for better-customized treatment at home as part of a specialist-supported community telemedicine programme.

Respiratory care management information systems.

PubMed

Ford, Richard M

2004-04-01

Hospital-wide computerized information systems evolved from the need to capture patient information and perform billing and other financial functions. These systems, however, have fallen short of meeting the needs of respiratory care departments regarding work load assessment, productivity management, and the level of outcome reporting required to support programs such as patient-driven protocols. The respiratory care management information systems (RCMIS) of today offer many advantages over paper-based systems and hospital-wide computer systems. RCMIS are designed to facilitate functions specific to respiratory care, including assessing work demand, assigning and tracking resources, charting, billing, and reporting results. RCMIS incorporate mobile, point-of-care charting and are highly configurable to meet the specific needs of individual respiratory care departments. Important and substantial benefits can be realized with an RCMIS and mobile, wireless charting devices. The initial and ongoing costs of an RCMIS are justified by increased charge capture and reduced costs, by way of improved productivity and efficiency. It is not unusual to recover the total cost of an RCMIS within the first year of its operation. In addition, such systems can facilitate and monitor patient-care protocols and help to efficiently manage the vast amounts of information encountered during the practitioner's workday. Respiratory care departments that invest in RCMIS have an advantage in the provision of quality care and in reducing expenses. A centralized respiratory therapy department with an RCMIS is the most efficient and cost-effective way to monitor work demand and manage the hospital-wide allocation of respiratory care services.

Respiratory monitoring by porphyrin modified quartz crystal microbalance sensors.

PubMed

Selyanchyn, Roman; Korposh, Serhiy; Wakamatsu, Shunichi; Lee, Seung-Woo

2011-01-01

A respiratory monitoring system based on a quartz crystal microbalance (QCM) sensor with a functional film was designed and investigated. Porphyrins 5,10,15,20-tetrakis-(4-sulfophenyl)-21H,23H-porphine (TSPP) and 5,10,15,20-tetrakis-(4-sulfophenyl)-21H, 23H-porphine manganese (III) chloride (MnTSPP) used as sensitive elements were assembled with a poly(diallyldimethyl ammonium chloride) (PDDA). Films were deposited on the QCM resonators using layer-by-layer method in order to develop the sensor. The developed system, in which the sensor response reflects lung movements, was able to track human respiration providing respiratory rate (RR) and respiratory pattern (RP). The sensor system was tested on healthy volunteers to compare RPs and calculate RRs. The operation principle of the proposed system is based on the fast adsorption/desorption behavior of water originated from human breath into the sensor films deposited on the QCM electrode.

Respiratory Monitoring by Porphyrin Modified Quartz Crystal Microbalance Sensors

PubMed Central

Selyanchyn, Roman; Korposh, Serhiy; Wakamatsu, Shunichi; Lee, Seung-Woo

2011-01-01

A respiratory monitoring system based on a quartz crystal microbalance (QCM) sensor with a functional film was designed and investigated. Porphyrins 5,10,15,20-tetrakis-(4-sulfophenyl)-21H,23H-porphine (TSPP) and 5,10,15,20-tetrakis-(4-sulfophenyl)-21H, 23H-porphine manganese (III) chloride (MnTSPP) used as sensitive elements were assembled with a poly(diallyldimethyl ammonium chloride) (PDDA). Films were deposited on the QCM resonators using layer-by-layer method in order to develop the sensor. The developed system, in which the sensor response reflects lung movements, was able to track human respiration providing respiratory rate (RR) and respiratory pattern (RP). The sensor system was tested on healthy volunteers to compare RPs and calculate RRs. The operation principle of the proposed system is based on the fast adsorption/desorption behavior of water originated from human breath into the sensor films deposited on the QCM electrode. PMID:22346621

A new laboratory-based surveillance system (Respiratory DataMart System) for influenza and other respiratory viruses in England: results and experience from 2009 to 2012.

PubMed

Zhao, H; Green, H; Lackenby, A; Donati, M; Ellis, J; Thompson, C; Bermingham, A; Field, J; Sebastianpillai, P; Zambon, M; Watson, Jm; Pebody, R

2014-01-23

During the 2009 influenza A(H1N1) pandemic, a new laboratory-based virological sentinel surveillance system, the Respiratory DataMart System (RDMS), was established in a network of 14 Health Protection Agency (now Public Health England (PHE)) and National Health Service (NHS) laboratories in England. Laboratory results (both positive and negative) were systematically collected from all routinely tested clinical respiratory samples for a range of respiratory viruses including influenza, respiratory syncytial virus (RSV), rhinovirus, parainfluenza virus, adenovirus and human metapneumovirus (hMPV). The RDMS also monitored the occurrence of antiviral resistance of influenza viruses. Data from the RDMS for the 2009–2012 period showed that the 2009 pandemic influenza virus caused three waves of activity with different intensities during the pandemic and post pandemic periods. Peaks in influenza A(H1N1)pdm09 positivity (defined as number of positive samples per total number of samples tested) were seen in summer and autumn in 2009, with slightly higher peak positivity observed in the first post-pandemic season in 2010/2011. The influenza A(H1N1)pdm09 virus strain almost completely disappeared in the second postpandemic season in 2011/2012. The RDMS findings are consistent with other existing community-based virological and clinical surveillance systems. With a large sample size, this new system provides a robust supplementary mechanism, through the collection of routinely available laboratory data at minimum extra cost, to monitor influenza as well as other respiratory virus activity. A near real-time, daily reporting mechanism in the RDMS was established during the London 2012 Olympic and Paralympic Games. Furthermore, this system can be quickly adapted and used to monitor future influenza pandemics and other major outbreaks of respiratory infectious disease, including novel pathogens.

Accuracy Verification of Respiratory-gated Radiotherapy that Combines the Respiration-Monitoring Device and Respiratory-gated System.

PubMed

Shintani, Naoya; Monzen, Hajime; Tamura, Masaya; Asai, Yoshiyuki; Shimomura, Kouhei; Matsumoto, Kenji; Okumura, Masahiko; Nishimura, Yasumasa

2016-01-01

The purpose of this study is to evaluate the mechanical accuracy of a respiratory-gated radiation system that combines the Linear Indicator-equipped Abches respiration-monitoring device and the Varian Real-time Position Management system (LI-RPM system). This combined configuration, implemented for the first time in Japan, was compared with the stand-alone Varian RPM system (RPM system). The delay times, dose profiles, and output waveforms of the LI-RPM and RPM systems were evaluated using a self-produced dynamic phantom. The delay times for the LI-RPM and RPM systems were both 0.1 s for 4 s and 8 s test periods. The corresponding output waveform correlation factors (R 2 ) for the 4 s and 8 s test periods were 0.9981 and 0.9975, respectively. No difference was observed in the dose profiles of the two systems. Thus, the present results indicate that the proposed LI-RPM combined respiratory-gated radiation system has similar properties to the RPM system. However, it offers several advantages in terms of its versatility, including its alignment assistance capabilities for non-coplanar treatments.

Development of real time abdominal compression force monitoring and visual biofeedback system

NASA Astrophysics Data System (ADS)

Kim, Tae-Ho; Kim, Siyong; Kim, Dong-Su; Kang, Seong-Hee; Cho, Min-Seok; Kim, Kyeong-Hyeon; Shin, Dong-Seok; Suh, Tae-Suk

2018-03-01

In this study, we developed and evaluated a system that could monitor abdominal compression force (ACF) in real time and provide a surrogating signal, even under abdominal compression. The system could also provide visual-biofeedback (VBF). The real-time ACF monitoring system developed consists of an abdominal compression device, an ACF monitoring unit and a control system including an in-house ACF management program. We anticipated that ACF variation information caused by respiratory abdominal motion could be used as a respiratory surrogate signal. Four volunteers participated in this test to obtain correlation coefficients between ACF variation and tidal volumes. A simulation study with another group of six volunteers was performed to evaluate the feasibility of the proposed system. In the simulation, we investigated the reproducibility of the compression setup and proposed a further enhanced shallow breathing (ESB) technique using VBF by intentionally reducing the amplitude of the breathing range under abdominal compression. The correlation coefficient between the ACF variation caused by the respiratory abdominal motion and the tidal volume signal for each volunteer was evaluated and R 2 values ranged from 0.79 to 0.84. The ACF variation was similar to a respiratory pattern and slight variations of ACF ranges were observed among sessions. About 73-77% average ACF control rate (i.e. compliance) over five trials was observed in all volunteer subjects except one (64%) when there was no VBF. The targeted ACF range was intentionally reduced to achieve ESB for VBF simulation. With VBF, in spite of the reduced target range, overall ACF control rate improved by about 20% in all volunteers except one (4%), demonstrating the effectiveness of VBF. The developed monitoring system could help reduce the inter-fraction ACF set up error and the intra fraction ACF variation. With the capability of providing a real time surrogating signal and VBF under compression, it could improve the quality of respiratory tumor motion management in abdominal compression radiation therapy.

Smart Textile Based on Fiber Bragg Grating Sensors for Respiratory Monitoring: Design and Preliminary Trials

PubMed Central

Ciocchetti, Marco; Massaroni, Carlo; Saccomandi, Paola; Caponero, Michele A.; Polimadei, Andrea; Formica, Domenico; Schena, Emiliano

2015-01-01

Continuous respiratory monitoring is important to assess adequate ventilation. We present a fiber optic-based smart textile for respiratory monitoring able to work during Magnetic Resonance (MR) examinations. The system is based on the conversion of chest wall movements into strain of two fiber Bragg grating (FBG) sensors, placed on the upper thorax (UT). FBGs are glued on the textile by an adhesive silicon rubber. To increase the system sensitivity, the FBGs positioning was led by preliminary experiments performed using an optoelectronic system: FBGs placed on the chest surface experienced the largest strain during breathing. System performances, in terms of respiratory period (TR), duration of inspiratory (TI) and expiratory (TE) phases, as well as left and right UT volumes, were assessed on four healthy volunteers. The comparison of results obtained by the proposed system and an optoelectronic plethysmography highlights the high accuracy in the estimation of TR, TI, and TE: Bland-Altman analysis shows mean of difference values lower than 0.045 s, 0.33 s, and 0.35 s for TR, TI, and TE, respectively. The mean difference of UT volumes between the two systems is about 8.3%. The promising results foster further development of the system to allow routine use during MR examinations. PMID:26389961

Real Time Apnoea Monitoring of Children Using the Microsoft Kinect Sensor: A Pilot Study.

PubMed

Al-Naji, Ali; Gibson, Kim; Lee, Sang-Heon; Chahl, Javaan

2017-02-03

The objective of this study was to design a non-invasive system for the observation of respiratory rates and detection of apnoea using analysis of real time image sequences captured in any given sleep position and under any light conditions (even in dark environments). A Microsoft Kinect sensor was used to visualize the variations in the thorax and abdomen from the respiratory rhythm. These variations were magnified, analyzed and detected at a distance of 2.5 m from the subject. A modified motion magnification system and frame subtraction technique were used to identify breathing movements by detecting rapid motion areas in the magnified frame sequences. The experimental results on a set of video data from five subjects (3 h for each subject) showed that our monitoring system can accurately measure respiratory rate and therefore detect apnoea in infants and young children. The proposed system is feasible, accurate, safe and low computational complexity, making it an efficient alternative for non-contact home sleep monitoring systems and advancing health care applications.

Technical Note: Evaluation of the latency and the beam characteristics of a respiratory gating system using an Elekta linear accelerator and a respiratory indicator device, Abches.

PubMed

Saito, Masahide; Sano, Naoki; Ueda, Koji; Shibata, Yuki; Kuriyama, Kengo; Komiyama, Takafumi; Marino, Kan; Aoki, Shinichi; Onishi, Hiroshi

2018-01-01

To evaluate the basic performance of a respiratory gating system using an Elekta linac and an Abches respiratory-monitoring device. The gating system was comprised of an Elekta Synergy linac equipped with a Response TM gating interface module and an Abches respiratory-monitoring device. The latencies from a reference respiratory signal to the resulting Abches gating output signal and the resulting monitor-ion-chamber output signal were measured. Then, the flatness and symmetry of the gated beams were measured using a two-dimensional ionization chamber array for fixed and arc beams, respectively. Furthermore, the beam quality, TPR 20,10 , and the output of the fixed gated beams were also measured using a Farmer chamber. Each of the beam characteristics was compared with each of those for nongated irradiation. The full latencies at beam-on and beam-off for 6-MV gated beams were 336.4 ± 23.4 ms and 87.6 ± 7.1 ms, respectively. The differences in flatness between the gated and nongated beams were within 0.91% and 0.87% for the gun-target and left-right directions, respectively. In the same manner, the beam symmetries were within 0.68% and 0.82%, respectively. The percentage differences in beam quality and beam output were below 1% for a beam-on time range of 1.1-7 s. The latency of the Elekta gating system combined with Abches was found to be acceptable using our measurement method. Furthermore, we demonstrated that the beam characteristics of the gating system using our respiratory indicator were comparable with the nongated beams for a single-arc gated beam delivery. © 2017 American Association of Physicists in Medicine.

Assessing interactions among multiple physiological systems during walking outside a laboratory: An Android based gait monitor

PubMed Central

Sejdić, E.; Millecamps, A.; Teoli, J.; Rothfuss, M. A.; Franconi, N. G.; Perera, S.; Jones, A. K.; Brach, J. S.; Mickle, M. H.

2015-01-01

Gait function is traditionally assessed using well-lit, unobstructed walkways with minimal distractions. In patients with subclinical physiological abnormalities, these conditions may not provide enough stress on their ability to adapt to walking. The introduction of challenging walking conditions in gait can induce responses in physiological systems in addition to the locomotor system. There is a need for a device that is capable of monitoring multiple physiological systems in various walking conditions. To address this need, an Android-based gait-monitoring device was developed that enabled the recording of a patient's physiological systems during walking. The gait-monitoring device was tested during self-regulated overground walking sessions of fifteen healthy subjects that included 6 females and 9 males aged 18 to 35 years. The gait-monitoring device measures the patient's stride interval, acceleration, electrocardiogram, skin conductance and respiratory rate. The data is stored on an Android phone and is analyzed offline through the extraction of features in the time, frequency and time-frequency domains. The analysis of the data depicted multisystem physiological interactions during overground walking in healthy subjects. These interactions included locomotion-electrodermal, locomotion-respiratory and cardiolocomotion couplings. The current results depicting strong interactions between the locomotion system and the other considered systems (i.e., electrodermal, respiratory and cardivascular systems) warrant further investigation into multisystem interactions during walking, particularly in challenging walking conditions with older adults. PMID:26390946

Continuous on-line measurements of respiratory system, lung and chest wall mechanics during mechanic ventilation.

PubMed

Kárason, S; Søndergaard, S; Lundin, S; Stenqvist, O

2001-08-01

We present a concept of on-line, manoeuvre-free monitoring of respiratory mechanics during dynamic conditions, displaying calculated alveolar pressure/volume curves continuously and separating lung and chest wall mechanics. Prospective observational study. Intensive care unit of a university hospital. Ten ventilator-treated patients with acute lung injury. Different positive end-expiratory pressure (PEEP) and tidal volumes, low flow inflation. Previously validated methods were used to present a single-value dynostatic compliance for the whole breath and a dynostatic volume-dependent initial, middle and final compliance within the breath. A high individual variation of respiratory mechanics was observed. Reproducibility of repeated measurements was satisfactory (coefficients of variations for dynostatic volume-dependent compliance: < or =9.2% for total respiratory system, < or =18% for lung). Volume-dependent compliance showed a statistically significant pattern of successively decreasing compliance from the initial segment through the middle and final parts within each breath at all respiratory settings. This pattern became more prominent with increasing PEEP and tidal volume, indicating a greater distension of alveoli. No lower inflection point (LIP) was seen in patients with respiratory rate 20/min and PEEP at 4 cmH2O. A trial with low flow inflation in four of the patients showed formation of a LIP in three of them and an upper inflection in one. The monitoring concept revealed a constant pattern of successively decreasing compliance within each breath, which became more prominent with increasing PEEP and tidal volume. The monitoring concept offers a simple and reliable method of monitoring respiratory mechanics during ongoing ventilator treatment.

A novel approach to detect respiratory phases from pulmonary acoustic signals using normalised power spectral density and fuzzy inference system.

PubMed

Palaniappan, Rajkumar; Sundaraj, Kenneth; Sundaraj, Sebastian; Huliraj, N; Revadi, S S

2016-07-01

Monitoring respiration is important in several medical applications. One such application is respiratory rate monitoring in patients with sleep apnoea. The respiratory rate in patients with sleep apnoea disorder is irregular compared with the controls. Respiratory phase detection is required for a proper monitoring of respiration in patients with sleep apnoea. To develop a model to detect the respiratory phases present in the pulmonary acoustic signals and to evaluate the performance of the model in detecting the respiratory phases. Normalised averaged power spectral density for each frame and change in normalised averaged power spectral density between the adjacent frames were fuzzified and fuzzy rules were formulated. The fuzzy inference system (FIS) was developed with both Mamdani and Sugeno methods. To evaluate the performance of both Mamdani and Sugeno methods, correlation coefficient and root mean square error (RMSE) were calculated. In the correlation coefficient analysis in evaluating the fuzzy model using Mamdani and Sugeno method, the strength of the correlation was found to be r = 0.9892 and r = 0.9964, respectively. The RMSE for Mamdani and Sugeno methods are RMSE = 0.0853 and RMSE = 0.0817, respectively. The correlation coefficient and the RMSE of the proposed fuzzy models in detecting the respiratory phases reveals that Sugeno method performs better compared with the Mamdani method. © 2014 John Wiley & Sons Ltd.

MIMO Radar System for Respiratory Monitoring Using Tx and Rx Modulation with M-Sequence Codes

NASA Astrophysics Data System (ADS)

Miwa, Takashi; Ogiwara, Shun; Yamakoshi, Yoshiki

The importance of respiratory monitoring systems during sleep have increased due to early diagnosis of sleep apnea syndrome (SAS) in the home. This paper presents a simple respiratory monitoring system suitable for home use having 3D ranging of targets. The range resolution and azimuth resolution are obtained by a stepped frequency transmitting signal and MIMO arrays with preferred pair M-sequence codes doubly modulating in transmission and reception, respectively. Due to the use of these codes, Gold sequence codes corresponding to all the antenna combinations are equivalently modulated in receiver. The signal to interchannel interference ratio of the reconstructed image is evaluated by numerical simulations. The results of experiments on a developed prototype 3D-MIMO radar system show that this system can extract only the motion of respiration of a human subject 2m apart from a metallic rotatable reflector. Moreover, it is found that this system can successfully measure the respiration information of sleeping human subjects for 96.6 percent of the whole measurement time except for instances of large posture change.

Technical Note: A respiratory monitoring and processing system based on computer vision: prototype and proof of principle

PubMed Central

Atallah, Vincent; Escarmant, Patrick; Vinh‐Hung, Vincent

2016-01-01

Monitoring and controlling respiratory motion is a challenge for the accuracy and safety of therapeutic irradiation of thoracic tumors. Various commercial systems based on the monitoring of internal or external surrogates have been developed but remain costly. In this article we describe and validate Madibreast, an in‐house‐made respiratory monitoring and processing device based on optical tracking of external markers. We designed an optical apparatus to ensure real‐time submillimetric image resolution at 4 m. Using OpenCv libraries, we optically tracked high‐contrast markers set on patients' breasts. Validation of spatial and time accuracy was performed on a mechanical phantom and on human breast. Madibreast was able to track motion of markers up to a 5 cm/s speed, at a frame rate of 30 fps, with submillimetric accuracy on mechanical phantom and human breasts. Latency was below 100 ms. Concomitant monitoring of three different locations on the breast showed discrepancies in axial motion up to 4 mm for deep‐breathing patterns. This low‐cost, computer‐vision system for real‐time motion monitoring of the irradiation of breast cancer patients showed submillimetric accuracy and acceptable latency. It allowed the authors to highlight differences in surface motion that may be correlated to tumor motion. PACS number(s): 87.55.km PMID:27685116

Technical Note: A respiratory monitoring and processing system based on computer vision: prototype and proof of principle.

PubMed

Leduc, Nicolas; Atallah, Vincent; Escarmant, Patrick; Vinh-Hung, Vincent

2016-09-08

Monitoring and controlling respiratory motion is a challenge for the accuracy and safety of therapeutic irradiation of thoracic tumors. Various commercial systems based on the monitoring of internal or external surrogates have been developed but remain costly. In this article we describe and validate Madibreast, an in-house-made respiratory monitoring and processing device based on optical tracking of external markers. We designed an optical apparatus to ensure real-time submillimetric image resolution at 4 m. Using OpenCv libraries, we optically tracked high-contrast markers set on patients' breasts. Validation of spatial and time accuracy was performed on a mechanical phantom and on human breast. Madibreast was able to track motion of markers up to a 5 cm/s speed, at a frame rate of 30 fps, with submillimetric accuracy on mechanical phantom and human breasts. Latency was below 100 ms. Concomitant monitoring of three different locations on the breast showed discrepancies in axial motion up to 4 mm for deep-breathing patterns. This low-cost, computer-vision system for real-time motion monitoring of the irradiation of breast cancer patients showed submillimetric accuracy and acceptable latency. It allowed the authors to highlight differences in surface motion that may be correlated to tumor motion.v. © 2016 The Authors.

Real Time Apnoea Monitoring of Children Using the Microsoft Kinect Sensor: A Pilot Study

PubMed Central

Al-Naji, Ali; Gibson, Kim; Lee, Sang-Heon; Chahl, Javaan

2017-01-01

The objective of this study was to design a non-invasive system for the observation of respiratory rates and detection of apnoea using analysis of real time image sequences captured in any given sleep position and under any light conditions (even in dark environments). A Microsoft Kinect sensor was used to visualize the variations in the thorax and abdomen from the respiratory rhythm. These variations were magnified, analyzed and detected at a distance of 2.5 m from the subject. A modified motion magnification system and frame subtraction technique were used to identify breathing movements by detecting rapid motion areas in the magnified frame sequences. The experimental results on a set of video data from five subjects (3 h for each subject) showed that our monitoring system can accurately measure respiratory rate and therefore detect apnoea in infants and young children. The proposed system is feasible, accurate, safe and low computational complexity, making it an efficient alternative for non-contact home sleep monitoring systems and advancing health care applications. PMID:28165382

SU-F-T-91: Development of Real Time Abdominal Compression Force (ACF) Monitoring System

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kim, T; Kim, D; Kang, S

Purpose: Hard-plate based abdominal compression is known to be effective, but no explicit method exists to quantify abdominal compression force (ACF) and maintain the proper ACF through the whole procedure. In addition, even with compression, it is necessary to do 4D CT to manage residual motion but, 4D CT is often not possible due to reduced surrogating sensitivity. In this study, we developed and evaluated a system that both monitors ACF in real time and provides surrogating signal even under compression. The system can also provide visual-biofeedback. Methods: The system developed consists of a compression plate, an ACF monitoring unitmore » and a visual-biofeedback device. The ACF monitoring unit contains a thin air balloon in the size of compression plate and a gas pressure sensor. The unit is attached to the bottom of the plate thus, placed between the plate and the patient when compression is applied, and detects compression pressure. For reliability test, 3 volunteers were directed to take several different breathing patterns and the ACF variation was compared with the respiratory flow and external respiratory signal to assure that the system provides corresponding behavior. In addition, guiding waveform were generated based on free breathing, and then applied for evaluating the effectiveness of visual-biofeedback. Results: We could monitor ACF variation in real time and confirmed that the data was correlated with both respiratory flow data and external respiratory signal. Even under abdominal compression, in addition, it was possible to make the subjects successfully follow the guide patterns using the visual biofeedback system. Conclusion: The developed real time ACF monitoring system was found to be functional as intended and consistent. With the capability of both providing real time surrogating signal under compression and enabling visual-biofeedback, it is considered that the system would improve the quality of respiratory motion management in radiation therapy. This research was supported by the Mid-career Researcher Program through NRF funded by the Ministry of Science, ICT & Future Planning of Korea (NRF-2014R1A2A1A10050270) and by the Radiation Technology R&D program through the National Research Foundation of Korea funded by the Ministry of Science, ICT & Future Planning (No. 2013M2A2A7038291)« less

Respiratory monitoring system based on fiber optic macro bending

NASA Astrophysics Data System (ADS)

Purnamaningsih, Retno Wigajatri; Widyakinanti, Astari; Dhia, Arika; Gumelar, Muhammad Raditya; Widianto, Arif; Randy, Muhammad; Soedibyo, Harry

2018-02-01

We proposed a respiratory monitoring system for living activities in human body based on fiber optic macro-bending for laboratory scale. The respiration sensor consists of a single-mode optical fiber and operating on a wavelength at around 1550 nm. The fiber optic was integrated into an elastic fabric placed on the chest and stomach of the monitored human subject. Deformations of the flexible textile involving deformations of the fiber optic bending curvature, which was proportional to the chest and stomach expansion. The deformation of the fiber was detected using photodetector and processed using microcontroller PIC18F14K50. The results showed that this system able to display various respiration pattern and rate for sleeping, and after walking and running activities in real time.

A Wearable Capacitive Sensor for Monitoring Human Respiratory Rate

NASA Astrophysics Data System (ADS)

Kundu, Subrata Kumar; Kumagai, Shinya; Sasaki, Minoru

2013-04-01

Realizing an untethered, low-cost, and comfortably wearable respiratory rate sensor for long-term breathing monitoring application still remains a challenge. In this paper, a conductive-textile-based wearable respiratory rate sensing technique based on the capacitive sensing approach is proposed. The sensing unit consists of two conductive textile electrodes that can be easily fabricated, laminated, and integrated in garments. Respiration cycle is detected by measuring the capacitance of two electrodes placed on the inner anterior and posterior sides of a T-shirt at either the abdomen or chest position. A convenient wearable respiratory sensor setup with a capacitance-to-voltage converter has been devised. Respiratory rate as well as breathing mode can be accurately identified using the designed sensor. The sensor output provides significant information on respiratory flow. The effectiveness of the proposed system for different breathing patterns has been evaluated by experiments.

Assessing Respiratory System Mechanical Function.

PubMed

Restrepo, Ruben D; Serrato, Diana M; Adasme, Rodrigo

2016-12-01

The main goals of assessing respiratory system mechanical function are to evaluate the lung function through a variety of methods and to detect early signs of abnormalities that could affect the patient's outcomes. In ventilated patients, it has become increasingly important to recognize whether respiratory function has improved or deteriorated, whether the ventilator settings match the patient's demand, and whether the selection of ventilator parameters follows a lung-protective strategy. Ventilator graphics, esophageal pressure, intra-abdominal pressure, and electric impedance tomography are some of the best-known monitoring tools to obtain measurements and adequately evaluate the respiratory system mechanical function. Copyright © 2016 Elsevier Inc. All rights reserved.

The Clinical Utilisation of Respiratory Elastance Software (CURE Soft): a bedside software for real-time respiratory mechanics monitoring and mechanical ventilation management.

PubMed

Szlavecz, Akos; Chiew, Yeong Shiong; Redmond, Daniel; Beatson, Alex; Glassenbury, Daniel; Corbett, Simon; Major, Vincent; Pretty, Christopher; Shaw, Geoffrey M; Benyo, Balazs; Desaive, Thomas; Chase, J Geoffrey

2014-09-30

Real-time patient respiratory mechanics estimation can be used to guide mechanical ventilation settings, particularly, positive end-expiratory pressure (PEEP). This work presents a software, Clinical Utilisation of Respiratory Elastance (CURE Soft), using a time-varying respiratory elastance model to offer this ability to aid in mechanical ventilation treatment. CURE Soft is a desktop application developed in JAVA. It has two modes of operation, 1) Online real-time monitoring decision support and, 2) Offline for user education purposes, auditing, or reviewing patient care. The CURE Soft has been tested in mechanically ventilated patients with respiratory failure. The clinical protocol, software testing and use of the data were approved by the New Zealand Southern Regional Ethics Committee. Using CURE Soft, patient's respiratory mechanics response to treatment and clinical protocol were monitored. Results showed that the patient's respiratory elastance (Stiffness) changed with the use of muscle relaxants, and responded differently to ventilator settings. This information can be used to guide mechanical ventilation therapy and titrate optimal ventilator PEEP. CURE Soft enables real-time calculation of model-based respiratory mechanics for mechanically ventilated patients. Results showed that the system is able to provide detailed, previously unavailable information on patient-specific respiratory mechanics and response to therapy in real-time. The additional insight available to clinicians provides the potential for improved decision-making, and thus improved patient care and outcomes.

Management of the baseline shift using a new and simple method for respiratory-gated radiation therapy: Detectability and effectiveness of a flexible monitoring system

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tachibana, Hidenobu; Kitamura, Nozomi; Ito, Yasushi

2011-07-15

Purpose: In respiratory-gated radiation therapy, a baseline shift decreases the accuracy of target coverage and organs at risk (OAR) sparing. The effectiveness of audio-feedback and audio-visual feedback in correcting the baseline shift in the breathing pattern of the patient has been demonstrated previously. However, the baseline shift derived from the intrafraction motion of the patient's body cannot be corrected by these methods. In the present study, the authors designed and developed a simple and flexible system. Methods: The system consisted of a web camera and a computer running our in-house software. The in-house software was adapted to template matching andmore » also to no preimage processing. The system was capable of monitoring the baseline shift in the intrafraction motion of the patient's body. Another marker box was used to monitor the baseline shift due to the flexible setups required of a marker box for gated signals. The system accuracy was evaluated by employing a respiratory motion phantom and was found to be within AAPM Task Group 142 tolerance (positional accuracy <2 mm and temporal accuracy <100 ms) for respiratory-gated radiation therapy. Additionally, the effectiveness of this flexible and independent system in gated treatment was investigated in healthy volunteers, in terms of the results from the differences in the baseline shift detectable between the marker positions, which the authors evaluated statistically. Results: The movement of the marker on the sternum [1.599 {+-} 0.622 mm (1 SD)] was substantially decreased as compared with the abdomen [6.547 {+-} 0.962 mm (1 SD)]. Additionally, in all of the volunteers, the baseline shifts for the sternum [-0.136 {+-} 0.868 (2 SD)] were in better agreement with the nominal baseline shifts than was the case for the abdomen [-0.722 {+-} 1.56 mm (2 SD)]. The baseline shifts could be accurately measured and detected using the monitoring system, which could acquire the movement of the marker on the sternum. The baseline shift-monitoring system with the displacement-based methods for highly accurate respiratory-gated treatments should be used to make most of the displacement-based gating methods. Conclusions: The advent of intensity modulated radiation therapy and volumetric modulated radiation therapy facilitates margin reduction for the planning target volumes and the OARs, but highly accurate irradiation is needed to achieve target coverage and OAR sparing with a small margin. The baseline shifts can affect treatment not only with the respiratory gating system but also without the system. Our system can manage the baseline shift and also enables treatment irradiation to be undertaken with high accuracy.« less

Reliability and Validity of the Zephyr[TM] BioHarness[TM] to Measure Respiratory Responses to Exercise

ERIC Educational Resources Information Center

Hailstone, Jono; Kilding, Andrew E.

2011-01-01

The Zephyr[TM] BioHarness[TM] (Zephyr Technology, Auckland, New Zealand) is a wireless physiological monitoring system that has the ability to measure respiratory rate unobtrusively. However, the ability of the BioHarness[TM] to accurately and reproducibly determine respiratory rate across a range of intensities is currently unknown. The aim of…

A Nano-Thin Film-Based Prototype QCM Sensor Array for Monitoring Human Breath and Respiratory Patterns.

PubMed

Selyanchyn, Roman; Wakamatsu, Shunichi; Hayashi, Kenshi; Lee, Seung-Woo

2015-07-31

Quartz crystal microbalance (QCM) sensor array was developed for multi-purpose human respiration assessment. The sensor system was designed to provide feedback for human respiration. Thorough optimization of measurement conditions: air flow, temperature in the QCM chamber, frequency measurement rate, and electrode position regarding to the gas flow-was performed. As shown, acquisition of respiratory parameters (rate and respiratory pattern) could be achieved even with a single electrode used in the system. The prototype system contains eight available QCM channels that can be potentially used for selective responses to certain breath chemicals. At present, the prototype machine is ready for the assessment of respiratory functions in larger populations in order to gain statistical validation. To the best of our knowledge, the developed prototype is the only respiratory assessment system based on surface modified QCM sensors.

Strength and Cycle Time of Ventilatory Oscillations in Unacclimatized Humans at High Altitude,

DTIC Science & Technology

1983-03-04

that our respiratory monitor- ing techniques were identical. We assume this difference is due to lack of acclimatization in our current subjects. In the...instability in the blood gas feedback con- trol system. Respiratory control system modeling by Khoo et al (8) has shown that such instability is...In a respiratory control sys- tem model a stronger pattern corresponds to increased loop gain at a phase angle of 180 degrees. As shown by Khoo, et

The Casualty Network System Capstone Project

DTIC Science & Technology

2012-12-01

capable of recording and transmitting a variety of vital signs such as: pulse rate, respiratory rate, SpO2 , and skin temperature. The IBD transmits...monitor biometric data of each individual on the team. When the MM is combined with CBRN sensor detection, the device will alert in the network to...obvious. By constantly monitoring vital signs of the team involved early clues of exposure (such as decreased SpO2 , increased respiratory rate and

Micro-gas analysis system for measurement of nitric oxide and nitrogen dioxide: respiratory treatment and environmental mobile monitoring.

PubMed

Toda, Kei; Hato, Yuki; Ohira, Shin-ichi; Namihira, Takao

2007-11-05

In this paper, novel microsystems for gas analysis and gas generation are described. The same microchannel devices covered with a gas permeable membrane were used for both the gas collection and the gas generation. For the first time, a dual liquid flow system was utilized in a micro-gas analysis system. Even though micropumps are utilized in the dual line microsystem, a good baseline was obtained in the NO2 measurement with Griess-Saltzman chemistry. The system was developed for on-site measurements in medical treatment; the treatment is of respiratory disease syndrome by NO inhalation and the monitoring is of the product NO and the harmful byproduct NO2. The system was also applied to mobile atmospheric monitoring. Chemical NO generation using the microchannel device was investigated for safe NO inhalation as an alternative to a NO generator based on pulsed arc discharge.

A new respiratory monitoring and processing system based on Wii remote: proof of principle.

PubMed

Peng, Y; Vedam, S; Gao, S; Balter, P

2013-07-01

To create a patient respiratory management system and patient self-practice tool using the Wii remote, a widely available consumer hardware product. The Wii remote (Wiimote) (Nintendo, Redmond, WA) contains an infrared (IR) camera that can track up to four spots whose coordinates are reported to a host computer via Bluetooth. The Wiimote is capable of tracking a fiducial box currently used by a commercial monitoring system [Real-time Position Management(TM) (RPM) system, Varian Associates, Palo Alto, CA], if the correct IR source is used. The authors validated the Wiimote tracking by comparing the amplitude and frequency of signals among those reported by Wiimote with known movements from an inhouse servo-driven respiratory simulator, as well as with those measured using the RPM. The simulator comparison was done using standard sinusoid signals with amplitude of 2.0 cm as well as recorded patient respiratory traces. The RPM comparisons were done by simultaneously recording the RPM reflective box position with the Wiimote and the RPM. Timing was compared between these two systems by using the digital beam-on signal from the CT scanner, for the 4DCT to synchronize these acquisitions. The data acquisition rate from the Wiimote was 100.0 ± 0.4 Hz with a version 2.1 Bluetooth adaptor. The standard deviation of the height of the motion extrema was 0.06 and 1.1 mm when comparing those measured by the Wiimote and the servomotor encoder for standard sinusoid signal and prerecorded patient respiratory signal, respectively. The standard deviation of the amplitude of motion extrema between the Wiimote and RPM was 0.9 mm and the timing difference was 253 ms. The performance of Wiimote shows promise for respiratory monitoring for its faster sampling rate as well as the potential optical and GPU abilities. If used with care it can deliver reasonable spatial and temporal accuracy.

Experimental verification of a two-dimensional respiratory motion compensation system with ultrasound tracking technique in radiation therapy.

PubMed

Ting, Lai-Lei; Chuang, Ho-Chiao; Liao, Ai-Ho; Kuo, Chia-Chun; Yu, Hsiao-Wei; Zhou, Yi-Liang; Tien, Der-Chi; Jeng, Shiu-Chen; Chiou, Jeng-Fong

2018-05-01

This study proposed respiratory motion compensation system (RMCS) combined with an ultrasound image tracking algorithm (UITA) to compensate for respiration-induced tumor motion during radiotherapy, and to address the problem of inaccurate radiation dose delivery caused by respiratory movement. This study used an ultrasound imaging system to monitor respiratory movements combined with the proposed UITA and RMCS for tracking and compensation of the respiratory motion. Respiratory motion compensation was performed using prerecorded human respiratory motion signals and also sinusoidal signals. A linear accelerator was used to deliver radiation doses to GAFchromic EBT3 dosimetry film, and the conformity index (CI), root-mean-square error, compensation rate (CR), and planning target volume (PTV) were used to evaluate the tracking and compensation performance of the proposed system. Human respiratory pattern signals were captured using the UITA and compensated by the RMCS, which yielded CR values of 34-78%. In addition, the maximum coronal area of the PTV ranged from 85.53 mm 2 to 351.11 mm 2 (uncompensated), which reduced to from 17.72 mm 2 to 66.17 mm 2 after compensation, with an area reduction ratio of up to 90%. In real-time monitoring of the respiration compensation state, the CI values for 85% and 90% isodose areas increased to 0.7 and 0.68, respectively. The proposed UITA and RMCS can reduce the movement of the tracked target relative to the LINAC in radiation therapy, thereby reducing the required size of the PTV margin and increasing the effect of the radiation dose received by the treatment target. Copyright © 2018 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Assessment of the feasibility of an ultra-low power, wireless digital patch for the continuous ambulatory monitoring of vital signs.

PubMed

Hernandez-Silveira, Miguel; Ahmed, Kamran; Ang, Su-Shin; Zandari, Fahriya; Mehta, Tinaz; Weir, Rebecca; Burdett, Alison; Toumazou, Chris; Brett, Stephen J

2015-05-19

Vital signs are usually recorded at 4-8 h intervals in hospital patients, and deterioration between measurements can have serious consequences. The primary study objective was to assess agreement between a new ultra-low power, wireless and wearable surveillance system for continuous ambulatory monitoring of vital signs and a widely used clinical vital signs monitor. The secondary objective was to examine the system's ability to automatically identify and reject invalid physiological data. Single hospital centre. Heart and respiratory rate were recorded over 2 h in 20 patients undergoing elective surgery and a second group of 41 patients with comorbid conditions, in the general ward. Primary outcome measures were limits of agreement and bias. The secondary outcome measure was proportion of data rejected. The digital patch provided reliable heart rate values in the majority of patients (about 80%) with normal sinus rhythm, and in the presence of abnormal ECG recordings (excluding aperiodic arrhythmias such as atrial fibrillation). The mean difference between systems was less than ±1 bpm in all patient groups studied. Although respiratory data were more frequently rejected as invalid because of the high sensitivity of impedance pneumography to motion artefacts, valid rates were reported for 50% of recordings with a mean difference of less than ±1 brpm compared with the bedside monitor. Correlation between systems was statistically significant (p<0.0001) for heart and respiratory rate, apart from respiratory rate in patients with atrial fibrillation (p=0.02). Overall agreement between digital patch and clinical monitor was satisfactory, as was the efficacy of the system for automatic rejection of invalid data. Wireless monitoring technologies, such as the one tested, may offer clinical value when implemented as part of wider hospital systems that integrate and support existing clinical protocols and workflows. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

A new system for continuous and remote monitoring of patients receiving home mechanical ventilation

NASA Astrophysics Data System (ADS)

Battista, L.

2016-09-01

Home mechanical ventilation is the treatment of patients with respiratory failure or insufficiency by means of a mechanical ventilator at a patient's home. In order to allow remote patient monitoring, several tele-monitoring systems have been introduced in the last few years. However, most of them usually do not allow real-time services, as they have their own proprietary communication protocol implemented and some ventilation parameters are not always measured. Moreover, they monitor only some breaths during the whole day, despite the fact that a patient's respiratory state may change continuously during the day. In order to reduce the above drawbacks, this work reports the development of a novel remote monitoring system for long-term, home-based ventilation therapy; the proposed system allows for continuous monitoring of the main physical quantities involved during home-care ventilation (e.g., differential pressure, volume, and air flow rate) and is developed in order to allow observations of different remote therapy units located in different places of a city, region, or country. The developed remote patient monitoring system is able to detect various clinical events (e.g., events of tube disconnection and sleep apnea events) and has been successfully tested by means of experimental tests carried out with pulmonary ventilators typically used to support sick patients.

A new system for continuous and remote monitoring of patients receiving home mechanical ventilation.

PubMed

Battista, L

2016-09-01

Home mechanical ventilation is the treatment of patients with respiratory failure or insufficiency by means of a mechanical ventilator at a patient's home. In order to allow remote patient monitoring, several tele-monitoring systems have been introduced in the last few years. However, most of them usually do not allow real-time services, as they have their own proprietary communication protocol implemented and some ventilation parameters are not always measured. Moreover, they monitor only some breaths during the whole day, despite the fact that a patient's respiratory state may change continuously during the day. In order to reduce the above drawbacks, this work reports the development of a novel remote monitoring system for long-term, home-based ventilation therapy; the proposed system allows for continuous monitoring of the main physical quantities involved during home-care ventilation (e.g., differential pressure, volume, and air flow rate) and is developed in order to allow observations of different remote therapy units located in different places of a city, region, or country. The developed remote patient monitoring system is able to detect various clinical events (e.g., events of tube disconnection and sleep apnea events) and has been successfully tested by means of experimental tests carried out with pulmonary ventilators typically used to support sick patients.

A Nano-Thin Film-Based Prototype QCM Sensor Array for Monitoring Human Breath and Respiratory Patterns

PubMed Central

Selyanchyn, Roman; Wakamatsu, Shunichi; Hayashi, Kenshi; Lee, Seung-Woo

2015-01-01

Quartz crystal microbalance (QCM) sensor array was developed for multi-purpose human respiration assessment. The sensor system was designed to provide feedback for human respiration. Thorough optimization of measurement conditions: air flow, temperature in the QCM chamber, frequency measurement rate, and electrode position regarding to the gas flow—was performed. As shown, acquisition of respiratory parameters (rate and respiratory pattern) could be achieved even with a single electrode used in the system. The prototype system contains eight available QCM channels that can be potentially used for selective responses to certain breath chemicals. At present, the prototype machine is ready for the assessment of respiratory functions in larger populations in order to gain statistical validation. To the best of our knowledge, the developed prototype is the only respiratory assessment system based on surface modified QCM sensors. PMID:26263994

Respiratory rate detection using a wearable electromagnetic generator.

PubMed

Padasdao, Bryson; Boric-Lubecke, Olga

2011-01-01

Wearable health and fitness monitoring systems are a promising new way of collecting physiological data without inconveniencing patients. Human energy harvesting may be used to power wearable sensors. In this paper, we explore this zero-net energy biosensor concept through sensing and harvesting of respiratory effort. An off the shelf servo motor operation in reverse was used to successfully obtain respiratory rate, while also demonstrating significant harvested power. These are the first reported respiratory rate sensing results using electromagnetic generators.

A Respiratory Movement Monitoring System Using Fiber-Grating Vision Sensor for Diagnosing Sleep Apnea Syndrome

NASA Astrophysics Data System (ADS)

Takemura, Yasuhiro; Sato, Jun-Ya; Nakajima, Masato

2005-01-01

A non-restrictive and non-contact respiratory movement monitoring system that finds the boundary between chest and abdomen automatically and detects the vertical movement of each part of the body separately is proposed. The system uses a fiber-grating vision sensor technique and the boundary position detection is carried out by calculating the centers of gravity of upward moving and downward moving sampling points, respectively. In the experiment to evaluate the ability to detect the respiratory movement signals of each part and to discriminate between obstructive and central apneas, detected signals of the two parts and their total clearly showed the peculiarities of obstructive and central apnea. The cross talk between the two categories classified automatically according to several rules that reflect the peculiarities was ≤ 15%. This result is sufficient for discriminating central sleep apnea syndrome from obstructive sleep apnea syndrome and indicates that the system is promising as screening equipment. Society of Japan

TH-AB-202-07: Radar Tracking of Respiratory Motion in Real Time

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fung, A; Li, C; Torres, C

Purpose: To propose a method of real time tracking of respiratory motion in patients undergoing radiation therapy. Radar technology can be employed to detection the movement of diaphragm and thoracic anatomy. Methods: A radar transceiver was specially designed. During experiment, the radar device was securely attached to a fixed frame. Respiratory motion was simulated with: 1) Varian RPM phantom, 2) Standard Imaging Respiratory Gating Platform. Signals recorded with radar equipment were compared with those measured with Varian RPM system as a reference. Results: Motion generated by Varian RPM phantom was recorded by the radar device, and compared to the signalsmore » recorded by RPM camera. The results showed exact agreement between the two monitoring equipments. Motion was also generated by Standard Imaging Respiratory Motion Platform. The results showed the radar device was capable of measuring motion of various amplitudes and periods. Conclusion: The proposed radar device is able to measure movements such as respiratory motion. Compared to state-of-the-art respiratory detection instrument, the radar device is shown to be equally precise and effective for monitoring respiration in radiation oncology patients.« less

A noncontact RF-based respiratory sensor: results of a clinical trial.

PubMed

Madsen, Spence; Baczuk, Jordan; Thorup, Kurt; Barton, Richard; Patwari, Neal; Langell, John T

2016-06-01

Respiratory rate (RR) is a critical vital signs monitored in health care setting. Current monitors suffer from sensor-contact failure, inaccurate data, and limited patient mobility. There is a critical need for an accurate and reliable and noncontact system to monitor RR. We developed a contact-free radio frequency (RF)-based system that measures movement using WiFi signal diffraction, which is converted into interpretable data using a Fourier transform. Here, we investigate the system's ability to measure fine movements associated with human respiration. Testing was conducted on subjects using visual cue, fixed-tempo instruction to breath at standard RRs. Blinded instruction-based RRs were compared to RF-acquired data to determine measurement accuracy. The RF-based technology was studied on postoperative ventilator-dependent patients. Blinded ventilator capnographic RR data were collected for each patient and compared to RF-acquired data to determine measurement accuracy. Respiratory rate data collected from 10 subjects breathing at a fixed RR (14, 16, 18, or 20) demonstrated 95.5% measurement accuracy between the patient's actual rate and that measured by our RF technology. Ten patients were enrolled into the clinical trial. Blinded ventilator capnographic RR data were compared to RF-based acquired data. The RF-based data showed 88.8% measurement accuracy with ventilator capnography. Initial clinical pilot trials with our contact-free RF-based monitoring system demonstrate a high degree of RR measurement accuracy when compared to capnographic data. Based on these results, we believe RF-based systems present a promising noninvasive, inexpensive, and accurate tool for continuous RR monitoring. Copyright © 2016 Elsevier Inc. All rights reserved.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kim, T; Kim, D; Kang, S

Purpose: Abdominal compression is known to be effective but, often makes external-marker-based monitoring of breathing motion not feasible. In this study, we developed and evaluated a system that enables both abdominal compression and monitoring of residual abdominal motion simultaneously. The system can also provide visual-biofeedback capability. Methods: The system developed consists of a compression belt, an abdominal motion monitoring sensor (gas pressure sensor) and a visual biofeedback device. The compression belt was designed to be able to compress the frontal side of the abdomen. The pressure level of the belt is controlled by air volume and monitored in real timemore » using the gas pressure sensor. The system displays not only the real-time monitoring curve but also a guiding respiration model (e.g., a breath hold or shallow breathing curve) simultaneously on the head mounted display to help patients keep their breathing pattern as consistent as possible. Three healthy volunteers were enrolled in this pilot study and respiratory signals (pressure variations) were obtained both with and without effective abdominal compression to investigate the feasibility of the developed system. Two guidance patterns, breath hold and shallow breathing, were tested. Results: All volunteers showed smaller abdominal motion with compression (about 40% amplitude reduction compared to without compression). However, the system was able to monitor residual abdominal motion for all volunteers. Even under abdominal compression, in addition, it was possible to make the subjects successfully follow the guide patterns using the visual biofeedback system. Conclusion: The developed abdominal compression & respiratory guiding system was feasible for residual abdominal motion management. It is considered that the system can be used for a respiratory motion involved radiation therapy while maintaining the merit of abdominal compression. This work was supported by the Radiation Technology R&D program (No. 2013M2A2A7043498) and the Mid-career Researcher Program (2014R1A2A1A10050270) through the National Research Foundation of Korea funded by the Ministry of Science, ICT&Future Planning.« less

Quality assurance for respiratory care services: a computer-assisted program.

PubMed

Elliott, C G

1993-01-01

At present, the principal advantage of computer-assisted quality assurance is the acquisition of quality assurance date without resource-consuming chart reviews. A surveillance program like the medical director's alert may reduce morbidity and mortality. Previous research suggests that inadequate oxygen therapy or failures in airway management are important causes of preventable deaths in hospitals. Furthermore, preventable deaths tend to occur among patients who have lower severity-of-illness scores and who are not in ICUs. Thus, surveillance of the entire hospital, as performed by the HIS medical director's alert, may significantly impact hospital mortality related to respiratory care. Future research should critically examine the potential of such computerized systems to favorably change the morbidity and mortality of hospitalized patients. The departments of respiratory care and medical informatics at LDS Hospital have developed a computer-assisted approach to quality assurance monitoring of respiratory care services. This system provides frequent and consistent samples of a variety of respiratory care data. The immediate needs of patients are addressed through a daily surveillance system (medical director's alert). The departmental quality assurance program utilizes a separate program that monitors clinical indicators of staff performance in terms of stated departmental policies and procedures (rate-based clinical indicators). The availability of an integrated patient database allows these functions to be performed without labor-intensive chart audits.

A telemedicine instrument for Internet-based home monitoring of thoracoabdominal motion in patients with respiratory diseases

NASA Astrophysics Data System (ADS)

da Silva Junior, Evert Pereira; Esteves, Guilherme Pompeu; Dames, Karla Kristine; Melo, Pedro Lopes de

2011-01-01

Changes in thoracoabdominal motion are highly prevalent in patients with chronic respiratory diseases. Home care services that use telemedicine techniques and Internet-based monitoring have the potential to improve the management of these patients. However, there is no detailed description in the literature of a system for Internet-based monitoring of patients with disturbed thoracoabdominal motion. The purpose of this work was to describe the development of a new telemedicine instrument for Internet-based home monitoring of thoracoabdominal movement. The instrument directly measures changes in the thorax and abdomen circumferences and transfers data through a transmission control protocol/Internet protocol connection. After the design details are described, the accuracy of the electronic and software processing units of the instrument is evaluated by using electronic signals simulating normal subjects and individuals with thoracoabdominal motion disorders. The results obtained during in vivo studies on normal subjects simulating thoracoabdominal motion disorders showed that this new system is able to detect a reduction in abdominal movement that is associated with abnormal thoracic breathing (p < 0.0001) and the reduction in thoracic movement during abnormal abdominal breathing (p < 0.005). Simulated asynchrony in thoracoabdominal motion was also adequately detected by the system (p < 0.0001). The experimental results obtained for patients with respiratory diseases were in close agreement with the expected values, providing evidence that this instrument can be a useful tool for the evaluation of thoracoabdominal motion. The Internet transmission tests showed that the acquisition and analysis of the thoracoabdominal motion signals can be performed remotely. The user can also receive medical recommendations. The proposed system can be used in a spectrum of telemedicine scenarios, which can reduce the costs of assistance offered to patients with respiratory diseases.

Measurement and Data Transmission Validity of a Multi-Biosensor System for Real-Time Remote Exercise Monitoring Among Cardiac Patients.

PubMed

Rawstorn, Jonathan C; Gant, Nicholas; Warren, Ian; Doughty, Robert Neil; Lever, Nigel; Poppe, Katrina K; Maddison, Ralph

2015-03-20

Remote telemonitoring holds great potential to augment management of patients with coronary heart disease (CHD) and atrial fibrillation (AF) by enabling regular physiological monitoring during physical activity. Remote physiological monitoring may improve home and community exercise-based cardiac rehabilitation (exCR) programs and could improve assessment of the impact and management of pharmacological interventions for heart rate control in individuals with AF. Our aim was to evaluate the measurement validity and data transmission reliability of a remote telemonitoring system comprising a wireless multi-parameter physiological sensor, custom mobile app, and middleware platform, among individuals in sinus rhythm and AF. Participants in sinus rhythm and with AF undertook simulated daily activities, low, moderate, and/or high intensity exercise. Remote monitoring system heart rate and respiratory rate were compared to reference measures (12-lead ECG and indirect calorimeter). Wireless data transmission loss was calculated between the sensor, mobile app, and remote Internet server. Median heart rate (-0.30 to 1.10 b∙min -1 ) and respiratory rate (-1.25 to 0.39 br∙min -1 ) measurement biases were small, yet statistically significant (all P≤.003) due to the large number of observations. Measurement reliability was generally excellent (rho=.87-.97, all P<.001; intraclass correlation coefficient [ICC]=.94-.98, all P<.001; coefficient of variation [CV]=2.24-7.94%), although respiratory rate measurement reliability was poor among AF participants (rho=.43, P<.001; ICC=.55, P<.001; CV=16.61%). Data loss was minimal (<5%) when all system components were active; however, instability of the network hosting the remote data capture server resulted in data loss at the remote Internet server during some trials. System validity was sufficient for remote monitoring of heart and respiratory rates across a range of exercise intensities. Remote exercise monitoring has potential to augment current exCR and heart rate control management approaches by enabling the provision of individually tailored care to individuals outside traditional clinical environments. ©Jonathan C Rawstorn, Nicholas Gant, Ian Warren, Robert Neil Doughty, Nigel Lever, Katrina K Poppe, Ralph Maddison. Originally published in JMIR Rehabilitation and Assistive Technology (http://rehab.jmir.org), 20.03.2015.

Respiratory failure in diabetic ketoacidosis.

PubMed

Konstantinov, Nikifor K; Rohrscheib, Mark; Agaba, Emmanuel I; Dorin, Richard I; Murata, Glen H; Tzamaloukas, Antonios H

2015-07-25

Respiratory failure complicating the course of diabetic ketoacidosis (DKA) is a source of increased morbidity and mortality. Detection of respiratory failure in DKA requires focused clinical monitoring, careful interpretation of arterial blood gases, and investigation for conditions that can affect adversely the respiration. Conditions that compromise respiratory function caused by DKA can be detected at presentation but are usually more prevalent during treatment. These conditions include deficits of potassium, magnesium and phosphate and hydrostatic or non-hydrostatic pulmonary edema. Conditions not caused by DKA that can worsen respiratory function under the added stress of DKA include infections of the respiratory system, pre-existing respiratory or neuromuscular disease and miscellaneous other conditions. Prompt recognition and management of the conditions that can lead to respiratory failure in DKA may prevent respiratory failure and improve mortality from DKA.

Respiratory failure in diabetic ketoacidosis

PubMed Central

Konstantinov, Nikifor K; Rohrscheib, Mark; Agaba, Emmanuel I; Dorin, Richard I; Murata, Glen H; Tzamaloukas, Antonios H

2015-01-01

Respiratory failure complicating the course of diabetic ketoacidosis (DKA) is a source of increased morbidity and mortality. Detection of respiratory failure in DKA requires focused clinical monitoring, careful interpretation of arterial blood gases, and investigation for conditions that can affect adversely the respiration. Conditions that compromise respiratory function caused by DKA can be detected at presentation but are usually more prevalent during treatment. These conditions include deficits of potassium, magnesium and phosphate and hydrostatic or non-hydrostatic pulmonary edema. Conditions not caused by DKA that can worsen respiratory function under the added stress of DKA include infections of the respiratory system, pre-existing respiratory or neuromuscular disease and miscellaneous other conditions. Prompt recognition and management of the conditions that can lead to respiratory failure in DKA may prevent respiratory failure and improve mortality from DKA. PMID:26240698

Timely diagnosis of dairy calf respiratory disease using a standardized scoring system.

PubMed

McGuirk, Sheila M; Peek, Simon F

2014-12-01

Respiratory disease of young dairy calves is a significant cause of morbidity, mortality, economic loss, and animal welfare concern but there is no gold standard diagnostic test for antemortem diagnosis. Clinical signs typically used to make a diagnosis of respiratory disease of calves are fever, cough, ocular or nasal discharge, abnormal breathing, and auscultation of abnormal lung sounds. Unfortunately, routine screening of calves for respiratory disease on the farm is rarely performed and until more comprehensive, practical and affordable respiratory disease-screening tools such as accelerometers, pedometers, appetite monitors, feed consumption detection systems, remote temperature recording devices, radiant heat detectors, electronic stethoscopes, and thoracic ultrasound are validated, timely diagnosis of respiratory disease can be facilitated using a standardized scoring system. We have developed a scoring system that attributes severity scores to each of four clinical parameters; rectal temperature, cough, nasal discharge, ocular discharge or ear position. A total respiratory score of five points or higher (provided that at least two abnormal parameters are observed) can be used to distinguish affected from unaffected calves. This can be applied as a screening tool twice-weekly to identify pre-weaned calves with respiratory disease thereby facilitating early detection. Coupled with effective treatment protocols, this scoring system will reduce post-weaning pneumonia, chronic pneumonia, and otitis media.

Noncontact respiration-monitoring system using fiber grating sensor

NASA Astrophysics Data System (ADS)

Sato, Isao; Nakajima, Masato

2004-10-01

In this research, the new non-contact breathing motion monitoring system using Fiber Grating 3-dimension Sensor is used to measure the respiratory movement of the chest and the abdomen and the shape of the human body simultaneously. Respiratory trouble during sleep brings about various kinds of diseases. Particularly, Sleep Apnea Syndrome (SAS), which restricts respiration during sleep, has been in the spotlight in recent years. However, present equipment for analyzing the blessing motion requires attaching various sensors on the patient's body. This system adopted two CCD cameras to measure the movements of projected infrared bright spots on the patient's body which measure the body form, breathing motion of the chest and breathing motion of the abdomen in detail. Since the equipment does not contact the patient's body, the patient feels incompatibility, and there is no necessity to worry about the equipment coming off. Sleep Apnea Syndrome is classified into three types by their respiratory pattern-Obstructive, Central and Mixed SAS based on the characteristic. This paper reports the method of diagnosing SAS automatically. It is thought that this method will be helpful not only for the diagnosis of SAS but also for the diagnosis of other kinds of complicated respiratory disease.

Are vital signs indicative for bacteremia in newborns?

PubMed

Yapıcıoğlu, Hacer; Özlü, Ferda; Sertdemir, Yaşar

2015-01-01

Neonatal systemic infection is a leading cause of morbidity and mortality both in industrialized and developing countries. The aim of this prospective study was to evaluate if vital signs had a predictive power in neonatal sepsis as an early marker. This study was designed as a matched case-control study. Vital signs were monitorized prior to infection in newborns that had healthcare-associated blood stream infection (BSI). Maximum and minimum values of the vital signs (blood pressure, heart rate, respiratory rate and temperature) of the babies at rest were recorded from the nurse observation charts five days prior to clinical sepsis and compared with vital signs of healthy, age-matched babies. Maximum mean heart rates, respiratory rates and systolic blood pressure levels of the patients in BSI group were significantly higher than the control group in the past three days prior to clinical deterioration. Monitoring vital signs closely might be helpful in a newborn infant to define a BSI. In future, a respiratory and blood pressure predictive monitoring system such as heart rate variability index may be developed for newborn patients with sepsis.

Neural network for photoplethysmographic respiratory rate monitoring

NASA Astrophysics Data System (ADS)

Johansson, Anders

2001-10-01

The photoplethysmographic signal (PPG) includes respiratory components seen as frequency modulation of the heart rate (respiratory sinus arrhythmia, RSA), amplitude modulation of the cardiac pulse, and respiratory induced intensity variations (RIIV) in the PPG baseline. The aim of this study was to evaluate the accuracy of these components in determining respiratory rate, and to combine the components in a neural network for improved accuracy. The primary goal is to design a PPG ventilation monitoring system. PPG signals were recorded from 15 healthy subjects. From these signals, the systolic waveform, diastolic waveform, respiratory sinus arrhythmia, pulse amplitude and RIIV were extracted. By using simple algorithms, the rates of false positive and false negative detection of breaths were calculated for each of the five components in a separate analysis. Furthermore, a simple neural network (NN) was tried out in a combined pattern recognition approach. In the separate analysis, the error rates (sum of false positives and false negatives) ranged from 9.7% (pulse amplitude) to 14.5% (systolic waveform). The corresponding value of the NN analysis was 9.5-9.6%.

A system for respiratory motion detection using optical fibers embedded into textiles.

PubMed

D'Angelo, L T; Weber, S; Honda, Y; Thiel, T; Narbonneau, F; Luth, T C

2008-01-01

In this contribution, a first prototype for mobile respiratory motion detection using optical fibers embedded into textiles is presented. The developed system consists of a T-shirt with an integrated fiber sensor and a portable monitoring unit with a wireless communication link enabling the data analysis and visualization on a PC. A great effort is done worldwide to develop mobile solutions for health monitoring of vital signs for patients needing continuous medical care. Wearable, comfortable and smart textiles incorporating sensors are good approaches to solve this problem. In most of the cases, electrical sensors are integrated, showing significant limits such as for the monitoring of anaesthetized patients during Magnetic Resonance Imaging (MRI). OFSETH (Optical Fibre Embedded into technical Textile for Healthcare) uses optical sensor technologies to extend the current capabilities of medical technical textiles.

Respiratory system dynamical mechanical properties: modeling in time and frequency domain.

PubMed

Carvalho, Alysson Roncally; Zin, Walter Araujo

2011-06-01

The mechanical properties of the respiratory system are important determinants of its function and can be severely compromised in disease. The assessment of respiratory system mechanical properties is thus essential in the management of some disorders as well as in the evaluation of respiratory system adaptations in response to an acute or chronic process. Most often, lungs and chest wall are treated as a linear dynamic system that can be expressed with differential equations, allowing determination of the system's parameters, which will reflect the mechanical properties. However, different models that encompass nonlinear characteristics and also multicompartments have been used in several approaches and most specifically in mechanically ventilated patients with acute lung injury. Additionally, the input impedance over a range of frequencies can be assessed with a convenient excitation method allowing the identification of the mechanical characteristics of the central and peripheral airways as well as lung periphery impedance. With the evolution of computational power, the airway pressure and flow can be recorded and stored for hours, and hence continuous monitoring of the respiratory system mechanical properties is already available in some mechanical ventilators. This review aims to describe some of the most frequently used models for the assessment of the respiratory system mechanical properties in both time and frequency domain.

Low-power system for the acquisition of the respiratory signal of neonates using diaphragmatic electromyography.

PubMed

Torres, Róbinson; López-Isaza, Sergio; Mejía-Mejía, Elisa; Paniagua, Viviana; González, Víctor

2017-01-01

An apnea episode is defined as the cessation of breathing for ≥15 seconds or as any suspension of breathing accompanied by hypoxia and bradycardia. Obtaining information about the respiratory system in a neonate can be accomplished using electromyography signals from the diaphragm muscle. The purpose of this paper is to illustrate a method by which the respiratory and electrocardiographic signals from neonates can be obtained using diaphragmatic electromyography. The system was developed using single-supply, micropower components, which deliver a low-power consumption system appropriate for the development of portable devices. The stages of the system were tested in both adult and neonate patients. The system delivers signals as those expected in both patients and allows the acquisition of respiratory signals directly from the diaphragmatic electromyography. This low-power system may present a good alternative for monitoring the cardiac and respiratory activity in newborn babies, both in the hospital and at home. The system delivers good signals but needs to be validated for its use in neonates. It is being used in the Neonatal Intensive Care Unit of the Hospital General de Medellín Luz Castro de Gutiérrez.

Noncontact Monitoring of Respiration by Dynamic Air-Pressure Sensor.

PubMed

Takarada, Tohru; Asada, Tetsunosuke; Sumi, Yoshihisa; Higuchi, Yoshinori

2015-01-01

We have previously reported that a dynamic air-pressure sensor system allows respiratory status to be visually monitored for patients in minimally clothed condition. The dynamic air-pressure sensor measures vital information using changes in air pressure. To utilize this device in the field, we must clarify the influence of clothing conditions on measurement. The present study evaluated use of the dynamic air-pressure sensor system as a respiratory monitor that can reliably detect change in breathing patterns irrespective of clothing. Twelve healthy volunteers reclined on a dental chair positioned horizontally with the sensor pad for measuring air-pressure signals corresponding to respiration placed on the seat back of the dental chair in the central lumbar region. Respiratory measurements were taken under 2 conditions: (a) thinly clothed (subject lying directly on the sensor pad); and (b) thickly clothed (subject lying on the sensor pad covered with a pressure-reducing sheet). Air-pressure signals were recorded and time integration values for air pressure during each expiration were calculated. This information was compared with expiratory tidal volume measured simultaneously by a respirometer connected to the subject via face mask. The dynamic air-pressure sensor was able to receive the signal corresponding to respiration regardless of clothing conditions. A strong correlation was identified between expiratory tidal volume and time integration values for air pressure during each expiration for all subjects under both clothing conditions (0.840-0.988 for the thinly clothed condition and 0.867-0.992 for the thickly clothed condition). These results show that the dynamic air-pressure sensor is useful for monitoring respiratory physiology irrespective of clothing.

A Wireless Electronic Esophageal Stethoscope for Continuous Monitoring of Cardiovascular and Respiratory Systems during Anaesthesia

PubMed Central

Parsaei, H.; Vakily, A.; Shafiei, A.M.

2017-01-01

Background: The basic requirements for monitoring anesthetized patients during surgery are assessing cardiac and respiratory function. Esophageal stethoscopes have been developed for this purpose, but these devices may not provide clear heart and lung sound due to existence of various noises in operating rooms. In addition, the stethoscope is not applicable for continues monitoring, and it is unsuitable for observing inaccessible patients in some conditions such as during CT scan. Objective: A wireless electronic esophageal stethoscope is designed for continues auscultation of heart and lung sounds in anesthetized patients. The system consists of a transmitter and a receiver. The former acquires, amplifies and transmits the acquired sound signals to the latter via a frequency modulation transmitter. The receiver demodulates, amplifies, and delivers the received signal to a headphone to be heard by anesthesiologist. Results: The usability and effectiveness of the designed system was qualitatively evaluated by 5 anesthesiologists in Namazi Hospital and Shahid Chamran Hospital, Shiraz, Iran on 30 patients in several operating rooms in different conditions; e.g., when electro surgery instruments are working. Fortunately, the experts on average ranked good quality for the heard heart and lung sounds and very good on the user friendly being of the instrument. Conclusion: Evaluation results demonstrate that the developed system is capable of capturing and transmitting heart and lung sounds successfully. Therefore, it can be used to continuously monitor anesthetized patients’ cardiac and respiratory function. Since via the instrument wireless auscultation is possible, it could be suitable for observing inaccessible patients in several conditions such as during CT scan. PMID:28451580

Application of digital signal processing methods for the diagnosis of respiration disorders during sleep with the use of plethysmographic wave analysis

NASA Astrophysics Data System (ADS)

Hatlinski, Grzegorz J.; Kornacki, Witold; Kukwa, Andrzej; Dobrowiecka, Bozena; Pikiel, Marek

2004-07-01

This paper proposes non-invasive solution to the problem of sleep apnea diagnosis especially in small children when sudden death syndrome is suspected. Plethysmographic wave analysis and digital signal processing algorithms are applied in order to find the effect invoked by respiratory movements of sleeping patients so as to diagnose the sleep apnea syndrome. The practical results of finding solution to problems mentioned above will be the possibility of algorithms implementation in a portable intelligent measurement system with a non-invasive monitoring of respiratory action. It works without any disturbances of sleep and respiratory movements especially in small children what could make possible in the future when continuous monitoring were applied to prevent sudden death syndrome occurrence.

Respiratory analysis system and method

NASA Technical Reports Server (NTRS)

Liu, F. F. (Inventor)

1973-01-01

A system is described for monitoring the respiratory process in which the gas flow rate and the frequency of respiration and expiration cycles can be determined on a real time basis. A face mask is provided with one-way inlet and outlet valves where the gas flow is through independent flowmeters and through a mass spectrometer. The opening and closing of a valve operates an electrical switch, and the combination of the two switches produces a low frequency electrical signal of the respiratory inhalation and exhalation cycles. During the time a switch is operated, the corresponsing flowmeter produces electric pulses representative of the flow rate; the electrical pulses being at a higher frequency than that of the breathing cycle and combined with the low frequency signal. The high frequency pulses are supplied to conventional analyzer computer which also receives temperature and pressure inputs and computes mass flow rate and totalized mass flow of gas. From the mass spectrometer, components of the gas are separately computed as to flow rate. The electrical switches cause operation of up-down inputs of a reversible counter. The respective up and down cycles can be individually monitored and combined for various respiratory measurements.

Use of a turbine in a breath-by-breath computer-based respiratory measurement system.

PubMed

Venkateswaran, R S; Gallagher, R R

1997-01-01

The Computer-Based Respiratory Measurement System (CBRMS) is capable of analyzing individual breaths to monitor the kinetics of oxygen uptake, carbon dioxide production, tidal volumes, pulmonary ventilation, and other respiratory parameters during rest, exercise, and recovery. Respiratory gas volumes are measured by a calibrated turbine transducer while the respiratory gas concentrations are measured by a calibrated, fast-responding medical gas analyzer. To improve accuracy of the results, the inspiratory volumes and gas concentrations are measured and not assumed to be equal to expiratory volumes or ambient concentrations respectively. The respiratory gas volumes and concentration signals are digitized and stored in arrays. The gas volumes are converted to flow signals by software differentiation. These digitized data arrays are stored as files in a personal computer. Time alignment of the flow and gas concentration signals is performed at each breath for maximum accuracy in analysis. For system verification, data were obtained under resting conditions and under constant load exercises at 50 W, 100 W, and 150 W. These workloads were performed by a healthy, male subject on a bicycle ergometer. A strong correlation existed between the CBRMS steady-state results and the standard end-expirate bag collection technique. Thus, there is reason to believe that the CBRMS is capable of calculating respiratory transient responses accurately, a significant contribution to an understanding of total respiratory system function.

Pleth variability index and respiratory system compliance to direct PEEP settings in mechanically ventilated patients, an exploratory study.

PubMed

Zhou, Jing; Han, Yi

2016-01-01

To analyze the ability of pleth variability index (PVI) and respiratory system compliance (RSC) on evaluating the hemodynamic and respiratory effects of positive end expiratory pressure (PEEP), then to direct PEEP settings in mechanically ventilated critical patients. We studied 22 mechanically ventilated critical patients in the intensive care unit. Patients were monitored with classical monitor and a pulse co-oximeter, with pulse sensors attached to patients' index fingers. Hemodynamic data [heart rate (HR), perfusion index (PI), PVI, central venous pressure (CVP), mean arterial pressure (MAP), peripheral blood oxygen saturation (SPO2), peripheral blood oxygen content (SPOC) and peripheral blood hemoglobin (SPHB)] as well as the respiratory data [respiratory rate (RR), tidal volume (VT), RSC and controlled airway pressure] were recorded for 15 min each at 3 different levels of PEEP (0, 5 and 10 cmH2O). Different levels of PEEP (0, 5 and 10 cmH2O) had no obvious effect on RR, HR, MAP, SPO2 and SPOC. However, 10 cmH2O PEEP induced significant hemodynamic disturbances, including decreases of PI, and increases of both PVI and CVP. Meanwhile, 5 cmH2O PEEP induced no significant changes on hemodynamics such as CVP, PI and PVI, but improved the RSC. RSC and PVI may be useful in detecting the hemodynamic and respiratory effects of PEEP, thus may help clinicians individualize PEEP settings in mechanically ventilated patients.

Wireless non-invasive continuous respiratory monitoring with FMCW radar: a clinical validation study.

PubMed

van Loon, K; Breteler, M J M; van Wolfwinkel, L; Rheineck Leyssius, A T; Kossen, S; Kalkman, C J; van Zaane, B; Peelen, L M

2016-12-01

Altered respiratory rate is one of the first symptoms of medical conditions that require timely intervention, e.g., sepsis or opioid-induced respiratory depression. To facilitate continuous respiratory rate monitoring on general hospital wards a contactless, non-invasive, prototype monitor was developed using frequency modulated continuous wave radar. We aimed to study whether radar can reliably measure respiratory rate in postoperative patients. In a diagnostic cross-sectional study patients were monitored with the radar and the reference monitor (pneumotachograph during mechanical ventilation and capnography during spontaneous breathing). Eight patients were included; yielding 796 min of observation time during mechanical ventilation and 521 min during spontaneous breathing. After elimination of movement artifacts the bias and 95 % limits of agreement for mechanical ventilation and spontaneous breathing were -0.12 (-1.76 to 1.51) and -0.59 (-5.82 to 4.63) breaths per minute respectively. The radar was able to accurately measure respiratory rate in mechanically ventilated patients, but the accuracy decreased during spontaneous breathing.

MO-FG-BRA-02: A Feasibility Study of Integrating Breathing Audio Signal with Surface Surrogates for Respiratory Motion Management

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lei, Y; Zhu, X; Zheng, D

Purpose: Tracking the surrogate placed on patient skin surface sometimes leads to problematic signals for certain patients, such as shallow breathers. This in turn impairs the 4D CT image quality and dosimetric accuracy. In this pilot study, we explored the feasibility of monitoring human breathing motion by integrating breathing sound signal with surface surrogates. Methods: The breathing sound signals were acquired though a microphone attached adjacently to volunteer’s nostrils, and breathing curve were analyzed using a low pass filter. Simultaneously, the Real-time Position Management™ (RPM) system from Varian were employed on a volunteer to monitor respiratory motion including both shallowmore » and deep breath modes. The similar experiment was performed by using Calypso system, and three beacons taped on volunteer abdominal region to capture breath motion. The period of each breathing curves were calculated with autocorrelation functions. The coherence and consistency between breathing signals using different acquisition methods were examined. Results: Clear breathing patterns were revealed by the sound signal which was coherent with the signal obtained from both the RPM system and Calypso system. For shallow breathing, the periods of breathing cycle were 3.00±0.19 sec (sound) and 3.00±0.21 sec (RPM); For deep breathing, the periods were 3.49± 0.11 sec (sound) and 3.49±0.12 sec (RPM). Compared with 4.54±0.66 sec period recorded by the calypso system, the sound measured 4.64±0.54 sec. The additional signal from sound could be supplement to the surface monitoring, and provide new parameters to model the hysteresis lung motion. Conclusion: Our preliminary study shows that the breathing sound signal can provide a comparable way as the RPM system to evaluate the respiratory motion. It’s instantaneous and robust characteristics facilitate it possibly to be a either independently or as auxiliary methods to manage respiratory motion in radiotherapy.« less

Information system for diagnosis of respiratory system diseases

NASA Astrophysics Data System (ADS)

Abramov, G. V.; Korobova, L. A.; Ivashin, A. L.; Matytsina, I. A.

2018-05-01

An information system is for the diagnosis of patients with lung diseases. The main problem solved by this system is the definition of the parameters of cough fragments in the monitoring recordings using a voice recorder. The authors give the recognition criteria of recorded cough moments, audio records analysis. The results of the research are systematized. The cough recognition system can be used by the medical specialists to diagnose the condition of the patients and to monitor the process of their treatment.

Low-power system for the acquisition of the respiratory signal of neonates using diaphragmatic electromyography

PubMed Central

Torres, Róbinson; López-Isaza, Sergio; Mejía-Mejía, Elisa; Paniagua, Viviana; González, Víctor

2017-01-01

Introduction An apnea episode is defined as the cessation of breathing for ≥15 seconds or as any suspension of breathing accompanied by hypoxia and bradycardia. Obtaining information about the respiratory system in a neonate can be accomplished using electromyography signals from the diaphragm muscle. Objective The purpose of this paper is to illustrate a method by which the respiratory and electrocardiographic signals from neonates can be obtained using diaphragmatic electromyography. Materials and methods The system was developed using single-supply, micropower components, which deliver a low-power consumption system appropriate for the development of portable devices. The stages of the system were tested in both adult and neonate patients. Results The system delivers signals as those expected in both patients and allows the acquisition of respiratory signals directly from the diaphragmatic electromyography. Conclusion This low-power system may present a good alternative for monitoring the cardiac and respiratory activity in newborn babies, both in the hospital and at home. Significance The system delivers good signals but needs to be validated for its use in neonates. It is being used in the Neonatal Intensive Care Unit of the Hospital General de Medellín Luz Castro de Gutiérrez. PMID:28260954

Evaluation of a national pharmacy‐based syndromic surveillance system

PubMed Central

Muchaal, PK; Parker, S; Meganath, K; Landry, L; Aramini, J

2015-01-01

Background Traditional public health surveillance provides accurate information but is typically not timely. New early warning systems leveraging timely electronic data are emerging, but the public health value of such systems is still largely unknown. Objective To assess the timeliness and accuracy of pharmacy sales data for both respiratory and gastrointestinal infections and to determine its utility in supporting the surveillance of gastrointestinal illness. Methods To assess timeliness, a prospective and retrospective analysis of data feeds was used to compare the chronological characteristics of each data stream. To assess accuracy, Ontario antiviral prescriptions were compared to confirmed cases of influenza and cases of influenza-like-illness (ILI) from August 2009 to January 2015 and Nova Scotia sales of respiratory over-the-counter products (OTC) were compared to laboratory reports of respiratory pathogen detections from January 2014 to March 2015. Enteric outbreak data (2011-2014) from Nova Scotia were compared to sales of gastrointestinal products for the same time period. To assess utility, pharmacy sales of gastrointestinal products were monitored across Canada to detect unusual increases and reports were disseminated to the provinces and territories once a week between December 2014 and March 2015 and then a follow-up evaluation survey of stakeholders was conducted. Results Ontario prescriptions of antivirals between 2009 and 2015 correlated closely with the onset dates and magnitude of confirmed influenza cases. Nova Scotia sales of respiratory OTC products correlated with increases in non-influenza respiratory pathogens in the community. There were no definitive correlations identified between the occurrence of enteric outbreaks and the sales of gastrointestinal OTCs in Nova Scotia. Evaluation of national monitoring showed no significant increases in sales of gastrointestinal products that could be linked to outbreaks that included more than one province or territory. Conclusion Monitoring of pharmacy-based drug prescriptions and OTC sales can provide a timely and accurate complement to traditional respiratory public health surveillance activities but initial evaluation did not show that tracking gastrointestinal-related OTCs were of value in identifying an enteric disease outbreak in more than one province or territory during the study period. PMID:29769953

The effects of awareness and count duration on adult respiratory rate measurements: An experimental study.

PubMed

Hill, Andrew; Kelly, Eliza; Horswill, Mark S; Watson, Marcus O

2018-02-01

To investigate whether awareness of manual respiratory rate monitoring affects respiratory rate in adults, and whether count duration influences respiratory rate estimates. Nursing textbooks typically suggest that the patient should ideally be unaware of respiratory rate observations; however, there is little published evidence of the effect of awareness on respiratory rate, and none specific to manual measurement. In addition, recommendations about the length of the respiratory rate count vary from text to text, and the relevant empirical evidence is scant, inconsistent and subject to substantial methodological limitations. Experimental study with awareness of respiration monitoring (aware, unaware; randomised between-subjects) and count duration (60 s, 30 s, 15 s; within-subjects) as the independent variables. Respiratory rate (breaths/minute) was the dependent variable. Eighty-two adult volunteers were randomly assigned to aware and unaware conditions. In the baseline block, no live monitoring occurred. In the subsequent experimental block, the researcher informed aware participants that their respiratory rate would be counted, and did so. Respirations were captured throughout via video recording, and counted by blind raters viewing 60-, 30- and 15-s extracts. The data were collected in 2015. There was no baseline difference between the groups. During the experimental block, the respiratory rates of participants in the aware condition were an average of 2.13 breaths/minute lower compared to unaware participants. Reducing the count duration from 1 min to 15 s caused respiratory rate to be underestimated by an average of 2.19 breaths/minute (and 0.95 breaths/minute for 30-s counts). The awareness effect did not depend on count duration. Awareness of monitoring appears to reduce respiratory rate, and shorter monitoring durations yield systematically lower respiratory rate estimates. When interpreting and acting upon respiratory rate data, clinicians should consider the potential influence of these factors, including cumulative effects. © 2017 The Authors. Journal of Clinical Nursing Published by John Wiley & Sons Ltd.

Video-based respiration monitoring with automatic region of interest detection.

PubMed

Janssen, Rik; Wang, Wenjin; Moço, Andreia; de Haan, Gerard

2016-01-01

Vital signs monitoring is ubiquitous in clinical environments and emerging in home-based healthcare applications. Still, since current monitoring methods require uncomfortable sensors, respiration rate remains the least measured vital sign. In this paper, we propose a video-based respiration monitoring method that automatically detects a respiratory region of interest (RoI) and signal using a camera. Based on the observation that respiration induced chest/abdomen motion is an independent motion system in a video, our basic idea is to exploit the intrinsic properties of respiration to find the respiratory RoI and extract the respiratory signal via motion factorization. We created a benchmark dataset containing 148 video sequences obtained on adults under challenging conditions and also neonates in the neonatal intensive care unit (NICU). The measurements obtained by the proposed video respiration monitoring (VRM) method are not significantly different from the reference methods (guided breathing or contact-based ECG; p-value  =  0.6), and explain more than 99% of the variance of the reference values with low limits of agreement (-2.67 to 2.81 bpm). VRM seems to provide a valid solution to ECG in confined motion scenarios, though precision may be reduced for neonates. More studies are needed to validate VRM under challenging recording conditions, including upper-body motion types.

A Wearable Respiratory Biofeedback System Based on Generalized Body Sensor Network

PubMed Central

Liu, Guan-Zheng; Huang, Bang-Yu

2011-01-01

Abstract Wearable medical devices have enabled unobtrusive monitoring of vital signs and emerging biofeedback services in a pervasive manner. This article describes a wearable respiratory biofeedback system based on a generalized body sensor network (BSN) platform. The compact BSN platform was tailored for the strong requirements of overall system optimizations. A waist-worn biofeedback device was designed using the BSN. Extensive bench tests have shown that the generalized BSN worked as intended. In-situ experiments with 22 subjects indicated that the biofeedback device was discreet, easy to wear, and capable of offering wearable respiratory trainings. Pilot studies on wearable training patterns and resultant heart rate variability suggested that paced respirations at abdominal level and with identical inhaling/exhaling ratio were more appropriate for decreasing sympathetic arousal and increasing parasympathetic activities. PMID:21545293

A cloud-based mobile system to improve respiratory therapy services at home.

PubMed

Risso, Nicolas A; Neyem, Andrés; Benedetto, Jose I; Carrillo, Marie J; Farías, Angélica; Gajardo, Macarena J; Loyola, Oscar

2016-10-01

Chronic respiratory diseases are one of the most prevalent health problems in the world. Treatment for these kind of afflictions often take place at home, where the continuous care of a medical specialist is frequently beyond the economical means of the patient, therefore having to rely on informal caregivers (family, friends, etc.). Unfortunately, these treatments require a deep involvement on their part, which results in a heavy burden on the caregivers' routine and usually end up deteriorating their quality of life. In recent years, mHealth and eHealth applications have gained a wide interest in academia due to new capabilities enabled by the latest advancements in mobile technologies and wireless communication infrastructure. These innovations have resulted in several applications that have successfully managed to improve automatic patient monitoring and treatment and to bridge the distance between patients, caregivers and medical specialists. We therefore seek to move this trend forward by now pushing these capabilities into the field of respiratory therapies in order to assist patients with chronic respiratory diseases with their treatment, and to improve both their own and their caregivers' quality of life. This paper presents a cloud-based mobile system to support and improve homecare for respiratory diseases. The platform described uses vital signs monitoring as a way of sharing data between hospitals, caregivers and patients. Using an iterative research approach and the user's direct feedback, we show how mobile technologies can improve a respiratory therapy and a family's quality of life. Copyright © 2016 Elsevier Inc. All rights reserved.

A contact-free respiration monitor for smart bed and ambulatory monitoring applications.

PubMed

Hart, Adam; Tallevi, Kevin; Wickland, David; Kearney, Robert E; Cafazzo, Joseph A

2010-01-01

The development of a contact-free respiration monitor has a broad range of clinical applications in the home and hospital setting. Current approaches suffer from a variety of problems including unreliability, low sensitivity, and high cost. This work describes a novel approach to contact-free respiration monitoring that addresses these shortcomings by employing a highly sensitive capacitance sensor to detect variations in capacitive coupling caused by breathing. A prototype system consisting of a synthetic-metallic pad, sensor electronics, and iPhone interface was built and its performance compared experimentally to the gold standard technique (Respiratory Inductance Plethysmography) on both a healthy volunteer and SimMan robotic mannequin. The prototype sensor effectively captured respiratory movements over breathing rates of 5-55 bpm; achieving an average spectral correlation of 0.88 (CI: 0.86-0.90) and 0.95 (CI: 0.95-0.96) to the gold standard using the SimMan and healthy volunteer respectively.

Respiratory Compromise as a New Paradigm for the Care of Vulnerable Hospitalized Patients.

PubMed

Morris, Timothy A; Gay, Peter C; MacIntyre, Neil R; Hess, Dean R; Hanneman, Sandra K; Lamberti, James P; Doherty, Dennis E; Chang, Lydia; Seckel, Maureen A

2017-04-01

Acute respiratory compromise describes a deterioration in respiratory function with a high likelihood of rapid progression to respiratory failure and death. Identifying patients at risk for respiratory compromise coupled with monitoring of patients who have developed respiratory compromise might allow earlier interventions to prevent or mitigate further decompensation. The National Association for the Medical Direction of Respiratory Care (NAMDRC) organized a workshop meeting with representation from many national societies to address the unmet needs of respiratory compromise from a clinical practice perspective. Respiratory compromise may arise de novo or may complicate preexisting lung disease. The group identified distinct subsets of respiratory compromise that present similar opportunities for early detection and useful intervention to prevent respiratory failure. The subtypes were characterized by the pathophysiological mechanisms they had in common: impaired control of breathing, impaired airway protection, parenchymal lung disease, increased airway resistance, hydrostatic pulmonary edema, and right-ventricular failure. Classification of acutely ill respiratory patients into one or more of these categories may help in selecting the screening and monitoring strategies that are most appropriate for the patient's particular pathophysiology. Standardized screening and monitoring practices for patients with similar mechanisms of deterioration may enhance the ability to predict respiratory failure early and prevent its occurrence. Copyright © 2017 by Daedalus Enterprises.

Numerically based design of an orifice plate flowmetering system for human respiratory flow monitoring.

PubMed

Fortuna, A O; Gurd, J R

1999-01-01

During certain medical procedures, it is important to continuously measure the respiratory flow of a patient, as lack of proper ventilation can cause brain damage and ultimately death. The monitoring of the ventilatory condition of a patient is usually performed with the aid of flowmeters. However, water and other secretions present in the expired air can build up and ultimately block a traditional, restriction-based flowmeter; by using an orifice plate flowmeter, such blockages are minimized. This paper describes the design of an orifice plate flowmetering system including, especially, a description of the numerical and computational techniques adopted in order to simulate human respiratory and sinusoidal air flow across various possible designs for the orifice plate flowmeter device. Parallel computation and multigrid techniques were employed in order to reduce execution time. The simulated orifice plate was later built and tested under unsteady sinusoidal flows. Experimental tests show reasonable agreement with the numerical simulation, thereby reinforcing the general hypothesis that computational exploration of the design space is sufficiently accurate to allow designers of such systems to use this in preference to the more traditional, mechanical prototyping techniques.

Diagnosis and Anti-Reflux Therapy for GERD with Respiratory Symptoms: A Study Using Multichannel Intraluminal Impedance-pH Monitoring

PubMed Central

Zhang, Chao; Wu, Jimin; Hu, Zhiwei; Yan, Chao; Gao, Xiang; Liang, Weitao; Liu, Diangang; Li, Fei; Wang, Zhonggao

2016-01-01

Background/Aims Respiratory symptoms are often associated with gastroesophageal reflux disease (GERD). Although the role of multichannel intraluminal impedance–pH (MII-pH) monitoring in GERD is clear, little is known regarding the characteristics of patients with respiratory symptoms based on MII-pH monitoring and anti-reflux therapy. We evaluated a cohort of GERD patients to identify the MII-pH parameters of GERD-related respiratory symptoms and to assess the anti-reflux therapy outcomes. Methods We undertook a prospective study of patients who were referred for GERD evaluation from January 2011 to January 2012. One hundred ninety-five patients underwent MII-pH monitoring and esophageal manometry, and one hundred sixty-five patients underwent invasive anti-reflux therapy that included laparoscopic Toupet fundoplication (LTF) and the Stretta procedure. The patient characteristics and MII-pH parameters were analyzed, and the symptom scores were assessed at baseline and at 1- and 3-year follow-up evaluations. Results Of the 195 patients, 96 (49.2%) exhibited respiratory symptoms and significantly more reflux episodes (70.7±29.3) than patients without respiratory symptoms (64.7±24.4, p = 0.044) based on the MII-pH monitoring results. Moreover, the group of patients with respiratory symptoms exhibited more proximal reflux episodes (35.2±21.3) than the non-respiratory symptomatic group (28.3±17.9, p = 0.013). One hundred twenty-five patients following the Stretta procedure (n = 60, 31 with respiratory symptoms) or LTF (n = 65, 35 with respiratory symptoms) completed the designated 3-year follow-up period and were included in the final analysis. The symptom scores after anti-reflux therapy all decreased relative to the corresponding baseline values (p<0.05), and there were no significant differences in the control of respiration between the Stretta procedure and LTF (p>0.05). However, LTF significantly reduced the recurrence (re-operation) rate compared with the Stretta procedure (0 vs. 19.4%, p = 0.006). Conclusions MII-pH monitoring effectively detected respiratory-related predictive parameters, including total/proximal reflux episodes and symptom correlations. We found that GERD patients with respiratory symptoms exhibited more proximal and total reflux episodes but not more acid-related episodes, as determined by MII-pH monitoring. Thus, such monitoring could be useful for diagnosing atypical GERD patients with respiratory symptoms. Furthermore, LTF exhibited a more significant effect on controlling typical symptoms in all GERD patients and reducing the recurrence rate than the Stretta procedure in patients with respiratory symptoms. PMID:27532103

Rural and remote care

PubMed Central

Marciniuk, Darcy

2016-01-01

The challenges of providing quality respiratory care to persons living in rural or remote communities can be daunting. These populations are often vulnerable in terms of both health status and access to care, highlighting the need for innovation in service delivery. The rapidly expanding options available using telehealthcare technologies have the capacity to allow patients in rural and remote communities to connect with providers at distant sites and to facilitate the provision of diagnostic, monitoring, and therapeutic services. Successful implementation of telehealthcare programs in rural and remote settings is, however, contingent upon accounting for key technical, organizational, social, and legal considerations at the individual, community, and system levels. This review article discusses five types of telehealthcare delivery that can facilitate respiratory care for residents of rural or remote communities: remote monitoring (including wearable and ambient systems; remote consultations (between providers and between patients and providers), remote pulmonary rehabilitation, telepharmacy, and remote sleep monitoring. Current and future challenges related to telehealthcare are discussed. PMID:26902542

A portable respiratory rate estimation system with a passive single-lead electrocardiogram acquisition module.

PubMed

Nayan, Nazrul Anuar; Risman, Nur Sabrina; Jaafar, Rosmina

2016-07-27

Among vital signs of acutely ill hospital patients, respiratory rate (RR) is a highly accurate predictor of health deterioration. This study proposes a system that consists of a passive and non-invasive single-lead electrocardiogram (ECG) acquisition module and an ECG-derived respiratory (EDR) algorithm in the working prototype of a mobile application. Before estimating RR that produces the EDR rate, ECG signals were evaluated based on the signal quality index (SQI). The SQI algorithm was validated quantitatively using the PhysioNet/Computing in Cardiology Challenge 2011 training data set. The RR extraction algorithm was validated by adopting 40 MIT PhysioNet Multiparameter Intelligent Monitoring in Intensive Care II data set. The estimated RR showed a mean absolute error (MAE) of 1.4 compared with the ``gold standard'' RR. The proposed system was used to record 20 ECGs of healthy subjects and obtained the estimated RR with MAE of 0.7 bpm. Results indicate that the proposed hardware and algorithm could replace the manual counting method, uncomfortable nasal airflow sensor, chest band, and impedance pneumotachography often used in hospitals. The system also takes advantage of the prevalence of smartphone usage and increase the monitoring frequency of the current ECG of patients with critical illnesses.

Respiratory Care year in review 2013: airway management, noninvasive monitoring, and invasive mechanical ventilation.

PubMed

Durbin, Charles G; Blanch, Lluís; Fan, Eddy; Hess, Dean R

2014-04-01

Fundamental to respiratory care practice are airway management, noninvasive monitoring, and invasive mechanical ventilation. The purpose of this paper is to review the recent literature related to these topics in a manner that is most likely to have interest to the readers of Respiratory Care.

Detecting Vital Signs with Wearable Wireless Sensors

PubMed Central

Yilmaz, Tuba; Foster, Robert; Hao, Yang

2010-01-01

The emergence of wireless technologies and advancements in on-body sensor design can enable change in the conventional health-care system, replacing it with wearable health-care systems, centred on the individual. Wearable monitoring systems can provide continuous physiological data, as well as better information regarding the general health of individuals. Thus, such vital-sign monitoring systems will reduce health-care costs by disease prevention and enhance the quality of life with disease management. In this paper, recent progress in non-invasive monitoring technologies for chronic disease management is reviewed. In particular, devices and techniques for monitoring blood pressure, blood glucose levels, cardiac activity and respiratory activity are discussed; in addition, on-body propagation issues for multiple sensors are presented. PMID:22163501

Radio telemetry devices to monitor breathing in non-sedated animals.

PubMed

Samson, Nathalie; Dumont, Sylvain; Specq, Marie-Laure; Praud, Jean-Paul

2011-12-15

Radio telemetry equipment has significantly improved over the last 10-15 years and is increasingly being used in research for monitoring a variety of physiological parameters in non-sedated animals. The aim of this review is to provide an update on the current state of development of radio telemetry for recording respiration. Our literature review found only rare reports of respiratory studies via radio telemetry. Much of this article will hence report our experience with our custom-built radio telemetry devices designed for recording respiratory signals, together with numerous other physiological signals in lambs. Our current radio telemetry system allows to record 24 simultaneous signals 24h/day for several days. To our knowledge, this is the highest number of physiological signals, which can be recorded wirelessly. Our devices have been invaluable for studying respiration in our ovine models of preterm birth, reflux laryngitis, postnatal exposure to cigarette smoke, respiratory syncytial virus infection and nasal ventilation, all of which are relevant to neonatal respiratory problems. Copyright © 2011 Elsevier B.V. All rights reserved.

Establishing an emergency department syndromic surveillance system to support the London 2012 Olympic and Paralympic Games.

PubMed

Elliot, Alex J; Hughes, Helen E; Hughes, Thomas C; Locker, Thomas E; Shannon, Tony; Heyworth, John; Wapling, Andy; Catchpole, Mike; Ibbotson, Sue; McCloskey, Brian; Smith, Gillian E

2012-12-01

The London 2012 Olympic and Paralympic Games is a mass gathering event that will present a major public health challenge. The Health Protection Agency, in collaboration with the College of Emergency Medicine, has established the Emergency Department Sentinel Syndromic Surveillance System (EDSSS) to support the public health surveillance requirements of the Games. This feasibility study assesses the usefulness of EDSSS in monitoring indicators of disease in the community. Daily counts of anonymised attendance data from six emergency departments across England were analysed by patient demographics (age, gender, partial postcode), triage coding and diagnosis codes. Generic and specific syndromic indicators were developed using aggregations of diagnosis codes recorded during each attendance. Over 339,000 attendances were recorded (26 July 2010 to 25 July 2011). The highest attendances recorded on weekdays between 10:00 and 11:00 and on weekends between 12:00 and 13:00. The mean daily attendance per emergency department was 257 (range 38-435). Syndromic indicators were developed including: respiratory, gastrointestinal, cardiac, acute respiratory infection, gastroenteritis and myocardial ischaemia. Respiratory and acute respiratory infection indicators peaked during December 2010, concomitant with national influenza activity, as monitored through other influenza surveillance systems. The EDSSS has been established to provide an enhanced surveillance system for the London 2012 Olympics. Further validation of the data will be required; however, the results from this initial descriptive study demonstrate the potential for identifying unusual and/or severe outbreaks of infectious disease, or other incidents with public health impact, within the community.

Use of the PiCCO system in critically ill patients with septic shock and acute respiratory distress syndrome: a study protocol for a randomized controlled trial.

PubMed

Zhang, Zhongheng; Xu, Xiao; Yao, Min; Chen, Huilan; Ni, Hongying; Fan, Haozhe

2013-02-01

Hemodynamic monitoring is very important in critically ill patients with shock or acute respiratory distress syndrome(ARDS). The PiCCO (Pulse index Contour Continuous Cardiac Output, Pulsion Medical Systems, Germany) system has been developed and used in critical care settings for several years. However, its impact on clinical outcomes remains unknown. The study is a randomized controlled multi-center trial. A total of 708 patients with ARDS, septic shock or both will be included from January 2012 to January 2014. Subjects will be randomized to receive PiCCO monitoring or not. Our primary end point is 30-day mortality, and secondary outcome measures include ICU length of stay, days on mechanical ventilation, days of vasoactive agent support, ICU-free survival days during a 30-day period, mechanical-ventilation-free survival days during a 30-day period, and maximum SOFA score during the first 7 days. We investigate whether the use of PiCCO monitoring will improve patient outcomes in critically ill patients with ARDS or septic shock. This will provide additional data on hemodynamic monitoring and help clinicians to make decisions on the use of PiCCO. http://www.clinicaltrials.gov NCT01526382.

Algorithms to qualify respiratory data collected during the transport of trauma patients.

PubMed

Chen, Liangyou; McKenna, Thomas; Reisner, Andrew; Reifman, Jaques

2006-09-01

We developed a quality indexing system to numerically qualify respiratory data collected by vital-sign monitors in order to support reliable post-hoc mining of respiratory data. Each monitor-provided (reference) respiratory rate (RR(R)) is evaluated, second-by-second, to quantify the reliability of the rate with a quality index (QI(R)). The quality index is calculated from: (1) a breath identification algorithm that identifies breaths of 'typical' sizes and recalculates the respiratory rate (RR(C)); (2) an evaluation of the respiratory waveform quality (QI(W)) by assessing waveform ambiguities as they impact the calculation of respiratory rates and (3) decision rules that assign a QI(R) based on RR(R), RR(C) and QI(W). RR(C), QI(W) and QI(R) were compared to rates and quality indices independently determined by human experts, with the human measures used as the 'gold standard', for 163 randomly chosen 15 s respiratory waveform samples from our database. The RR(C) more closely matches the rates determined by human evaluation of the waveforms than does the RR(R) (difference of 3.2 +/- 4.6 breaths min(-1) versus 14.3 +/- 19.3 breaths min(-1), mean +/- STD, p < 0.05). Higher QI(W) is found to be associated with smaller differences between calculated and human-evaluated rates (average differences of 1.7 and 8.1 breaths min(-1) for the best and worst QI(W), respectively). Establishment of QI(W) and QI(R), which ranges from 0 for the worst-quality data to 3 for the best, provides a succinct quantitative measure that allows for automatic and systematic selection of respiratory waveforms and rates based on their data quality.

Assessing workplace chemical exposures: the role of exposure monitoring.

PubMed

Harper, Martin

2004-05-01

Occupational exposure is the condition of being subjected through employment to a chemical, physical, or biological agent, or to a specific process, practice, behavior, or organization of work. Exposure to a chemical agent is typically the contact of that agent with the outer boundary of a subject, such as the respiratory system, skin, or digestive system. In occupational hygiene we are most concerned with exposure through the respiratory system, although, increasingly we are concerned with the results of dermal exposures, including those exposures to the skin that can be transferred to the mouth and digestive system. This presentation will detail methods available for assessing personal exposures to chemicals through monitoring. The results from monitoring can then be compared to established guidelines and regulations, although this is not the only rationale for making measurements. These monitoring methods are currently used around the world to establish the benchmark hazard from which risk to the worker can be predicted. The presentation will describe the general techniques for assessing exposures to the respiratory system from chemical gases and vapors, chemical dusts, and exposures to the skin from bulk chemicals or chemical contamination of surfaces. For respiratory exposures, direct-reading instruments are available for spot measurements, and for monitoring short-term fluctuations in concentration. However, most standards and regulations are based on time-integrated (time-weighted average) exposures, requiring longer-term integrative methods. Therefore, the specific focus of this review will be the methods available for full work-shift sampling. For gases and vapors this will include taking whole-air samples in canisters or polymer bags, or concentration of chemicals by absorption in liquids or adsorption on solid sorbents, with subsequent chemical analysis. Chemical concentration can take place by pumping air through the sorbing media, or by allowing molecules to diffuse to the sorbent surface. Transfer of the collected chemicals to the analytical instrumentation can be accomplished using solvent displacement and injection, or through the application of heat to bring the collected molecules back into the vapor phase. For particles, the particle size is important as this determines the site of deposition in the lungs, and so time-integrated sampling on filters using various types of size-selective samplers is preferred. Finally, some techniques that have been used to assess the potential for chemical contamination of the skin are presented. Biomonitoring is another tool that can be used to assess exposure, and the results are more relevant to dosimetric considerations than exposure. Biomonitoring is a complex subject worthy of a separate review, and will be considered only briefly here.

Pulse oximetry-derived respiratory rate in general care floor patients.

PubMed

Addison, Paul S; Watson, James N; Mestek, Michael L; Ochs, James P; Uribe, Alberto A; Bergese, Sergio D

2015-02-01

Respiratory rate is recognized as a clinically important parameter for monitoring respiratory status on the general care floor (GCF). Currently, intermittent manual assessment of respiratory rate is the standard of care on the GCF. This technique has several clinically-relevant shortcomings, including the following: (1) it is not a continuous measurement, (2) it is prone to observer error, and (3) it is inefficient for the clinical staff. We report here on an algorithm designed to meet clinical needs by providing respiratory rate through a standard pulse oximeter. Finger photoplethysmograms were collected from a cohort of 63 GCF patients monitored during free breathing over a 25-min period. These were processed using a novel in-house algorithm based on continuous wavelet-transform technology within an infrastructure incorporating confidence-based averaging and logical decision-making processes. The computed oximeter respiratory rates (RRoxi) were compared to an end-tidal CO2 reference rate (RRETCO2). RRETCO2 ranged from a lowest recorded value of 4.7 breaths per minute (brpm) to a highest value of 32.0 brpm. The mean respiratory rate was 16.3 brpm with standard deviation of 4.7 brpm. Excellent agreement was found between RRoxi and RRETCO2, with a mean difference of -0.48 brpm and standard deviation of 1.77 brpm. These data demonstrate that our novel respiratory rate algorithm is a potentially viable method of monitoring respiratory rate in GCF patients. This technology provides the means to facilitate continuous monitoring of respiratory rate, coupled with arterial oxygen saturation and pulse rate, using a single non-invasive sensor in low acuity settings.

Cumulative lesioning of respiratory interneurons disrupts and precludes motor rhythms in vitro

PubMed Central

Hayes, John A.; Wang, Xueying; Del Negro, Christopher A.

2012-01-01

How brain functions degenerate in the face of progressive cell loss is an important issue that pertains to neurodegenerative diseases and basic properties of neural networks. We developed an automated system that uses two-photon microscopy to detect rhythmic neurons from calcium activity, and then individually laser ablates the targets while monitoring network function in real time. We applied this system to the mammalian respiratory oscillator located in the pre-Bötzinger Complex (preBötC) of the ventral medulla, which spontaneously generates breathing-related motor activity in vitro. Here, we show that cumulatively deleting preBötC neurons progressively decreases respiratory frequency and the amplitude of motor output. On average, the deletion of 120 ± 45 neurons stopped spontaneous respiratory rhythm, and our data suggest ≈82% of the rhythm-generating neurons remain unlesioned. Cumulative ablations in other medullary respiratory regions did not affect frequency but diminished the amplitude of motor output to a lesser degree. These results suggest that the preBötC can sustain insults that destroy no more than ≈18% of its constituent interneurons, which may have implications for the onset of respiratory pathologies in disease states. PMID:22566628

Elimination of Drifts in Long-Duration Monitoring for Apnea-Hypopnea of Human Respiration.

PubMed

Jiang, Peng; Zhu, Rong

2016-10-25

This paper reports a methodology to eliminate an uncertain baseline drift in respiratory monitoring using a thermal airflow sensor exposed in a high humidity environment. Human respiratory airflow usually contains a large amount of moisture (relative humidity, RH > 85%). Water vapors in breathing air condense gradually on the surface of the sensor so as to form a thin water film that leads to a significant sensor drift in long-duration respiratory monitoring. The water film is formed by a combination of condensation and evaporation, and therefore the behavior of the humidity drift is complicated. Fortunately, the exhale and inhale responses of the sensor exhibit distinguishing features that are different from the humidity drift. Using a wavelet analysis method, we removed the baseline drift of the sensor and successfully recovered the respiratory waveform. Finally, we extracted apnea-hypopnea events from the respiratory signals monitored in whole-night sleeps of patients and compared them with golden standard polysomnography (PSG) results.

Elimination of Drifts in Long-Duration Monitoring for Apnea-Hypopnea of Human Respiration

PubMed Central

Jiang, Peng; Zhu, Rong

2016-01-01

This paper reports a methodology to eliminate an uncertain baseline drift in respiratory monitoring using a thermal airflow sensor exposed in a high humidity environment. Human respiratory airflow usually contains a large amount of moisture (relative humidity, RH > 85%). Water vapors in breathing air condense gradually on the surface of the sensor so as to form a thin water film that leads to a significant sensor drift in long-duration respiratory monitoring. The water film is formed by a combination of condensation and evaporation, and therefore the behavior of the humidity drift is complicated. Fortunately, the exhale and inhale responses of the sensor exhibit distinguishing features that are different from the humidity drift. Using a wavelet analysis method, we removed the baseline drift of the sensor and successfully recovered the respiratory waveform. Finally, we extracted apnea-hypopnea events from the respiratory signals monitored in whole-night sleeps of patients and compared them with golden standard polysomnography (PSG) results. PMID:27792151

[Status of cardiorespiratory polysomnographic diagnosis in the sleep laboratory].

PubMed

Penzel, T

1995-03-01

The different types of sleep related breathing and cardiovascular disorders are well known and defined nowadays. Thereby it is possible to present a configuration by which a cardiorespiratory sleep laboratory is enabled to perform a complete differential diagnosis. This configuration consists of the function sleep with EEG, EOG and EMG, the function respiration with respiratory effort, respiratory flow and oxygen saturation, and the cardiovascular function with ECG and blood pressure if indicated. Continuous monitoring by videocamera and a patient call system with a technician present during the entire recording time must be assured. Recording and evaluation of all signals can be done with chart polygraphs or with computer systems if they provide a high-resolution graphic monitor. Automatic sleep analysis systems support evaluation of polysomnograms. But automatic analysis of sleep stages as well as automatic analysis of respiratory disorders needs visual counterchecking before results can be accepted. On the basis of today's knowledge recommendation for the setting of a sleep laboratory were set and new sleep labs are controlled on a voluntary basis by a commission of the German society for sleep research and sleep medicine. This first step of quality control is introduced to establish a procedure to keep quality of diagnosis and treatment on a high level in this medical specialty.

A Wearable System for Real-Time Continuous Monitoring of Physical Activity

PubMed Central

2018-01-01

Over the last decades, wearable systems have gained interest for monitoring of physiological variables, promoting health, and improving exercise adherence in different populations ranging from elite athletes to patients. In this paper, we present a wearable system for the continuous real-time monitoring of respiratory frequency (fR), heart rate (HR), and movement cadence during physical activity. The system has been experimentally tested in the laboratory (by simulating the breathing pattern with a mechanical ventilator) and by collecting data from one healthy volunteer. Results show the feasibility of the proposed device for real-time continuous monitoring of fR, HR, and movement cadence both in resting condition and during activity. Finally, different synchronization techniques have been investigated to enable simultaneous data collection from different wearable modules. PMID:29849993

Measuring the respiratory gas exchange of grazing cattle using the GreenFeed emissions monitoring system

USDA-ARS?s Scientific Manuscript database

Ruminants are a significant source of enteric methane, which has been identified as a powerful greenhouse gas that contributes to climate change. With interest in developing technologies to decrease enteric methane emission, systems are currently being developed to measure the methane emission by c...

Respiratory High-Dependency Care Units for the burden of acute respiratory failure.

PubMed

Scala, Raffaele

2012-06-01

The burden of acute respiratory failure (ARF) has become one of the greatest epidemiological challenges for the modern health systems. Consistently, the imbalance between the increasing prevalence of acutely de-compensated respiratory diseases and the shortage of high-daily cost ICU beds has stimulated new health cost-effective solutions. Respiratory High-Dependency Care Units (RHDCU) provide a specialised environment for patients who require an "intermediate" level of care between the ICU and the ward, where non-invasive monitoring and assisted ventilation techniques are preferentially applied. Since they are dedicated to the management of "mono-organ" decompensations, treatment of ARF patients in RHDCU avoids the dangerous "under-assistance" in the ward and unnecessary "over-assistance" in ICU. RHDCUs provide a specialised quality of care for ARF with health resources optimisation and their spread throughout health systems has been driven by their high-level of expertise in non-invasive ventilation (NIV), weaning from invasive ventilation, tracheostomy care, and discharging planning for ventilator-dependent patients. Copyright © 2011 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

Biological Monitoring of Air Pollutants and Its Influence on Human Beings

PubMed Central

Cen, Shihong

2015-01-01

Monitoring air pollutants via plants is an economic, convenient and credible method compared with the traditional ways. Plants show different damage symptoms to different air pollutants, which can be used to determine the species of air pollutants. Besides, pollutants mass concentration scope can be estimated by the damage extent of plants and the span of polluted time. Based on the domestic and foreign research, this paper discusses the principles, mechanism, advantages and disadvantages of plant-monitoring, and exemplifies plenty of such plants and the minimum mass concentration and pollution time of the plants showing damage symptoms. Finally, this paper introduced the human health effects of air pollutants on immune function of the body, such as decrease of the body's immune function, decline of lung function, respiratory and circulatory system changes, inducing and promoting human allergic diseases, respiratory diseases and other diseases. PMID:26628931

Validation of Contact-Free Sleep Monitoring Device with Comparison to Polysomnography.

PubMed

Tal, Asher; Shinar, Zvika; Shaki, David; Codish, Shlomi; Goldbart, Aviv

2017-03-15

To validate a contact-free system designed to achieve maximal comfort during long-term sleep monitoring, together with high monitoring accuracy. We used a contact-free monitoring system (EarlySense, Ltd., Israel), comprising an under-the-mattress piezoelectric sensor and a smartphone application, to collect vital signs and analyze sleep. Heart rate (HR), respiratory rate (RR), body movement, and calculated sleep-related parameters from the EarlySense (ES) sensor were compared to data simultaneously generated by the gold standard, polysomnography (PSG). Subjects in the sleep laboratory underwent overnight technician-attended full PSG, whereas subjects at home were recorded for 1 to 3 nights with portable partial PSG devices. Data were compared epoch by epoch. A total of 63 subjects (85 nights) were recorded under a variety of sleep conditions. Compared to PSG, the contact-free system showed similar values for average total sleep time (TST), % wake, % rapid eye movement, and % non-rapid eye movement sleep, with 96.1% and 93.3% accuracy of continuous measurement of HR and RR, respectively. We found a linear correlation between TST measured by the sensor and TST determined by PSG, with a coefficient of 0.98 (R = 0.87). Epoch-by-epoch comparison with PSG in the sleep laboratory setting revealed that the system showed sleep detection sensitivity, specificity, and accuracy of 92.5%, 80.4%, and 90.5%, respectively. TST estimates with the contact-free sleep monitoring system were closely correlated with the gold-standard reference. This system shows good sleep staging capability with improved performance over accelerometer-based apps, and collects additional physiological information on heart rate and respiratory rate. © 2017 American Academy of Sleep Medicine

Instrumentation for the analysis of respiratory system disorders during sleep: Design and application

NASA Astrophysics Data System (ADS)

de Melo, Pedro Lopes; de Andrade Lemes, Lucas Neves

2002-11-01

Sleep breathing disorders are estimated to be present in 2%-4% of middle-aged adults. Serious adverse consequences, such as systemic arterial hypertension, myocardial infraction, and cerebrovascular disease, can be related to these conditions. Intellectual deficits associated with attention, memory, and problem-solving have also been associated with a poor quality of sleep. The main causes of these disorders are obstructions resulting from repetitive narrowing and closure of the pharyngeal airway, which have been monitored by indirect measurements of temperature, displacement, and other highly invasive procedures. The measurement of mechanical impedance of the respiratory system by the forced oscillation technique (FOT) has recently been suggested to quantify the respiratory obstruction during sleep. It is claimed that the noninvasive and dynamic characteristics of this technique would allow a noninvasive and accurate analysis of these events. In spite of this high scientific and clinical potential, there is no detailed description of a complete instrumentation system to implement this promising technique in sleep studies. In this context, the purpose of this study was twofold: (1) describe the development of a new computer-based system for identification of the mechanical impedance of the respiratory system during sleep by the FOT and (2) evaluate the performance of this device in the description of respiratory events in conditions including no, mild, serious disease, and therapeutic procedures. These evaluations confirmed the desirable features achieved in laboratory tests and the high scientific and clinical potential of this system.

PlaIMoS: A Remote Mobile Healthcare Platform to Monitor Cardiovascular and Respiratory Variables

PubMed Central

Miramontes, Ramses; Aquino, Raúl; Flores, Arturo; Rodríguez, Guillermo; Anguiano, Rafael; Ríos, Arturo; Edwards, Arthur

2017-01-01

The number of elderly and chronically ill patients has grown significantly over the past few decades as life expectancy has increased worldwide, leading to increased demands on the health care system and significantly taxing traditional health care practices. Consequently, there is an urgent need to use technology to innovate and more constantly and intensely monitor, report and analyze critical patient physiological parameters beyond conventional clinical settings in a more efficient and cost effective manner. This paper presents a technological platform called PlaIMoS which consists of wearable sensors, a fixed measurement station, a network infrastructure that employs IEEE 802.15.4 and IEEE 802.11 to transmit data with security mechanisms, a server to analyze all information collected and apps for iOS, Android and Windows 10 mobile operating systems to provide real-time measurements. The developed architecture, designed primarily to record and report electrocardiogram and heart rate data, also monitors parameters associated with chronic respiratory illnesses, including patient blood oxygen saturation and respiration rate, body temperature, fall detection and galvanic resistance. PMID:28106832

PlaIMoS: A Remote Mobile Healthcare Platform to Monitor Cardiovascular and Respiratory Variables.

PubMed

Miramontes, Ramses; Aquino, Raúl; Flores, Arturo; Rodríguez, Guillermo; Anguiano, Rafael; Ríos, Arturo; Edwards, Arthur

2017-01-19

The number of elderly and chronically ill patients has grown significantly over the past few decades as life expectancy has increased worldwide, leading to increased demands on the health care system and significantly taxing traditional health care practices. Consequently, there is an urgent need to use technology to innovate and more constantly and intensely monitor, report and analyze critical patient physiological parameters beyond conventional clinical settings in a more efficient and cost effective manner. This paper presents a technological platform called PlaIMoS which consists of wearable sensors, a fixed measurement station, a network infrastructure that employs IEEE 802.15.4 and IEEE 802.11 to transmit data with security mechanisms, a server to analyze all information collected and apps for iOS, Android and Windows 10 mobile operating systems to provide real-time measurements. The developed architecture, designed primarily to record and report electrocardiogram and heart rate data, also monitors parameters associated with chronic respiratory illnesses, including patient blood oxygen saturation and respiration rate, body temperature, fall detection and galvanic resistance.

Respiratory Care Received by Individuals With Duchenne Muscular Dystrophy From 2000 to 2011.

PubMed

Andrews, Jennifer G; Soim, Aida; Pandya, Shree; Westfield, Christina P; Ciafaloni, Emma; Fox, Deborah J; Birnkrant, David J; Cunniff, Christopher M; Sheehan, Daniel W

2016-10-01

Duchenne muscular dystrophy (DMD) causes progressive respiratory muscle weakness and decline in function, which can go undetected without monitoring. DMD respiratory care guidelines recommend scheduled respiratory assessments and use of respiratory assist devices. To determine the extent of adherence to these guidelines, we evaluated respiratory assessments and interventions among males with DMD in the Muscular Dystrophy Surveillance, Tracking, and Research Network (MD STARnet) from 2000 to 2011. MD STARnet is a population-based surveillance system that identifies all individuals born during or after 1982 residing in Arizona, Colorado, Georgia, Hawaii, Iowa, and western New York with Duchenne or Becker muscular dystrophy. We analyzed MD STARnet respiratory care data for non-ambulatory adolescent males (12-17 y old) and men (≥18 y old) with DMD, assessing whether: (1) pulmonary function was measured twice yearly; (2) awake and asleep hypoventilation testing was performed at least yearly; (3) home mechanical insufflation-exsufflation, noninvasive ventilation, and tracheostomy/ventilators were prescribed; and (4) pulmonologists provided evaluations. During 2000-2010, no more than 50% of both adolescents and men had their pulmonary function monitored twice yearly in any of the years; 67% or fewer were assessed for awake and sleep hypoventilation yearly. Although the use of mechanical insufflation-exsufflation and noninvasive ventilation is probably increasing, prior use of these devices did not prevent all tracheostomies, and at least 18 of 29 tracheostomies were performed due to acute respiratory illnesses. Fewer than 32% of adolescents and men had pulmonologist evaluations in 2010-2011. Since the 2004 publication of American Thoracic Society guidelines, there have been few changes in pulmonary clinical practice. Frequencies of respiratory assessments and assist device use among males with DMD were lower than recommended in clinical guidelines. Collaboration of respiratory therapists and pulmonologists with clinicians caring for individuals with DMD should be encouraged to ensure access to the full spectrum of in-patient and out-patient pulmonary interventions. Copyright © 2016 by Daedalus Enterprises.

A national program for control of acute respiratory tract infections: the Philippine experience.

PubMed

Dayrit, E S

1999-02-01

Maturing programs on child immunization and diarrheal diseases, a community-based research project, and a rational drug-use program facilitated the launching in 1989 of a nationwide Philippine Control of Acute Respiratory Infections program (Phil-CARI). From 1990 to 1991 the Phil-CARI expanded rapidly, training >80% of its middle managers and frontline health care providers on the case-management protocols of the World Health Organization for acute respiratory infection. Multiple donors and good collaboration with various societies and medical schools assisted the program. However, by 1992, there were difficulties in maintaining training quality, follow-up, and supervision. Donor assistance dwindled and the health care delivery system decentralized. Government procurement systems were unable to meet the logistics demands of the program. The monitoring and evaluation system was inadequate to measure impact. The Phil-CARI provides lessons in searching for more sustainable approaches and systems to meet the various demands of a nationwide ARI control program and to create the desired impact.

Infrared Hollow Optical Fiber Probe for Localized Carbon Dioxide Measurement in Respiratory Tracts.

PubMed

Katagiri, Takashi; Shibayama, Kyosuke; Iida, Takeru; Matsuura, Yuji

2018-03-27

A real-time gas monitoring system based on optical absorption spectroscopy is proposed for localized carbon dioxide (CO₂) measurement in respiratory tracts. In this system, a small gas cell is attached to the end of a hollow optical fiber that delivers mid-infrared light with small transmission loss. The diameters of the fiber and the gas cell are smaller than 1.2 mm so that the probe can be inserted into a working channel of common bronchoscopes. The dimensions of the gas cell are designed based on absorption spectra of CO₂ standard gases in the 4.2 μm wavelength region, which are measured using a Fourier-transform infrared spectrometer. A miniature gas cell that is comprised of a stainless-steel tube with slots for gas inlet and a micro-mirror is fabricated. A compact probing system with a quantum cascade laser (QCL) light source is built using a gas cell with a hollow optical fiber for monitoring CO₂ concentration. Experimental results using human breaths show the feasibility of the system for in-situ measurement of localized CO₂ concentration in human airways.

Tele-monitoring of ventilator-dependent patients: a European Respiratory Society Statement.

PubMed

Ambrosino, Nicolino; Vitacca, Michele; Dreher, Michael; Isetta, Valentina; Montserrat, Josep M; Tonia, Thomy; Turchetti, Giuseppe; Winck, Joao Carlos; Burgos, Felip; Kampelmacher, Michael; Vagheggini, Guido

2016-09-01

The estimated prevalence of ventilator-dependent individuals in Europe is 6.6 per 100 000 people. The increasing number and costs of these complex patients make present health organisations largely insufficient to face their needs. As a consequence, their burden lays mostly over families. The need to reduce healthcare costs and to increase safety has prompted the development of tele-monitoring for home ventilatory assistance.A European Respiratory Society Task Force produced a literature research based statement on commonly accepted clinical criteria for indications, follow-up, equipment, facilities, legal and economic issues of tele-monitoring of these patients.Many remote health monitoring systems are available, ensuring safety, feasibility, effectiveness, sustainability and flexibility to face different patients' needs. The legal problems associated with tele-monitoring are still controversial. National and European Union (EU) governments should develop guidelines and ethical, legal, regulatory, technical, administrative standards for remote medicine. The economic advantages, if any, of this new approach must be compared to a "gold standard" of home care that is very variable among different European countries and within each European country.Much more research is needed before considering tele-monitoring a real improvement in the management of these patients. Copyright ©ERS 2016.

An Ethnographic Observational Study to Evaluate and Optimize the Use of Respiratory Acoustic Monitoring in Children Receiving Postoperative Opioid Infusions.

PubMed

Görges, Matthias; West, Nicholas C; Christopher, Nancy A; Koch, Jennifer L; Brodie, Sonia M; Lowlaavar, Nasim; Lauder, Gillian R; Ansermino, J Mark

2016-04-01

Respiratory depression in children receiving postoperative opioid infusions is a significant risk because of the interindividual variability in analgesic requirement. Detection of respiratory depression (or apnea) in these children may be improved with the introduction of automated acoustic respiratory rate (RR) monitoring. However, early detection of adverse events must be balanced with the risk of alarm fatigue. Our objective was to evaluate the use of acoustic RR monitoring in children receiving opioid infusions on a postsurgical ward and identify the causes of false alarm and optimal alarm thresholds. A video ethnographic study was performed using an observational, mixed methods approach. After surgery, an acoustic RR sensor was placed on the participant's neck and attached to a Rad87 monitor. The monitor was networked with paging for alarms. Vital signs data and paging notification logs were obtained from the central monitoring system. Webcam videos of the participant, infusion pump, and Rad87 monitor were recorded, stored on a secure server, and subsequently analyzed by 2 research nurses to identify the cause of the alarm, response, and effectiveness. Alarms occurring within a 90-second window were grouped into a single-alarm response opportunity. Data from 49 patients (30 females) with median age 14 (range, 4.4-18.8) years were analyzed. The 896 bedside vital sign threshold alarms resulted in 160 alarm response opportunities (44 low RR, 74 high RR, and 42 low SpO2). In 141 periods (88% of total), for which video was available, 65% of alarms were deemed effective (followed by an alarm-related action within 10 minutes). Nurses were the sole responders in 55% of effective alarms and the patient or parent in 20%. Episodes of desaturation (SpO2 < 90%) were observed in 9 patients: At the time of the SpO2 paging trigger, the RR was >10 bpm in 6 of 9 patients. Based on all RR samples observed, the default alarm thresholds, to serve as a starting point for each patient, would be a low RR of 6 (>10 years of age) and 10 (4-9 years of age). In this study, the use of RR monitoring did not improve the detection of respiratory depression. An RR threshold, which would have been predictive of desaturations, would have resulted in an unacceptably high false alarm rate. Future research using a combination of variables (e.g., SpO2 and RR), or the measurement of tidal volumes, may be needed to improve patient safety in the postoperative ward.

Fluoroscopic evaluation of diaphragmatic motion reduction with a respiratory gated radiotherapy system.

PubMed

Mageras, G S; Yorke, E; Rosenzweig, K; Braban, L; Keatley, E; Ford, E; Leibel, S A; Ling, C C

2001-01-01

We report on initial patient studies to evaluate the performance of a commercial respiratory gating radiotherapy system. The system uses a breathing monitor, consisting of a video camera and passive infrared reflective markers placed on the patient's thorax, to synchronize radiation from a linear accelerator with the patient's breathing cycle. Six patients receiving treatment for lung cancer participated in a study of system characteristics during treatment simulation with fluoroscopy. Breathing synchronized fluoroscopy was performed initially without instruction, followed by fluoroscopy with recorded verbal instruction (i.e., when to inhale and exhale) with the tempo matched to the patient's normal breathing period. Patients tended to inhale more consistently when given instruction, as assessed by an external marker movement. This resulted in smaller variation in expiration and inspiration marker positions relative to total excursion, thereby permitting more precise gating tolerances at those parts of the breathing cycle. Breathing instruction also reduced the fraction of session times having irregular breathing as measured by the system software, thereby potentially increasing the accelerator duty factor and decreasing treatment times. Fluoroscopy studies showed external monitor movement to correlate well with that of the diaphragm in four patients, whereas time delays of up to 0.7 s in diaphragm movement were observed in two patients with impaired lung function. From fluoroscopic observations, average patient diaphragm excursion was reduced from 1.4 cm (range 0.7-2.1 cm) without gating and without breathing instruction, to 0.3 cm (range 0.2-0.5 cm) with instruction and with gating tolerances set for treatment at expiration for 25% of the breathing cycle. Patients expressed no difficulty with following instruction for the duration of a session. We conclude that the external monitor accurately predicts internal respiratory motion in most cases; however, it may be important to check with fluoroscopy for possible time delays in patients with impaired lung function. Furthermore, we observe that verbal instruction can improve breathing regularity, thus improving the performance of gated treatments with this system.

Association between PM10 and respiratory hospital admissions in different seasons in heavily polluted Lanzhou City.

PubMed

An, Xingqin; Yan, Tao; Mi, Shengquan; Sun, Zhaobin; Hou, Qing

2015-01-01

Exposure-response relationship between particulate matter less than 10 μm in diameter (PM10) and human health in different seasons from 2001 to 2005 was examined based on hospital admissions data of respiratory system diseases from four major hospitals in Lanzhou, China. To quantify associations of respiratory system diseases with multiple air pollutants and meteorological conditions, a semiparametric generalized additive model was used in the authors' study by implementing daily ambient sulfur dioxide, nitrogen dioxide, and PM10 data collected from the Lanzhou Environmental Monitoring Station and daily meteorological data from Lanzhou Meteorological Bureau. Results showed that daily averaged PM10 increased per interquartile range the hospital admissions number of respiratory diseases by 3.3% in spring, 1.4% in summer, 3.6% in autumn, and 4.0% in winter from a single-pollutant model, or 3.1%, 1.4%, 3.0%, and 4.0% from a multi-pollutant model, respectively. The effect of PM10 on respiratory hospital admissions was lowest in summer and highest in winter. The relative risks of PM10 on female or the elderly (≥ 65 yrs.) were higher, showing a stronger association of PM10 with respiratory diseases in female and elderly groups than in males and people younger than 65.

Validation of Contact-Free Sleep Monitoring Device with Comparison to Polysomnography

PubMed Central

Tal, Asher; Shinar, Zvika; Shaki, David; Codish, Shlomi; Goldbart, Aviv

2017-01-01

Study Objectives: To validate a contact-free system designed to achieve maximal comfort during long-term sleep monitoring, together with high monitoring accuracy. Methods: We used a contact-free monitoring system (EarlySense, Ltd., Israel), comprising an under-the-mattress piezoelectric sensor and a smartphone application, to collect vital signs and analyze sleep. Heart rate (HR), respiratory rate (RR), body movement, and calculated sleep-related parameters from the EarlySense (ES) sensor were compared to data simultaneously generated by the gold standard, polysomnography (PSG). Subjects in the sleep laboratory underwent overnight technician-attended full PSG, whereas subjects at home were recorded for 1 to 3 nights with portable partial PSG devices. Data were compared epoch by epoch. Results: A total of 63 subjects (85 nights) were recorded under a variety of sleep conditions. Compared to PSG, the contact-free system showed similar values for average total sleep time (TST), % wake, % rapid eye movement, and % non-rapid eye movement sleep, with 96.1% and 93.3% accuracy of continuous measurement of HR and RR, respectively. We found a linear correlation between TST measured by the sensor and TST determined by PSG, with a coefficient of 0.98 (R = 0.87). Epoch-by-epoch comparison with PSG in the sleep laboratory setting revealed that the system showed sleep detection sensitivity, specificity, and accuracy of 92.5%, 80.4%, and 90.5%, respectively. Conclusions: TST estimates with the contact-free sleep monitoring system were closely correlated with the gold-standard reference. This system shows good sleep staging capability with improved performance over accelerometer-based apps, and collects additional physiological information on heart rate and respiratory rate. Citation: Tal A, Shinar Z, Shaki D, Codish S, Goldbart A. Validation of contact-free sleep monitoring device with comparison to polysomnography. J Clin Sleep Med. 2017;13(3):517–522. PMID:27998378

Design and performance of a respiratory amplitude gating device for PET/CT imaging

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chang Guoping; Chang Tingting; Clark, John W. Jr.

2010-04-15

Purpose: Recently, the authors proposed a free-breathing amplitude gating (FBAG) technique for PET/CT scanners. The implementation of this technique required specialized hardware and software components that were specifically designed to interface with commercial respiratory gating devices to generate the necessary triggers required for the FBAG technique. The objective of this technical note is to introduce an in-house device that integrates all the necessary hardware and software components as well as tracks the patient's respiratory motion to realize amplitude gating on PET/CT scanners. Methods: The in-house device is composed of a piezoelectric transducer coupled to a data-acquisition system in order tomore » monitor the respiratory waveform. A LABVIEW program was designed to control the data-acquisition device and inject triggers into the PET list stream whenever the detected respiratory amplitude crossed a predetermined amplitude range. A timer was also programmed to stop the scan when the accumulated time within the selected amplitude range reached a user-set interval. This device was tested using a volunteer and a phantom study. Results: The results from the volunteer and phantom studies showed that the in-house device can detect similar respiratory signals as commercially available respiratory gating systems and is able to generate the necessary triggers to suppress respiratory motion artifacts. Conclusions: The proposed in-house device can be used to implement the FBAG technique in current PET/CT scanners.« less

Medical Gas Analyzer

NASA Technical Reports Server (NTRS)

1983-01-01

The Remote Monitoring System (RMS) is manufactured by Perkin Elmer Corporation. The principal component of the RMS was originally developed for spacecraft use to monitor astronaut's respiratory gases in NASA's Gemini and Apollo program. At Wishard Memorial Hospital in Indianapolis, IN, the RMS is used in operating rooms for analysis of anesthetic gases and measurement of oxygen, carbon dioxide and nitrogen concentrations. It assures that the patient undergoing surgery has the proper breathing environment.

Pedestrians in Traffic Environments: Ultrafine Particle Respiratory Doses

PubMed Central

Manigrasso, Maurizio; Natale, Claudio; Vitali, Matteo; Protano, Carmela; Avino, Pasquale

2017-01-01

Particulate matter has recently received more attention than other pollutants. PM10 and PM2.5 have been primarily monitored, whereas scientists are focusing their studies on finer granulometric sizes due both to their high number concentration and their high penetration efficiency into the respiratory system. The purpose of this study is to investigate the population exposure to UltraFine Particles (UFP, submicrons in general) in outdoor environments. The particle number doses deposited into the respiratory system have been compared between healthy individuals and persons affected by Chronic Obstructive Pulmonary Disease (COPD). Measurements were performed by means of Dust Track and Nanoscan analyzers. Forty minute walking trails through areas with different traffic densities in downtown Rome have been considered. Furthermore, particle respiratory doses have been estimated for persons waiting at a bus stop, near a traffic light, or along a high-traffic road, as currently occurs in a big city. Large differences have been observed between workdays and weekdays: on workdays, UFP number concentrations are much higher due to the strong contribution of vehicular exhausts. COPD-affected individuals receive greater doses than healthy individuals due to their higher respiratory rate. PMID:28282961

Use of thoracic electrical impedance tomography as an auxiliary tool for alveolar recruitment maneuvers in acute respiratory distress syndrome: case report and brief literature review

PubMed Central

Rosa, Regis Goulart; Rutzen, William; Madeira, Laura; Ascoli, Aline Maria; Dexheimer Neto, Felippe Leopoldo; Maccari, Juçara Gasparetto; de Oliveira, Roselaine Pinheiro; Teixeira, Cassiano

2015-01-01

Thoracic electrical impedance tomography is a real-time, noninvasive monitoring tool of the regional pulmonary ventilation distribution. Its bedside use in patients with acute respiratory distress syndrome has the potential to aid in alveolar recruitment maneuvers, which are often necessary in cases of refractory hypoxemia. In this case report, we describe the monitoring results and interpretation of thoracic electrical impedance tomography used during alveolar recruitment maneuvers in a patient with acute respiratory distress syndrome, with transient application of high alveolar pressures and optimal positive end-expiratory pressure titration. Furthermore, we provide a brief literature review regarding the use of alveolar recruitment maneuvers and monitoring using thoracic electrical impedance tomography in patients with acute respiratory distress syndrome. PMID:26761481

A UWB Radar Signal Processing Platform for Real-Time Human Respiratory Feature Extraction Based on Four-Segment Linear Waveform Model.

PubMed

Hsieh, Chi-Hsuan; Chiu, Yu-Fang; Shen, Yi-Hsiang; Chu, Ta-Shun; Huang, Yuan-Hao

2016-02-01

This paper presents an ultra-wideband (UWB) impulse-radio radar signal processing platform used to analyze human respiratory features. Conventional radar systems used in human detection only analyze human respiration rates or the response of a target. However, additional respiratory signal information is available that has not been explored using radar detection. The authors previously proposed a modified raised cosine waveform (MRCW) respiration model and an iterative correlation search algorithm that could acquire additional respiratory features such as the inspiration and expiration speeds, respiration intensity, and respiration holding ratio. To realize real-time respiratory feature extraction by using the proposed UWB signal processing platform, this paper proposes a new four-segment linear waveform (FSLW) respiration model. This model offers a superior fit to the measured respiration signal compared with the MRCW model and decreases the computational complexity of feature extraction. In addition, an early-terminated iterative correlation search algorithm is presented, substantially decreasing the computational complexity and yielding negligible performance degradation. These extracted features can be considered the compressed signals used to decrease the amount of data storage required for use in long-term medical monitoring systems and can also be used in clinical diagnosis. The proposed respiratory feature extraction algorithm was designed and implemented using the proposed UWB radar signal processing platform including a radar front-end chip and an FPGA chip. The proposed radar system can detect human respiration rates at 0.1 to 1 Hz and facilitates the real-time analysis of the respiratory features of each respiration period.

Invited Review: Measuring the respiratory gas exchange by grazing cattle using the GreenFeed emissions monitoring system

USDA-ARS?s Scientific Manuscript database

Ruminants are a source of enteric methane (CH4), which has been identified as a greenhouse gas that contributes to climate change. With interest in developing technologies to decrease enteric CH4 emission, systems are currently being developed to measure the CH4 emission by cattle. An issue with g...

Vagal tone as an index of mental state

NASA Technical Reports Server (NTRS)

Porges, Stephen W.

1988-01-01

The utility of monitoring oscillations in the heart rate pattern as a window to the brain is discussed as an index of general central nervous system status. Quantification of the amplitude of respiratory sinus arrhythmia provides an accurate index of cardiac vagal tone. A number of studies have demonstrated the validity of this measure; the relationship between flight performance and vagal tone has also been studied. In general, the vagal tone index appears to monitor global states of the central nervous system and may be useful in screening the general state of pilots.

Body temperature and motion: Evaluation of an online monitoring system in pigs challenged with Porcine Reproductive & Respiratory Syndrome Virus.

PubMed

Süli, Tamás; Halas, Máté; Benyeda, Zsófia; Boda, Réka; Belák, Sándor; Martínez-Avilés, Marta; Fernández-Carrión, Eduardo; Sánchez-Vizcaíno, José Manuel

2017-10-01

Highly contagious and emerging diseases cause significant losses in the pig producing industry worldwide. Rapid and exact acquisition of real-time data, like body temperature and animal movement from the production facilities would enable early disease detection and facilitate adequate response. In this study, carried out within the European Union research project RAPIDIA FIELD, we tested an online monitoring system on pigs experimentally infected with the East European subtype 3 Porcine Reproductive & Respiratory Syndrome Virus (PRRSV) strain Lena. We linked data from different body temperature measurement methods and the real-time movement of the pigs. The results showed a negative correlation between body temperature and movement of the animals. The correlation was similar with both body temperature obtaining methods, rectal and thermal sensing microchip, suggesting some advantages of body temperature measurement with transponders compared with invasive and laborious rectal measuring. We also found a significant difference between motion values before and after the challenge with a virulent PRRSV strain. The decrease in motion values was noticeable before any clinical sign was recorded. Based on our results the online monitoring system could represent a practical tool in registering early warning signs of health status alterations, both in experimental and commercial production settings. Copyright © 2017 Elsevier Ltd. All rights reserved.

The Structure Design of Piezoelectric Poly(vinylidene Fluoride) (PVDF) Polymer-Based Sensor Patch for the Respiration Monitoring under Dynamic Walking Conditions.

PubMed

Lei, Kin-Fong; Hsieh, Yi-Zheng; Chiu, Yi-Yuan; Wu, Min-Hsien

2015-07-31

This study reports a piezoelectric poly(vinylidene fluoride) (PVDF) polymer-based sensor patch for respiration detections in dynamic walking condition. The working mechanism of respiration signal generation is based on the periodical deformations on a human chest wall during the respiratory movements, which in turn mechanically stretch the piezoelectric PVDF film to generate the corresponding electrical signals. In this study, the PVDF sensing film was completely encapsulated within the sensor patch forming a mass-spring-damper mechanical system to prevent the noises generated in a dynamic condition. To verify the design of sensor patch to prevent dynamic noises, experimental investigations were carried out. Results demonstrated the respiration signals generated and the respiratory rates measured by the proposed sensor patch were in line with the same measurements based on a commercial respiratory effort transducer both in a static (e.g., sitting) or dynamic (e.g., walking) condition. As a whole, this study has developed a PVDF-based sensor patch which is capable of monitoring respirations in a dynamic walking condition with high fidelity. Other distinctive features include its small size, light weight, ease of use, low cost, and portability. All these make it a promising sensing device to monitor respirations particularly in home care units.

Transportable Life Support for Treatment of Acute Lung Failure Due to Smoke Inhalation and Burns

DTIC Science & Technology

2014-04-01

and all vital sign and medical monitor data collected in the animal ICU . The system is in use in the animal ICU daily and we will report on its... Influenza A(H1N1) Acute Respiratory Distress Syndrome. JAMA. Nov 4 2009;302(17):1888-1895. 9. Napolitano LM, Park PK, Raghavendran K, Bartlett RH...Nonventilatory strategies for patients with life-threatening 2009 H1N1 influenza and severe respiratory failure. Crit Care Med. Apr 2010;38(4 Suppl

Unconstrained Respiration Measurement and Respiratory Arrest Detection Method by Dynamic Threshold in Transferring Patients by Stretchers

NASA Astrophysics Data System (ADS)

Kurihara, Yosuke; Watanabe, Kajiro; Kobayashi, Kazuyuki; Tanaka, Hiroshi

General anesthesia used for surgical operations may cause unstable conditions of the patients after the operations, which could lead to respiratory arrests. Under such circumstances, nurses could fail in finding the change of the conditions, and other malpractices could also occur. It is highly possible that such malpractices may occur while transferring a patient from ICU to the room using a stretcher. Monitoring the change in the blood oxygen saturation concentration and other vital signs to detect a respiratory arrest is not easy when transferring a patient on a stretcher. Here we present several noise reduction system and algorithm to detect respiratory arrests in transferring a patient, based on the unconstrained air pressure method that the authors presented previously. As the result, when the acceleration level of the stretcher noise was 0.5G, the respiratory arrest detection ratio using this novel method was 65%, while that with the conventional method was 0%.

Respiratory disease in relation to outdoor air pollution in Kanpur, India.

PubMed

Liu, Hai-Ying; Bartonova, Alena; Schindler, Martin; Sharma, Mukesh; Behera, Sailesh N; Katiyar, Kamlesh; Dikshit, Onkar

2013-01-01

This paper examines the effect of outdoor air pollution on respiratory disease in Kanpur, India, based on data from 2006. Exposure to air pollution is represented by annual emissions of sulfur dioxide (SO(2)), particulate matter (PM), and nitrogen oxides (NO(x)) from 11 source categories, established as a geographic information system (GIS)-based emission inventory in 2 km × 2 km grid. Respiratory disease is represented by number of patients who visited specialist pulmonary hospital with symptoms of respiratory disease. The results showed that (1) the main sources of air pollution are industries, domestic fuel burning, and vehicles; (2) the emissions of PM per grid are strongly correlated to the emissions of SO(2) and NO(x); and (3) there is a strong correlation between visits to a hospital due to respiratory disease and emission strength in the area of residence. These results clearly indicate that appropriate health and environmental monitoring, actions to reduce emissions to air, and further studies that would allow assessing the development in health status are necessary.

Health and Safety in Day Care.

ERIC Educational Resources Information Center

Sells, Clifford J.; Paeth, Susan

1987-01-01

Basic health and day care policies and procedures should be implemented and closely monitored with the help of a health consultant, particularly in terms of respiratory tract, enteric, skin, invasive bacterial, and multiple system infections; Acquired Immune Deficiency Syndrome; vaccine preventable diseases; and general safety procedures.…

Assessment of human respiration patterns via noncontact sensing using Doppler multi-radar system.

PubMed

Gu, Changzhan; Li, Changzhi

2015-03-16

Human respiratory patterns at chest and abdomen are associated with both physical and emotional states. Accurate measurement of the respiratory patterns provides an approach to assess and analyze the physical and emotional states of the subject persons. Not many research efforts have been made to wirelessly assess different respiration patterns, largely due to the inaccuracy of the conventional continuous-wave radar sensor to track the original signal pattern of slow respiratory movements. This paper presents the accurate assessment of different respiratory patterns based on noncontact Doppler radar sensing. This paper evaluates the feasibility of accurately monitoring different human respiration patterns via noncontact radar sensing. A 2.4 GHz DC coupled multi-radar system was used for accurate measurement of the complete respiration patterns without any signal distortion. Experiments were carried out in the lab environment to measure the different respiration patterns when the subject person performed natural breathing, chest breathing and diaphragmatic breathing. The experimental results showed that accurate assessment of different respiration patterns is feasible using the proposed noncontact radar sensing technique.

Assessment of Human Respiration Patterns via Noncontact Sensing Using Doppler Multi-Radar System

PubMed Central

Gu, Changzhan; Li, Changzhi

2015-01-01

Human respiratory patterns at chest and abdomen are associated with both physical and emotional states. Accurate measurement of the respiratory patterns provides an approach to assess and analyze the physical and emotional states of the subject persons. Not many research efforts have been made to wirelessly assess different respiration patterns, largely due to the inaccuracy of the conventional continuous-wave radar sensor to track the original signal pattern of slow respiratory movements. This paper presents the accurate assessment of different respiratory patterns based on noncontact Doppler radar sensing. This paper evaluates the feasibility of accurately monitoring different human respiration patterns via noncontact radar sensing. A 2.4 GHz DC coupled multi-radar system was used for accurate measurement of the complete respiration patterns without any signal distortion. Experiments were carried out in the lab environment to measure the different respiration patterns when the subject person performed natural breathing, chest breathing and diaphragmatic breathing. The experimental results showed that accurate assessment of different respiration patterns is feasible using the proposed noncontact radar sensing technique. PMID:25785310

The role of respiratory measures to assess mental load in pilot selection.

PubMed

Grassmann, Mariel; Vlemincx, Elke; von Leupoldt, Andreas; Van den Bergh, Omer

2016-06-01

While cardiovascular measures have a long tradition of being used to determine operator load, responsiveness of the respiratory system to mental load has rarely been investigated. In this study, we assessed basic and variability measures of respiration rate (RR), partial pressure of end-tidal carbon dioxide (petCO2) as well as performance measures in 63 male pilot candidates during completion of a complex cognitive task and subsequent recovery. Mental load was associated with an increase in RR and a decrease in respiratory variability. A significant decrease was also found for petCO2. RR and respiratory variability showed partial and complete effects of recovery, respectively, whereas petCO2 did not return to baseline level. Overall, a good performance was related to a stronger reactivity in RR. Our findings suggest that respiratory parameters would be a useful supplement to common measures for the assessment of mental load in pilot selection. Practitioner Summary: Respiratory measures are a promising yet poorly investigated approach to monitor operator load. For pilot selection, we assessed respiration in response to multitasking in 63 candidates. Task-related changes as well as covariation with performance strongly support the consideration of respiratory parameters when evaluating reactivity to mental load.

AMON: a wearable multiparameter medical monitoring and alert system.

PubMed

Anliker, Urs; Ward, Jamie A; Lukowicz, Paul; Tröster, Gerhard; Dolveck, François; Baer, Michel; Keita, Fatou; Schenker, Eran B; Catarsi, Fabrizio; Coluccini, Luca; Belardinelli, Andrea; Shklarski, Dror; Alon, Menachem; Hirt, Etienne; Schmid, Rolf; Vuskovic, Milica

2004-12-01

This paper describes an advanced care and alert portable telemedical monitor (AMON), a wearable medical monitoring and alert system targeting high-risk cardiac/respiratory patients. The system includes continuous collection and evaluation of multiple vital signs, intelligent multiparameter medical emergency detection, and a cellular connection to a medical center. By integrating the whole system in an unobtrusive, wrist-worn enclosure and applying aggressive low-power design techniques, continuous long-term monitoring can be performed without interfering with the patients' everyday activities and without restricting their mobility. In the first two and a half years of this EU IST sponsored project, the AMON consortium has designed, implemented, and tested the described wrist-worn device, a communication link, and a comprehensive medical center software package. The performance of the system has been validated by a medical study with a set of 33 subjects. The paper describes the main concepts behind the AMON system and presents details of the individual subsystems and solutions as well as the results of the medical validation.

Infrared Hollow Optical Fiber Probe for Localized Carbon Dioxide Measurement in Respiratory Tracts

PubMed Central

Katagiri, Takashi; Shibayama, Kyosuke; Iida, Takeru

2018-01-01

A real-time gas monitoring system based on optical absorption spectroscopy is proposed for localized carbon dioxide (CO2) measurement in respiratory tracts. In this system, a small gas cell is attached to the end of a hollow optical fiber that delivers mid-infrared light with small transmission loss. The diameters of the fiber and the gas cell are smaller than 1.2 mm so that the probe can be inserted into a working channel of common bronchoscopes. The dimensions of the gas cell are designed based on absorption spectra of CO2 standard gases in the 4.2 μm wavelength region, which are measured using a Fourier-transform infrared spectrometer. A miniature gas cell that is comprised of a stainless-steel tube with slots for gas inlet and a micro-mirror is fabricated. A compact probing system with a quantum cascade laser (QCL) light source is built using a gas cell with a hollow optical fiber for monitoring CO2 concentration. Experimental results using human breaths show the feasibility of the system for in-situ measurement of localized CO2 concentration in human airways. PMID:29584666

Mass Gatherings and Respiratory Disease Outbreaks in the United States - Should We Be Worried? Results from a Systematic Literature Review and Analysis of the National Outbreak Reporting System.

PubMed

Rainey, Jeanette J; Phelps, Tiffani; Shi, Jianrong

2016-01-01

Because mass gatherings create environments conducive for infectious disease transmission, public health officials may recommend postponing or canceling large gatherings during a moderate or severe pandemic. Despite these recommendations, limited empirical information exists on the frequency and characteristics of mass gathering-related respiratory disease outbreaks occurring in the United States. We conducted a systematic literature review to identify articles about mass gathering-related respiratory disease outbreaks occurring in the United States from 2005 to 2014. A standard form was used to abstract information from relevant articles identified from six medical, behavioral and social science literature databases. We also analyzed data from the National Outbreaks Reporting System (NORS), maintained by the Centers for Disease Control and Prevention since 2009, to estimate the frequency of mass gathering-related respiratory disease outbreaks reported to the system. We identified 21 published articles describing 72 mass gathering-related respiratory disease outbreaks. Of these 72, 40 (56%) were associated with agriculture fairs and Influenza A H3N2v following probable swine exposure, and 25 (35%) with youth summer camps and pandemic Influenza A H1N1. Outbreaks of measles (n = 1) and mumps (n = 2) were linked to the international importation of disease. Between 2009 and 2013, 1,114 outbreaks were reported to NORS, including 96 respiratory disease outbreaks due to Legionella. None of these legionellosis outbreaks was linked to a mass gathering according to available data. Mass gathering-related respiratory disease outbreaks may be uncommon in the United States, but have been reported from fairs (zoonotic transmission) as well as at camps where participants have close social contact in communal housing. International importation can also be a contributing factor. NORS collects information on certain respiratory diseases and could serve as a platform to monitor mass gathering-related respiratory outbreaks in the future.

Mass Gatherings and Respiratory Disease Outbreaks in the United States – Should We Be Worried? Results from a Systematic Literature Review and Analysis of the National Outbreak Reporting System

PubMed Central

Rainey, Jeanette J.; Phelps, Tiffani; Shi, Jianrong

2016-01-01

Background Because mass gatherings create environments conducive for infectious disease transmission, public health officials may recommend postponing or canceling large gatherings during a moderate or severe pandemic. Despite these recommendations, limited empirical information exists on the frequency and characteristics of mass gathering-related respiratory disease outbreaks occurring in the United States. Methods We conducted a systematic literature review to identify articles about mass gathering-related respiratory disease outbreaks occurring in the United States from 2005 to 2014. A standard form was used to abstract information from relevant articles identified from six medical, behavioral and social science literature databases. We also analyzed data from the National Outbreaks Reporting System (NORS), maintained by the Centers for Disease Control and Prevention since 2009, to estimate the frequency of mass gathering-related respiratory disease outbreaks reported to the system. Results We identified 21 published articles describing 72 mass gathering-related respiratory disease outbreaks. Of these 72, 40 (56%) were associated with agriculture fairs and Influenza A H3N2v following probable swine exposure, and 25 (35%) with youth summer camps and pandemic Influenza A H1N1. Outbreaks of measles (n = 1) and mumps (n = 2) were linked to the international importation of disease. Between 2009 and 2013, 1,114 outbreaks were reported to NORS, including 96 respiratory disease outbreaks due to Legionella. None of these legionellosis outbreaks was linked to a mass gathering according to available data. Conclusion Mass gathering-related respiratory disease outbreaks may be uncommon in the United States, but have been reported from fairs (zoonotic transmission) as well as at camps where participants have close social contact in communal housing. International importation can also be a contributing factor. NORS collects information on certain respiratory diseases and could serve as a platform to monitor mass gathering-related respiratory outbreaks in the future. PMID:27536770

Fine Particulate Matter Pollution and Hospital Admissions for Respiratory Diseases in Beijing, China.

PubMed

Xiong, Qiulin; Zhao, Wenji; Gong, Zhaoning; Zhao, Wenhui; Tang, Tao

2015-09-22

Fine particulate matter has become the premier air pollutant of Beijing in recent years, enormously impacting the environmental quality of the city and the health of the residents. Fine particles with aerodynamic diameters of 0~0.3 μm, 0.3~0.5 μm, and 0.5~1.0 μm, from the yeasr 2007 to 2012, were monitored, and the hospital data about respiratory diseases during the same period was gathered and calculated. Then the correlation between respiratory health and fine particles was studied by spatial analysis and grey correlation analysis. The results showed that the aerial fine particulate matter pollution was mainly distributed in the Zizhuyuan sub-district office. There was a certain association between respiratory health and fine particles. Outpatients with respiratory system disease in this study area were mostly located in the southeastern regions (Balizhuang sub-district office, Ganjiakou sub-district office, Wanshoulu sub-district office, and Yongdinglu sub-district office) and east-central regions (Zizhuyuan sub-district office and Shuangyushu sub-district office) of the study area. Correspondingly, PM₁ (particulate matter with aerodynamic diameter smaller than 1.0 um) concentrations in these regions were higher than those in any other regions. Grey correlation analysis results showed that the correlation degree of the fine particle concentration with the number of outpatients is high, and the smaller fine particles had more obvious effects on respiratory system disease than larger particles.

Bio-Inspired Controller on an FPGA Applied to Closed-Loop Diaphragmatic Stimulation

PubMed Central

Zbrzeski, Adeline; Bornat, Yannick; Hillen, Brian; Siu, Ricardo; Abbas, James; Jung, Ranu; Renaud, Sylvie

2016-01-01

Cervical spinal cord injury can disrupt connections between the brain respiratory network and the respiratory muscles which can lead to partial or complete loss of ventilatory control and require ventilatory assistance. Unlike current open-loop technology, a closed-loop diaphragmatic pacing system could overcome the drawbacks of manual titration as well as respond to changing ventilation requirements. We present an original bio-inspired assistive technology for real-time ventilation assistance, implemented in a digital configurable Field Programmable Gate Array (FPGA). The bio-inspired controller, which is a spiking neural network (SNN) inspired by the medullary respiratory network, is as robust as a classic controller while having a flexible, low-power and low-cost hardware design. The system was simulated in MATLAB with FPGA-specific constraints and tested with a computational model of rat breathing; the model reproduced experimentally collected respiratory data in eupneic animals. The open-loop version of the bio-inspired controller was implemented on the FPGA. Electrical test bench characterizations confirmed the system functionality. Open and closed-loop paradigm simulations were simulated to test the FPGA system real-time behavior using the rat computational model. The closed-loop system monitors breathing and changes in respiratory demands to drive diaphragmatic stimulation. The simulated results inform future acute animal experiments and constitute the first step toward the development of a neuromorphic, adaptive, compact, low-power, implantable device. The bio-inspired hardware design optimizes the FPGA resource and time costs while harnessing the computational power of spike-based neuromorphic hardware. Its real-time feature makes it suitable for in vivo applications. PMID:27378844

The Respiratory Protection Effectiveness Clinical Trial (ResPECT): a cluster-randomized comparison of respirator and medical mask effectiveness against respiratory infections in healthcare personnel.

PubMed

Radonovich, Lewis J; Bessesen, Mary T; Cummings, Derek A; Eagan, Aaron; Gaydos, Charlotte; Gibert, Cynthia; Gorse, Geoffrey J; Nyquist, Ann-Christine; Reich, Nicholas G; Rodrigues-Barradas, Maria; Savor-Price, Connie; Shaffer, Ronald E; Simberkoff, Michael S; Perl, Trish M

2016-06-02

Although N95 filtering facepiece respirators and medical masks are commonly used for protection against respiratory infections in healthcare settings, more clinical evidence is needed to understand the optimal settings and exposure circumstances for healthcare personnel to use these devices. A lack of clinically germane research has led to equivocal, and occasionally conflicting, healthcare respiratory protection recommendations from public health organizations, professional societies, and experts. The Respiratory Protection Effectiveness Clinical Trial (ResPECT) is a prospective comparison of respiratory protective equipment to be conducted at multiple U.S. study sites. Healthcare personnel who work in outpatient settings will be cluster-randomized to wear N95 respirators or medical masks for protection against infections during respiratory virus season. Outcome measures will include laboratory-confirmed viral respiratory infections, acute respiratory illness, and influenza-like illness. Participant exposures to patients, coworkers, and others with symptoms and signs of respiratory infection, both within and beyond the workplace, will be recorded in daily diaries. Adherence to study protocols will be monitored by the study team. ResPECT is designed to better understand the extent to which N95s and MMs reduce clinical illness among healthcare personnel. A fully successful study would produce clinically relevant results that help clinician-leaders make reasoned decisions about protection of healthcare personnel against occupationally acquired respiratory infections and prevention of spread within healthcare systems. The trial is registered at clinicaltrials.gov, number NCT01249625 (11/29/2010).

Patient training in respiratory-gated radiotherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kini, Vijay R.; Vedam, Subrahmanya S.; Keall, Paul J.

2003-03-31

Respiratory gating is used to counter the effects of organ motion during radiotherapy for chest tumors. The effects of variations in patient breathing patterns during a single treatment and from day to day are unknown. We evaluated the feasibility of using patient training tools and their effect on the breathing cycle regularity and reproducibility during respiratory-gated radiotherapy. To monitor respiratory patterns, we used a component of a commercially available respiratory-gated radiotherapy system (Real Time Position Management (RPM) System, Varian Oncology Systems, Palo Alto, CA 94304). This passive marker video tracking system consists of reflective markers placed on the patient's chestmore » or abdomen, which are detected by a wall-mounted video camera. Software installed on a PC interfaced to this camera detects the marker motion digitally and records it. The marker position as a function of time serves as the motion signal that may be used to trigger imaging or treatment. The training tools used were audio prompting and visual feedback, with free breathing as a control. The audio prompting method used instructions to 'breathe in' or 'breathe out' at periodic intervals deduced from patients' own breathing patterns. In the visual feedback method, patients were shown a real-time trace of their abdominal wall motion due to breathing. Using this, they were asked to maintain a constant amplitude of motion. Motion traces of the abdominal wall were recorded for each patient for various maneuvers. Free breathing showed a variable amplitude and frequency. Audio prompting resulted in a reproducible frequency; however, the variability and the magnitude of amplitude increased. Visual feedback gave a better control over the amplitude but showed minor variations in frequency. We concluded that training improves the reproducibility of amplitude and frequency of patient breathing cycles. This may increase the accuracy of respiratory-gated radiation therapy.« less

Experimental investigation of a general real-time 3D target localization method using sequential kV imaging combined with respiratory monitoring.

PubMed

Cho, Byungchul; Poulsen, Per; Ruan, Dan; Sawant, Amit; Keall, Paul J

2012-11-21

The goal of this work was to experimentally quantify the geometric accuracy of a novel real-time 3D target localization method using sequential kV imaging combined with respiratory monitoring for clinically realistic arc and static field treatment delivery and target motion conditions. A general method for real-time target localization using kV imaging and respiratory monitoring was developed. Each dimension of internal target motion T(x, y, z; t) was estimated from the external respiratory signal R(t) through the correlation between R(t(i)) and the projected marker positions p(x(p), y(p); t(i)) on kV images by a state-augmented linear model: T(x, y, z; t) = aR(t) + bR(t - τ) + c. The model parameters, a, b, c, were determined by minimizing the squared fitting error ∑‖p(x(p), y(p); t(i)) - P(θ(i)) · (aR(t(i)) + bR(t(i) - τ) + c)‖(2) with the projection operator P(θ(i)). The model parameters were first initialized based on acquired kV arc images prior to MV beam delivery. This method was implemented on a trilogy linear accelerator consisting of an OBI x-ray imager (operating at 1 Hz) and real-time position monitoring (RPM) system (30 Hz). Arc and static field plans were delivered to a moving phantom programmed with measured lung tumour motion from ten patients. During delivery, the localization method determined the target position and the beam was adjusted in real time via dynamic multileaf collimator (DMLC) adaptation. The beam-target alignment error was quantified by segmenting the beam aperture and a phantom-embedded fiducial marker on MV images and analysing their relative position. With the localization method, the root-mean-squared errors of the ten lung tumour traces ranged from 0.7-1.3 mm and 0.8-1.4 mm during the single arc and five-field static beam delivery, respectively. Without the localization method, these errors ranged from 3.1-7.3 mm. In summary, a general method for real-time target localization using kV imaging and respiratory monitoring has been experimentally investigated for arc and static field delivery. The average beam-target error was 1 mm.

Experimental investigation of a general real-time 3D target localization method using sequential kV imaging combined with respiratory monitoring

NASA Astrophysics Data System (ADS)

Cho, Byungchul; Poulsen, Per; Ruan, Dan; Sawant, Amit; Keall, Paul J.

2012-11-01

The goal of this work was to experimentally quantify the geometric accuracy of a novel real-time 3D target localization method using sequential kV imaging combined with respiratory monitoring for clinically realistic arc and static field treatment delivery and target motion conditions. A general method for real-time target localization using kV imaging and respiratory monitoring was developed. Each dimension of internal target motion T(x, y, z; t) was estimated from the external respiratory signal R(t) through the correlation between R(ti) and the projected marker positions p(xp, yp; ti) on kV images by a state-augmented linear model: T(x, y, z; t) = aR(t) + bR(t - τ) + c. The model parameters, a, b, c, were determined by minimizing the squared fitting error ∑‖p(xp, yp; ti) - P(θi) · (aR(ti) + bR(ti - τ) + c)‖2 with the projection operator P(θi). The model parameters were first initialized based on acquired kV arc images prior to MV beam delivery. This method was implemented on a trilogy linear accelerator consisting of an OBI x-ray imager (operating at 1 Hz) and real-time position monitoring (RPM) system (30 Hz). Arc and static field plans were delivered to a moving phantom programmed with measured lung tumour motion from ten patients. During delivery, the localization method determined the target position and the beam was adjusted in real time via dynamic multileaf collimator (DMLC) adaptation. The beam-target alignment error was quantified by segmenting the beam aperture and a phantom-embedded fiducial marker on MV images and analysing their relative position. With the localization method, the root-mean-squared errors of the ten lung tumour traces ranged from 0.7-1.3 mm and 0.8-1.4 mm during the single arc and five-field static beam delivery, respectively. Without the localization method, these errors ranged from 3.1-7.3 mm. In summary, a general method for real-time target localization using kV imaging and respiratory monitoring has been experimentally investigated for arc and static field delivery. The average beam-target error was 1 mm.

A Compressed Sensing Based Method for Reducing the Sampling Time of A High Resolution Pressure Sensor Array System

PubMed Central

Sun, Chenglu; Li, Wei; Chen, Wei

2017-01-01

For extracting the pressure distribution image and respiratory waveform unobtrusively and comfortably, we proposed a smart mat which utilized a flexible pressure sensor array, printed electrodes and novel soft seven-layer structure to monitor those physiological information. However, in order to obtain high-resolution pressure distribution and more accurate respiratory waveform, it needs more time to acquire the pressure signal of all the pressure sensors embedded in the smart mat. In order to reduce the sampling time while keeping the same resolution and accuracy, a novel method based on compressed sensing (CS) theory was proposed. By utilizing the CS based method, 40% of the sampling time can be decreased by means of acquiring nearly one-third of original sampling points. Then several experiments were carried out to validate the performance of the CS based method. While less than one-third of original sampling points were measured, the correlation degree coefficient between reconstructed respiratory waveform and original waveform can achieve 0.9078, and the accuracy of the respiratory rate (RR) extracted from the reconstructed respiratory waveform can reach 95.54%. The experimental results demonstrated that the novel method can fit the high resolution smart mat system and be a viable option for reducing the sampling time of the pressure sensor array. PMID:28796188

Respiratory Belt Transducer Constructed Using a Singing Greeting Card Beeper

ERIC Educational Resources Information Center

Bhaskar, Anand; Subramani, Selvam; Ojha, Rajdeep

2013-01-01

An article by Belusic and Zupancic described the construction of a finger pulse sensor using a singing greeting card beeper. These authors felt that this beeper made of piezoelectric material could be easily modified to function as a respiratory belt transducer to monitor respiratory movements. Commercially available respiratory belt transducers,…

Acoustic method respiratory rate monitoring is useful in patients under intravenous anesthesia.

PubMed

Ouchi, Kentaro; Fujiwara, Shigeki; Sugiyama, Kazuna

2017-02-01

Respiratory depression can occur during intravenous general anesthesia without tracheal intubation. A new acoustic method for respiratory rate monitoring, RRa ® (Masimo Corp., Tokyo, Japan), has been reported to show good reliability in post-anesthesia care and emergency units. The purpose of this study was to investigate the reliability of the acoustic method for measurement of respiratory rate during intravenous general anesthesia, as compared with capnography. Patients with dental anxiety undergoing dental treatment under intravenous anesthesia without tracheal intubation were enrolled in this study. Respiratory rate was recorded every 30 s using the acoustic method and capnography, and detectability of respiratory rate was investigated for both methods. This study used a cohort study design. In 1953 recorded respiratory rate data points, the number of detected points by the acoustic method (1884, 96.5 %) was significantly higher than that by capnography (1682, 86.1 %) (P < 0.0001). In the intraoperative period, there was a significant difference in the LOA (95 % limits of agreement of correlation between difference and average of the two methods)/ULLOA (under the lower limit of agreement) in terms of use or non-use of a dental air turbine (P < 0.0001). In comparison between capnography, the acoustic method is useful for continuous monitoring of respiratory rate in spontaneously breathing subjects undergoing dental procedures under intravenous general anesthesia. However, the acoustic method might not accurately detect in cases in with dental air turbine.

Monitoring guidance for patients with hypophosphatasia treated with asfotase alfa.

PubMed

Kishnani, Priya S; Rush, Eric T; Arundel, Paul; Bishop, Nick; Dahir, Kathryn; Fraser, William; Harmatz, Paul; Linglart, Agnès; Munns, Craig F; Nunes, Mark E; Saal, Howard M; Seefried, Lothar; Ozono, Keiichi

2017-09-01

Hypophosphatasia (HPP) is a rare, inherited, systemic, metabolic disorder caused by autosomal recessive mutations or a single dominant-negative mutation in the gene encoding tissue-nonspecific alkaline phosphatase (TNSALP). The disease is associated with a broad range of signs, symptoms, and complications, including impaired skeletal mineralization, altered calcium and phosphate metabolism, recurrent fractures, pain, respiratory problems, impaired growth and mobility, premature tooth loss, developmental delay, and seizures. Asfotase alfa is a human, recombinant enzyme replacement therapy that is approved in many countries for the treatment of patients with HPP. To address the unmet need for guidance in the monitoring of patients receiving asfotase alfa, an international panel of physicians with experience in diagnosing and managing HPP convened in May 2016 to discuss treatment monitoring parameters. The panel discussions focused on recommendations for assessing and monitoring patients after the decision to treat with asfotase alfa had been made and did not include recommendations for whom to treat. Based on the consensus of panel members, this review provides guidance on the monitoring of patients with HPP during treatment with asfotase alfa, including recommendations for laboratory, efficacy, and safety assessments and the frequency with which these should be performed during the course of treatment. Recommended assessments are based on patient age and include regular monitoring of biochemistry, skeletal radiographs, respiratory function, growth, pain, mobility and motor function, and quality of life. Because of the systemic presentation of HPP, a coordinated, multidisciplinary, team-based, patient-focused approach is recommended in the management of patients receiving asfotase alfa. Monitoring of efficacy and safety outcomes must be tailored to the individual patient, depending on medical history, clinical manifestations, availability of resources in the clinical setting, and the clinician's professional judgment. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Effect of dynamic controlled atmosphere monitored by respiratory quotient and 1-methylcyclopropene on the metabolism and quality of 'Galaxy' apple harvested at three maturity stages.

PubMed

Thewes, Fabio Rodrigo; Brackmann, Auri; Anese, Rogerio de Oliveira; Ludwig, Vagner; Schultz, Erani Eliseu; Dos Santos, Luana Ferreira; Wendt, Lucas Mallmann

2017-05-01

The objective of this study was to evaluate the interaction between controlled atmosphere (CA), CA+1-methylcyclopropene (1-MCP) and dynamic controlled atmosphere monitored by respiratory quotient (DCA-RQ) with three fruit maturity stages at harvest (early harvest date, optimal harvest date and late harvest date) on 'Galaxy' apple metabolism and quality after harvest and 9months storage plus 7days of shelf life at 20°C. Fruit stored under dynamic controlled atmosphere monitored by respiratory quotient 1.3 (DCA-RQ 1.3) showed lower ethylene production, respiration rate, mealiness and higher flesh firmness in comparison to CA stored fruit, but did not differ from those treated with 1-MCP. The dynamic controlled atmosphere monitored by respiratory quotient 1.5 (DCA-RQ 1.5) increased the acetaldehyde, ethanol and ethyl acetate concentration, regardless of the fruit maturity at harvest. The storage of 'Galaxy' apple under DCA-RQ 1.3 is efficient in keeping quality regardless of the maturity stage at harvest. Copyright © 2016 Elsevier Ltd. All rights reserved.

A Brief Review of Non-invasive Monitoring of Respiratory Condition for Extubated Patients with or at Risk for Obstructive Sleep Apnea after Surgery

PubMed Central

Zhang, Xuezheng; Kassem, Mahmoud Attia Mohamed; Zhou, Ying; Shabsigh, Muhammad; Wang, Quanguang; Xu, Xuzhong

2017-01-01

Obstructive sleep apnea (OSA) is one of the important risk factors contributing to postoperative airway complications. OSA alters the respiratory physiology and increases the sensitivity of muscle tone of the upper airway after surgery to residual anesthetic medication. In addition, the prevalence of OSA was reported to be much higher among surgical patients than the general population. Therefore, appropriate monitoring to detect early respiratory impairment in postoperative extubated patients with possible OSA is challenging. Based on the comprehensive clinical observation, several equipment have been used for monitoring the respiratory conditions of OSA patients after surgery, including the continuous pulse oximetry, capnography, photoplethysmography (PPG), and respiratory volume monitor (RVM). To date, there has been no consensus on the most suitable device as a recommended standard of care. In this review, we describe the advantages and disadvantages of some possible monitoring strategies under certain clinical conditions. According to the literature, the continuous pulse oximetry, with its high sensitivity, is still the most widely used device. It is also cost-effective and convenient to use but has low specificity and does not reflect ventilation. Capnography is the most widely used device for detection of hypoventilation, but it may not provide reliable data for extubated patients. Even normal capnography cannot exclude the existence of hypoxia. PPG shows the state of both ventilation and oxygenation, but its sensitivity needs further improvement. RVM provides real-time detection of hypoventilation, quantitative precise demonstration of respiratory rate, tidal volume, and MV for extubated patients, but no reflection of oxygenation. Altogether, the sole use of any of these devices is not ideal for monitoring of extubated patients with or at risk for OSA after surgery. However, we expect that the combined use of continuous pulse oximetry and RVM may be promising for these patients due to their complementary function, which need further study. PMID:28337439

Assessment of perioperative minute ventilation in obese versus non-obese patients with a non-invasive respiratory volume monitor.

PubMed

Mehta, Jaideep H; Cattano, Davide; Brayanov, Jordan B; George, Edward E

2017-04-26

Monitoring the adequacy of spontaneous breathing is a major patient safety concern in the post-operative setting. Monitoring is particularly important for obese patients, who are at a higher risk for post-surgical respiratory complications and often have increased metabolic demand due to excess weight. Here we used a novel, noninvasive Respiratory Volume Monitor (RVM) to monitor ventilation in both obese and non-obese orthopedic patients throughout their perioperative course, in order to develop better monitoring strategies. We collected respiratory data from 62 orthopedic patients undergoing elective joint replacement surgery under general anesthesia using a bio-impedance based RVM with an electrode PadSet placed on the thorax. Patients were stratified into obese (BMI ≥ 30) and non-obese cohorts and minute ventilation (MV) at various perioperative time points was compared against each patient's predicted minute ventilation (MV PRED ) based on ideal body weight (IBW) and body surface area (BSA). The distributions of MV measurements were also compared across obese and non-obese cohorts. Obese patients had higher MV than the non-obese patients before, during, and after surgery. Measured MV of obese patients was significantly higher than their MV PRED from IBW formulas, with BSA-based MV PRED being a closer estimate. Obese patients also had greater variability in MV post-operatively when treated with standard opioid dosing. Our study demonstrated that obese patients have greater variability in ventilation post-operatively when treated with standard opioid doses, and despite overall higher ventilation, many of them are still at risk for hypoventilation. BSA-based MV PRED formulas may be more appropriate than IBW-based ones when estimating the respiratory demand of obese patients. The RVM allows for the continuous and non-invasive assessment of respiratory function in both obese and non-obese patients.

SU-E-J-31: Monitor Interfractional Variation of Tumor Respiratory Motion Using 4D KV Conebeam Computed Tomography for Stereotactic Body Radiation Therapy of Lung Cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tai, A; Prior, P; Gore, E

Purpose: 4DCT has been widely used to generate internal tumor volume (ITV) for a lung tumor for treatment planning. However, lung tumors may show different respiratory motion on the treatment day. The purpose of this study is to evaluate 4D KV conebeam computed tomography (CBCT) for monitoring tumor interfractional motion variation between simulation and each fraction of stereotactic body radiation therapy (SBRT) for lung cancer. Methods: 4D KV CBCT was acquired with the Elekta XVI system. The accuracy of 4D KV CBCT for image-guided radiation therapy (IGRT) was tested with a dynamic thorax motion phantom (CIRS, Virginia) with a linearmore » amplitude of 2 cm. In addition, an adult anthropomorphic phantom (Alderson, Rando) with optically stimulated luminescence (OSL) dosimeters embedded at the center and periphery of a slab of solid water was used to measure the dose of 4D KV CBCT and to compare it with the dose with 3D KV CBCT. The image registration was performed by aligning\\ each phase images of 4D KV CBCT to the planning images and the final couch shifts were calculated as a mean of all these individual shifts along each direction.A workflow was established based on these quality assurance tests for lung cancer patients. Results: 4D KV CBCT does not increase imaging dose in comparison to 3D KV CBCT. Acquisition of 4D KV CBCT is 4 minutes as compared to 2 minutes for 3D KV CBCT. Most of patients showed a small daily variation of tumor respiratory motion about 2 mm. However, some patients may have more than 5 mm variations of tumor respiratory motion. Conclusion: The radiation dose does not increase with 4D KV CBCT. 4D KV CBCT is a useful tool for monitoring interfractional variations of tumor respiratory motion before SBRT of lung cancer patients.« less

Automated determination of wakefulness and sleep in rats based on non-invasively acquired measures of movement and respiratory activity

PubMed Central

Zeng, Tao; Mott, Christopher; Mollicone, Daniel; Sanford, Larry D.

2012-01-01

The current standard for monitoring sleep in rats requires labor intensive surgical procedures and the implantation of chronic electrodes which have the potential to impact behavior and sleep. With the goal of developing a non-invasive method to determine sleep and wakefulness, we constructed a non-contact monitoring system to measure movement and respiratory activity using signals acquired with pulse Doppler radar and from digitized video analysis. A set of 23 frequency and time-domain features were derived from these signals and were calculated in 10 s epochs. Based on these features, a classification method for automated scoring of wakefulness, non-rapid eye movement sleep (NREM) and REM in rats was developed using a support vector machine (SVM). We then assessed the utility of the automated scoring system in discriminating wakefulness and sleep by comparing the results to standard scoring of wakefulness and sleep based on concurrently recorded EEG and EMG. Agreement between SVM automated scoring based on selected features and visual scores based on EEG and EMG were approximately 91% for wakefulness, 84% for NREM and 70% for REM. The results indicate that automated scoring based on non-invasively acquired movement and respiratory activity will be useful for studies requiring discrimination of wakefulness and sleep. However, additional information or signals will be needed to improve discrimination of NREM and REM episodes within sleep. PMID:22178621

Continuous glucose monitoring system in the screening of early glucose derangements in children and adolescents with cystic fibrosis.

PubMed

Franzese, Adriana; Valerio, Giuliana; Buono, Pietro; Spagnuolo, Maria Immacolata; Sepe, Angela; Mozzillo, Enza; De Simone, Ilaria; Raia, Valeria

2008-02-01

In cystic fibrosis (CF), diabetes mellitus (DM) is associated with progression of pulmonary disease and nutritional impairment. To compare oral glucose tolerance test (OGTT) and continuous glucose monitoring system (CGMS) in patients with CF with early glucose derangements. Thirty-two patients with CF (5-20 years) with intermediate glucose values > 7.7 mmol/l during OGTT received a CGMS registration. Patients were classified into those with normal glucose tolerance (NGT), impaired glucose tolerance (IGT) and DM, according to glucose values at 120 min of OGTT and during CGMS. Furthermore BMI z-scores, forced expiratory volume in 1 second (FEV1%), number of respiratory infections/year, enzyme supplementation, and HbA1c were evaluated. OGTT and CGMS derangements were in agreement in 43.7% of the patients. BMI z-scores, FEV1%, number of respiratory infections/ year, enzyme supplementation, and HbA1c did not differ among the three groups. HbA1c, correlated positively with 120 min OGTT (r = 0.34; p = 0.059), CGMS area (r = 0.35; p = 0.048) and the number of respiratory infections, and negatively with FEV1%. Intermediate glucose values during OGTT should be considered as a screening test in patients with CF. CGMS can be useful in studying the early occurrence of glucose derangements in selected patients.

Extraction and Analysis of Respiratory Motion Using Wearable Inertial Sensor System during Trunk Motion

PubMed Central

Gaidhani, Apoorva; Moon, Kee S.; Ozturk, Yusuf; Lee, Sung Q.; Youm, Woosub

2017-01-01

Respiratory activity is an essential vital sign of life that can indicate changes in typical breathing patterns and irregular body functions such as asthma and panic attacks. Many times, there is a need to monitor breathing activity while performing day-to-day functions such as standing, bending, trunk stretching or during yoga exercises. A single IMU (inertial measurement unit) can be used in measuring respiratory motion; however, breathing motion data may be influenced by a body trunk movement that occurs while recording respiratory activity. This research employs a pair of wireless, wearable IMU sensors custom-made by the Department of Electrical Engineering at San Diego State University. After appropriate sensor placement for data collection, this research applies principles of robotics, using the Denavit-Hartenberg convention, to extract relative angular motion between the two sensors. One of the obtained relative joint angles in the “Sagittal” plane predominantly yields respiratory activity. An improvised version of the proposed method and wearable, wireless sensors can be suitable to extract respiratory information while performing sports or exercises, as they do not restrict body motion or the choice of location to gather data. PMID:29258214

Systems for the management of respiratory disease in primary care--an international series: United Kingdom.

PubMed

Worth, Allison; Pinnock, Hilary; Fletcher, Monica; Hoskins, Gaylor; Levy, Mark L; Sheikh, Aziz

2011-03-01

The UK National Health Service (NHS) is essentially publicly funded through general taxation. Challenges facing the NHS include the rise in prevalence of long-term conditions and financial pressures. NATIONAL POLICY TRENDS: Political devolution within the UK has led to variations in the way services are organised and delivered between the four nations. PRIMARY CARE RESPIRATORY SERVICES IN THE UK: Primary care is the first point of contact with services. Most respiratory conditions are managed here, including prevention, diagnosis, treatment and palliative care. Respiratory disease accounts for more primary care consultations than any other type of illness, with 24 million consultations annually. Equitable access to care is an ongoing challenge: telehealthcare is being tried as a possible solution for monitoring of asthma and COPD. REFERRAL AND ACCESS TO SPECIALIST CARE: Referrals for specialist advice are usually to a secondary care respiratory physician, though respiratory General Practitioners with a Special Interest (GPwSIs) are an option in some localities. Prevalence of asthma and COPD is high. Asthma services are predominantly nurse-led. Self-management strategies are widely promoted but poorly implemented. COPD is high on the policy agenda with a shift in focus to preventive lung health and longterm condition management.

Respiratory manifestations of panic disorder in animals and humans: a unique opportunity to understand how supramedullary structures regulate breathing.

PubMed

Kinkead, Richard; Tenorio, Luana; Drolet, Guy; Bretzner, Frédéric; Gargaglioni, Luciane

2014-12-01

The control of breathing is commonly viewed as being a "brainstem affair". As the topic of this special issue of Respiratory Physiology and Neurobiology indicates, we should consider broadening this notion since the act of breathing is also tightly linked to many functions other than close regulation of arterial blood gases. Accordingly, "non-brainstem" structures can exert a powerful influence on the core elements of the respiratory control network and as it is often the case, the importance of these structures is revealed when their dysfunction leads to disease. There is a clear link between respiration and anxiety and key theories of the psychopathology of anxiety (including panic disorders; PD) focus on respiratory control and related CO2 monitoring system. With that in mind, we briefly present the respiratory manifestations of panic disorder and discuss the role of the dorso-medial/perifornical hypothalamus, the amygdalar complex, and the periaqueductal gray in respiratory control. We then present recent advances in basic research indicating how adult rodent previously subjected to neonatal stress may provide a very good model to investigate the pathophysiology of PD. Copyright © 2014 Elsevier B.V. All rights reserved.

Respiratory diagnostic possibilities during closed circuit anesthesia.

PubMed

Verkaaik, A P; Erdmann, W

1990-01-01

An automatic feed back controlled totally closed circuit system (Physioflex) has been developed for quantitative practice of inhalation anesthesia and ventilation. In the circuit system the gas is moved unidirectionally around by a blower at 70 l/min. In the system four membrane chambers are integrated for ventilation. Besides end-expiratory feed back control of inhalation anesthetics, and inspiratory closed loop control of oxygen, the system offers on-line registration of flow, volume and respiratory pressures as well as a capnogram and oxygen consumption. Alveolar ventilation and static compliance can easily be derived. On-line registration of oxygen consumption has proven to be of value for determination of any impairment of tissue oxygen supply when the oxygen delivery has dropped to critical values. Obstruction of the upper or lower airways are immediately detected and differentiated. Disregulations of metabolism, e.g. in malignant hyperthermia, are seen in a pre-crisis phase (increase of oxygen consumption and of CO2 production), and therapy can be started extremely early and before a disastrous condition has developed. Registration of compliance is only one of the continuously available parameters that guarantee a better and adequate control of lung function (e.g. atalectasis is early detected). The newly developed sophisticated anesthesia device enlarges tremendously the monitoring and respiratory diagnostic possibilities of artificial ventilation, gives new insights in the (patho)physiology and detects disturbances of respiratory parameters and metabolism in an early stage.

Classifying free-text triage chief complaints into syndromic categories with natural language processing.

PubMed

Chapman, Wendy W; Christensen, Lee M; Wagner, Michael M; Haug, Peter J; Ivanov, Oleg; Dowling, John N; Olszewski, Robert T

2005-01-01

Develop and evaluate a natural language processing application for classifying chief complaints into syndromic categories for syndromic surveillance. Much of the input data for artificial intelligence applications in the medical field are free-text patient medical records, including dictated medical reports and triage chief complaints. To be useful for automated systems, the free-text must be translated into encoded form. We implemented a biosurveillance detection system from Pennsylvania to monitor the 2002 Winter Olympic Games. Because input data was in free-text format, we used a natural language processing text classifier to automatically classify free-text triage chief complaints into syndromic categories used by the biosurveillance system. The classifier was trained on 4700 chief complaints from Pennsylvania. We evaluated the ability of the classifier to classify free-text chief complaints into syndromic categories with a test set of 800 chief complaints from Utah. The classifier produced the following areas under the ROC curve: Constitutional = 0.95; Gastrointestinal = 0.97; Hemorrhagic = 0.99; Neurological = 0.96; Rash = 1.0; Respiratory = 0.99; Other = 0.96. Using information stored in the system's semantic model, we extracted from the Respiratory classifications lower respiratory complaints and lower respiratory complaints with fever with a precision of 0.97 and 0.96, respectively. Results suggest that a trainable natural language processing text classifier can accurately extract data from free-text chief complaints for biosurveillance.

The nursing perspective on monitoring hemodynamics and oxygen transport.

PubMed

Tucker, Dawn; Hazinski, Mary Fran

2011-07-01

Maintenance of adequate systemic oxygen delivery requires careful clinical assessment integrated with hemodynamic measurements and calculations to detect and treat conditions that may compromise oxygen delivery and lead to life-threatening shock, respiratory failure, or cardiac arrest. The bedside nurse constantly performs such assessments and measurements to detect subtle changes and trends in patient condition. The purpose of this editorial is to highlight nursing perspectives about the hemodynamic and oxygen transport monitoring systems summarized in the Pediatric Cardiac Intensive Care Society Evidence- Based Review and Consensus Statement on Monitoring of Hemodynamics and Oxygen Transport Balance. There is no substitute for the observations of a knowledgeable and experienced clinician who understands the patient's condition and potential causes of deterioration and is able to evaluate response to therapy.

Computerized general practice based networks yield comparable performance with sentinel data in monitoring epidemiological time-course of influenza-like illness and acute respiratory illness.

PubMed

Truyers, Carla; Lesaffre, Emmanuel; Bartholomeeusen, Stefaan; Aertgeerts, Bert; Snacken, René; Brochier, Bernard; Yane, Fernande; Buntinx, Frank

2010-03-22

Computerized morbidity registration networks might serve as early warning systems in a time where natural epidemics such as the H1N1 flu can easily spread from one region to another. In this contribution we examine whether general practice based broad-spectrum computerized morbidity registration networks have the potential to act as a valid surveillance instrument of frequently occurring diseases. We compare general practice based computerized data assessing the frequency of influenza-like illness (ILI) and acute respiratory infections (ARI) with data from a well established case-specific sentinel network, the European Influenza Surveillance Scheme (EISS). The overall frequency and trends of weekly ILI and ARI data are compared using both networks. Detection of influenza-like illness and acute respiratory illness occurs equally fast in EISS and the computerized network. The overall frequency data for ARI are the same for both networks, the overall trends are similar, but the increases and decreases in frequency do not occur in exactly the same weeks. For ILI, the overall rate was slightly higher for the computerized network population, especially before the increase of ILI, the overall trend was almost identical and the increases and decreases occur in the same weeks for both networks. Computerized morbidity registration networks are a valid tool for monitoring frequent occurring respiratory diseases and the detection of sudden outbreaks.

An official American Thoracic Society/European Respiratory Society policy statement: disparities in respiratory health.

PubMed

Schraufnagel, Dean E; Blasi, Francesco; Kraft, Monica; Gaga, Mina; Finn, Patricia W; Rabe, Klaus F

2013-10-01

Health disparities, defined as a significant difference in health between populations, are more common for diseases of the respiratory system than for those of other organ systems, because of the environmental influence on breathing and the variation of the environment among different segments of the population. The lowest social groups are up to 14 times more likely to have respiratory diseases than are the highest. Tobacco smoke, air pollution, environmental exposures, and occupational hazards affect the lungs more than other organs, and occur disproportionately in ethnic minorities and those with lower socioeconomic status. Lack of access to quality health care contributes to disparities. The executive committees of the American Thoracic Society (ATS) and European Respiratory Society (ERS) established a writing committee to develop a policy on health disparities. The document was reviewed, edited, and approved by the full executive committees and boards of directors of the societies. This document expresses a policy to address health disparities by promoting scientific inquiry and training, disseminating medical information and best practices, and monitoring and advocating for public respiratory health. ERS and ATS have strong international commitments, and work with leaders from governments, academia, and organizations to address and reduce avoidable health inequalities. Their training initiatives improve the function of health care systems and health equality. Both the ATS and ERS support all aspects of this document, confer regularly, and act together when possible, but the activities to bring about change may vary because of the differences in the continents where the two organizations carry out most of their activities. The ATS and ERS pledge to frame their actions to reduce respiratory health disparities. The vision of the ATS and ERS is that all persons attain better and sustained respiratory health. They call on all their members and other societies to join in this commitment.

Respiratory problems in foals.

PubMed

Beech, J

1985-04-01

Despite major advances in our knowledge and ability to treat respiratory diseases in neonatal foals, neonatal respiratory medicine is still in its infancy. It is hoped that this article may serve as a guideline for diagnosis and treatment. Specific antibiotic regimens and emergency procedures are covered in other articles in this symposium. Because management factors play a critical role in the pathogenesis of respiratory disease, education of clients as to their importance would help both prophylactically and therapeutically. The necessity of very careful monitoring of neonates, which is critical to early detection of disease, should be stressed. As respiratory diseases can be fulminant and rapidly fatal, it is imperative not to delay diagnosis and therapy. Thorough examination and implementation of appropriate diagnostic techniques, as well as prompt early referral to a more sophisticated facility when indicated, would prevent many deaths. Although sophisticated support systems are vital for survival of some of these foals, good basic intensive nursing care combined with selection of appropriate drug therapy very early in the course of the disease is all that many foals require and can significantly improve survival rates.

Thermal noise variance of a receive radiofrequency coil as a respiratory motion sensor.

PubMed

Andreychenko, A; Raaijmakers, A J E; Sbrizzi, A; Crijns, S P M; Lagendijk, J J W; Luijten, P R; van den Berg, C A T

2017-01-01

Development of a passive respiratory motion sensor based on the noise variance of the receive coil array. Respiratory motion alters the body resistance. The noise variance of an RF coil depends on the body resistance and, thus, is also modulated by respiration. For the noise variance monitoring, the noise samples were acquired without and with MR signal excitation on clinical 1.5/3 T MR scanners. The performance of the noise sensor was compared with the respiratory bellow and with the diaphragm displacement visible on MR images. Several breathing patterns were tested. The noise variance demonstrated a periodic, temporal modulation that was synchronized with the respiratory bellow signal. The modulation depth of the noise variance resulting from the respiration varied between the channels of the array and depended on the channel's location with respect to the body. The noise sensor combined with MR acquisition was able to detect the respiratory motion for every k-space read-out line. Within clinical MR systems, the respiratory motion can be detected by the noise in receive array. The noise sensor does not require careful positioning unlike the bellow, any additional hardware, and/or MR acquisition. Magn Reson Med 77:221-228, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Implementation and assessment of an animal management system for small-animal micro-CT / micro-SPECT imaging

NASA Astrophysics Data System (ADS)

Holdsworth, David W.; Detombe, Sarah A.; Chiodo, Chris; Fricke, Stanley T.; Drangova, Maria

2011-03-01

Advances in laboratory imaging systems for CT, SPECT, MRI, and PET facilitate routine micro-imaging during pre-clinical investigations. Challenges still arise when dealing with immune-compromised animals, biohazardous agents, and multi-modality imaging. These challenges can be overcome with an appropriate animal management system (AMS), with the capability for supporting and monitoring a rat or mouse during micro-imaging. We report the implementation and assessment of a new AMS system for mice (PRA-3000 / AHS-2750, ASI Instruments, Warren MI), designed to be compatible with a commercial micro-CT / micro-SPECT imaging system (eXplore speCZT, GE Healthcare, London ON). The AMS was assessed under the following criteria: 1) compatibility with the imaging system (i.e. artifact generation, geometric dimensions); 2) compatibility with live animals (i.e. positioning, temperature regulation, anesthetic supply); 3) monitoring capabilities (i.e. rectal temperature, respiratory and cardiac monitoring); 4) stability of co-registration; and 5) containment. Micro-CT scans performed using a standardized live-animal protocol (90 kVp, 40 mA, 900 views, 16 ms per view) exhibited low noise (+/-19 HU) and acceptable artifact from high-density components within the AMS (e.g. ECG pad contacts). Live mice were imaged repeatedly (with removal and replacement of the AMS) and spatial registration was found to be stable to within +/-0.07 mm. All animals tolerated enclosure within the AMS for extended periods (i.e. > one hour) without distress, based on continuous recordings of rectal temperature, ECG waveform and respiratory rate. A sealed AMS system extends the capability of a conventional micro-imaging system to include immune-compromised and biosafety level 2 mouse-imaging protocols.

A novel apparatus for non-contact measurement of heart rate variability: a system to prevent secondary exposure of medical personnel to toxic materials under biochemical hazard conditions, in monitoring sepsis or in predicting multiple organ dysfunction syndrome.

PubMed

Matsui, T; Arai, I; Gotoh, S; Hattori, H; Takase, B; Kikuchi, M; Ishihara, M

2005-10-01

The impaired balance of the low-frequency/high-frequency ratio obtained from spectral components of RR intervals can be a diagnostic test for sepsis. In addition, it is known that a reduction of heart rate variability (HRV) is useful in identifying septic patients at risk of the development of multiple organ dysfunction syndrome (MODS). We have reported a non-contact method using a microwave radar to monitor the heart and respiratory rates of a healthy person placed inside an isolator or of experimental animals exposed to toxic materials. With the purpose of preventing secondary exposure of medical personnel to toxic materials under biochemical hazard conditions, we designed a novel apparatus for non-contact measurement of HRV using a 1215 MHz microwave radar, a high-pass filter, and a personal computer. The microwave radar monitors only the small reflected waves from the subject's chest wall, which are modulated by the cardiac and respiratory motion. The high-pass filter enhances the cardiac signal and attenuates the respiratory signal. In a human trial, RR intervals derived from the non-contact apparatus significantly correlated with those derived from ECG (r=0.98, P<0.0001). The non-contact apparatus showed a similar power spectrum of RR intervals to that of ECG. Our non-contact HRV measurement apparatus appears promising for future pre-hospital monitoring of septic patients or for predicting MODS patients, inside isolators or in the field for mass casualties under biochemical hazard circumstances.

The feasibility of the auto tuning respiratory compensation system with ultrasonic image tracking technique.

PubMed

Chuang, Ho-Chiao; Hsu, Hsiao-Yu; Nieh, Shu-Kan; Tien, Der-Chi

2015-01-01

The purpose of this study is to assess the feasibility of using the analytical technique of ultrasound images in combination with an auto tumor localization system. During respiration, the activity of breathing in and out causes organs displacement at the lower lobe of the lung, and the maximum displacement range happens in the Superior-Inferior (SI) direction. Therefore, in this study all the tumor positioning is in SI direction under respiratory compensation, in which the compensations are carried out to the organs at the lower lobe and adjacent to the lower lobe of lung.In this research, due to the processes of ultrasound imaging generation, image analysis and signal transmission, when the captured respiratory signals are sent to auto tumor localization system, there was a signal time delay. The total delay time of the entire signal transmission process was 0.254 ± 0.023 seconds (with the lowest standard deviation) after implementing a series of analyses. To compensate for this signal delay time (0.254 ± 0.023 sec), a phase lead compensator (PLC) was designed and built into the auto tumor localization system. By analyzing the impact of the delay time and the respiratory waveforms under different frequencies on the phase lead compensator, an overall system delay time can be configured. Results showed as the respiratory frequency increased, variable value ``a'' and the subsequent gain ``k'' in the controller becomes larger. Moreover, value ``a'' and ``k'' increased as the system delay time increased when the respiratory frequency was fixed. The relationship of value ``a'' and ``k'' to the respiratory frequency can be obtained by using the curve fitting method to compensate for the respiratory motion for tumor localization. Through the comparison of the uncompensated signal and the compensated signal performed by the auto tumor localization system on the simulated respiratory signal, the feasibility of using ultrasound image analysis technology combined with the developed auto tumor localization system can be evaluated. The results show that the simulated respiratory signals under different frequencies of 0.5, 0.333, 0.25, 0.2 and 0.167 Hz with phase lead compensators were improved and stabilized. The compensation rate increased to the range of 7.04$∼ $18.82%, and the final compensation rate is about 97%. Therefore the auto tumor localization system combined with the ultrasound image analysis techniques is feasible.In this study, the developed ultrasound image analysis techniques combined into the auto tumor localization system has the following four advantages: (1) It is a non-invasive way (ultrasonic images) to monitor the entire compensating process of the active respiration instead of using a C-arm (invasive) to observe the organs motion. (2) During radiation therapy, the whole treatment process can be continuous, which can save the overall treatment time. (3) It is an independent system, which can be mounted onto any treatment couch. (4) Users can operate this system easily without the need of prior complicated training process.

A patient self-collection method for longitudinal monitoring of respiratory virus infection in solid organ transplant recipients.

PubMed

Preiksaitis, Carl M; Kuypers, Jane M; Fisher, Cynthia E; Campbell, Angela P; Jerome, Keith R; Huang, Meei-Li; Boeckh, Michael; Limaye, Ajit P

2015-01-01

Methods for the longitudinal study of respiratory virus infections are cumbersome and limit our understanding of the natural history of these infections in solid organ transplant (SOT) recipients. To assess the feasibility and patient acceptability of self-collected foam nasal swabs for detection of respiratory viruses in SOT recipients and to define the virologic and clinical course. We prospectively monitored the course of symptomatic respiratory virus infection in 18 SOT patients (14 lung, 3 liver, and 1 kidney) using patient self-collected swabs. The initial study sample was positive in 15 patients with the following respiratory viruses: rhinovirus (6), metapneumovirus (1), coronavirus (2), respiratory syncytial virus (2), parainfluenza virus (2), and influenza A virus (2). One hundred four weekly self-collected nasal swabs were obtained, with a median of 4 samples per patient (range 1-17). Median duration of viral detection was 21 days (range 4-77 days). Additional new respiratory viruses detected during follow-up of these 15 patients included rhinovirus (3), metapneumovirus (2), coronavirus (1), respiratory syncytial virus (1), parainfluenza virus (1), and adenovirus (1). Specimen collection compliance was good; 16/18 (89%) patients collected all required specimens and 79/86 (92%) follow-up specimens were obtained within the 7 ± 3 day protocol-defined window. All participants agreed or strongly agreed that the procedure was comfortable, simple, and 13/14 (93%) were willing to participate in future studies using this procedure. Self-collected nasal swabs provide a convenient, feasible, and patient-acceptable methodology for longitudinal monitoring of upper respiratory virus infection in SOT recipients. Copyright © 2014 Elsevier B.V. All rights reserved.

Exposure assessment and heart rate variability monitoring in workers handling titanium dioxide particles: a pilot study

NASA Astrophysics Data System (ADS)

Ichihara, Sahoko; Li, Weihua; Omura, Seiichi; Fujitani, Yuji; Liu, Ying; Wang, Qiangyi; Hiraku, Yusuke; Hisanaga, Naomi; Wakai, Kenji; Ding, Xuncheng; Kobayashi, Takahiro; Ichihara, Gaku

2016-03-01

Titanium dioxide (TiO2) particles are used for surface coating and in a variety of products such as inks, fibers, food, and cosmetics. The present study investigated possible respiratory and cardiovascular effects of TiO2 particles in workers exposed to this particle at high concentration in a factory in China. The diameter of particles collected on filters was measured by scanning electron microscopy. Real-time size-dependent particle number concentration was monitored in the nostrils of four workers using condensation particle counter and optical particle counter. Electrocardiogram was recorded using Holter monitors for the same four workers to record heart rate variability. Sixteen workers underwent assessment of the respiratory and cardiovascular systems. Mass-based individual exposure levels were also measured with personal cascade impactors. The primary particle diameter ranged from 46 to 562 nm. Analysis of covariance of the pooled data of the four workers showed that number of particles with a diameter <300 nm was associated positively with total number of N-N and negatively with total number of increase or decrease in successive RR intervals greater than 50 ms (RR50+/-) or percentage of RR 50+/- that were parameters of parasympathetic function. The total mass concentration was 9.58-30.8 mg/m3 during work, but significantly less before work (0.36 mg/m3). The clear abnormality in respiratory function was not observed in sixteen workers who had worked for 10 months to 13 years in the factory. The study showed that exposure to particles with a diameter <300 nm might affect HRV in workers handling TiO2 particles. The results highlight the need to investigate the possible impact of exposure to nano-scaled particles on the autonomic nervous system.

Comprehensive self management and routine monitoring in chronic obstructive pulmonary disease patients in general practice: randomised controlled trial.

PubMed

Bischoff, Erik W M A; Akkermans, Reinier; Bourbeau, Jean; van Weel, Chris; Vercoulen, Jan H; Schermer, Tjard R J

2012-11-28

To assess the long term effects of two different modes of disease management (comprehensive self management and routine monitoring) on quality of life (primary objective), frequency and patients' management of exacerbations, and self efficacy (secondary objectives) in patients with chronic obstructive pulmonary disease (COPD) in general practice. 24 month, multicentre, investigator blinded, three arm, pragmatic, randomised controlled trial. 15 general practices in the eastern part of the Netherlands. Patients with COPD confirmed by spirometry and treated in general practice. Patients with very severe COPD or treated by a respiratory physician were excluded. A comprehensive self management programme as an adjunct to usual care, consisting of four tailored sessions with ongoing telephone support by a practice nurse; routine monitoring as an adjunct to usual care, consisting of 2-4 structured consultations a year with a practice nurse; or usual care alone (contacts with the general practitioner at the patients' own initiative). The primary outcome was the change in COPD specific quality of life at 24 months as measured with the chronic respiratory questionnaire total score. Secondary outcomes were chronic respiratory questionnaire domain scores, frequency and patients' management of exacerbations measured with the Nijmegen telephonic exacerbation assessment system, and self efficacy measured with the COPD self-efficacy scale. 165 patients were allocated to self management (n=55), routine monitoring (n=55), or usual care alone (n=55). At 24 months, adjusted treatment differences between the three groups in mean chronic respiratory questionnaire total score were not significant. Secondary outcomes did not differ, except for exacerbation management. Compared with usual care, more exacerbations in the self management group were managed with bronchodilators (odds ratio 2.81, 95% confidence interval 1.16 to 6.82) and with prednisolone, antibiotics, or both (3.98, 1.10 to 15.58). Comprehensive self management or routine monitoring did not show long term benefits in terms of quality of life or self efficacy over usual care alone in COPD patients in general practice. Patients in the self management group seemed to be more capable of appropriately managing exacerbations than did those in the usual care group. Clinical trials NCT00128765.

Advances in Audio-Based Systems to Monitor Patient Adherence and Inhaler Drug Delivery.

PubMed

Taylor, Terence E; Zigel, Yaniv; De Looze, Céline; Sulaiman, Imran; Costello, Richard W; Reilly, Richard B

2018-03-01

Hundreds of millions of people worldwide have asthma and COPD. Current medications to control these chronic respiratory diseases can be administered using inhaler devices, such as the pressurized metered dose inhaler and the dry powder inhaler. Provided that they are used as prescribed, inhalers can improve patient clinical outcomes and quality of life. Poor patient inhaler adherence (both time of use and user technique) is, however, a major clinical concern and is associated with poor disease control, increased hospital admissions, and increased mortality rates, particularly in low- and middle-income countries. There are currently limited methods available to health-care professionals to objectively and remotely monitor patient inhaler adherence. This review describes recent sensor-based technologies that use audio-based approaches that show promising opportunities for monitoring inhaler adherence in clinical practice. This review discusses how one form of sensor-based technology, audio-based monitoring systems, can provide clinically pertinent information regarding patient inhaler use over the course of treatment. Audio-based monitoring can provide health-care professionals with quantitative measurements of the drug delivery of inhalers, signifying a clear clinical advantage over other methods of assessment. Furthermore, objective audio-based adherence measures can improve the predictability of patient outcomes to treatment compared with current standard methods of adherence assessment used in clinical practice. Objective feedback on patient inhaler adherence can be used to personalize treatment to the patient, which may enhance precision medicine in the treatment of chronic respiratory diseases. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

Separation of Doppler radar-based respiratory signatures.

PubMed

Lee, Yee Siong; Pathirana, Pubudu N; Evans, Robin J; Steinfort, Christopher L

2016-08-01

Respiration detection using microwave Doppler radar has attracted significant interest primarily due to its unobtrusive form of measurement. With less preparation in comparison with attaching physical sensors on the body or wearing special clothing, Doppler radar for respiration detection and monitoring is particularly useful for long-term monitoring applications such as sleep studies (i.e. sleep apnoea, SIDS). However, motion artefacts and interference from multiple sources limit the widespread use and the scope of potential applications of this technique. Utilising the recent advances in independent component analysis (ICA) and multiple antenna configuration schemes, this work investigates the feasibility of decomposing respiratory signatures into each subject from the Doppler-based measurements. Experimental results demonstrated that FastICA is capable of separating two distinct respiratory signatures from two subjects adjacent to each other even in the presence of apnoea. In each test scenario, the separated respiratory patterns correlate closely to the reference respiration strap readings. The effectiveness of FastICA in dealing with the mixed Doppler radar respiration signals confirms its applicability in healthcare applications, especially in long-term home-based monitoring as it usually involves at least two people in the same environment (i.e. two people sleeping next to each other). Further, the use of FastICA to separate involuntary movements such as the arm swing from the respiratory signatures of a single subject was explored in a multiple antenna environment. The separated respiratory signal indeed demonstrated a high correlation with the measurements made by a respiratory strap used currently in clinical settings.

Follow-up of Contacts of Middle East Respiratory Syndrome Coronavirus-Infected Returning Travelers, the Netherlands, 2014.

PubMed

Mollers, Madelief; Jonges, Marcel; Pas, Suzan D; van der Eijk, Annemiek A; Dirksen, Kees; Jansen, Casper; Gelinck, Luc B S; Leyten, Eliane M S; Thurkow, Ingrid; Groeneveld, Paul H P; van Gageldonk-Lafeber, Arianne B; Koopmans, Marion P; Timen, Aura

2015-09-01

Notification of 2 imported cases of infection with Middle East respiratory syndrome coronavirus in the Netherlands triggered comprehensive monitoring of contacts. Observed low rates of virus transmission and the psychological effect of contact monitoring indicate that thoughtful assessment of close contacts is prudent and must be guided by clinical and epidemiologic risk factors.

A Comparison of Measurements of Change in Respiratory Status in Spontaneously Breathing Volunteers by the ExSpiron Noninvasive Respiratory Volume Monitor Versus the Capnostream Capnometer.

PubMed

Williams, George W; George, Christy A; Harvey, Brian C; Freeman, Jenny E

2017-01-01

Current respiratory monitoring technologies such as pulse oximetry and capnography have been insufficient to identify early signs of respiratory compromise in nonintubated patients. Pulse oximetry, when used appropriately, will alert the caregiver to an episode of dangerous hypoxemia. However, desaturation lags significantly behind hypoventilation and alarm fatigue due to false alarms poses an additional problem. Capnography, which measures end-tidal CO2 (EtCO2) and respiratory rate (RR), has not been universally used for nonintubated patients for multiple reasons, including the inability to reliably relate EtCO2 to the level of impending respiratory compromise and lack of patient compliance. Serious complications related to respiratory compromise continue to occur as evidenced by the Anesthesiology 2015 Closed Claims Report. The Anesthesia Patient Safety Foundation has stressed the need to improve monitoring modalities so that "no patient will be harmed by opioid-induced respiratory depression." A recently available, Food and Drug Administration-approved noninvasive respiratory volume monitor (RVM) can continuously and accurately monitor actual ventilation metrics: tidal volume, RR, and minute ventilation (MV). We designed this study to compare the capabilities of capnography versus the RVM to detect changes in respiratory metrics. Forty-eight volunteer subjects completed the study. RVM measurements (MV and RR) were collected simultaneously with capnography (EtCO2 and RR) using 2 sampling methods (nasal scoop cannula and snorkel mouthpiece with in-line EtCO2 sensor). For each sampling method, each subject performed 6 breathing trials at 3 different prescribed RRs (slow [5 min], normal [12.6 ± 0.6 min], and fast [25 min]). All data are presented as mean ± SEM unless otherwise indicated. Following transitions in prescribed RRs, the RVM reached a new steady state value of MV in 37.7 ± 1.4 seconds while EtCO2 changes were notably slower, often failing to reach a new asymptote before a 2.5-minute threshold. RRs as measured by RVM and capnography during steady breathing were strongly correlated (R = 0.98 ± 0.01, bias = Capnograph-based RR - RVM-based RR = 0.21 ± 1.24 [SD] min). As expected, changes in MV were negatively correlated with changes in EtCO2. However, large changes in MV following transitions in prescribed RR resulted in relatively small changes in EtCO2 (instrument sensitivity = ΔEtCO2/ΔMV = -0.71 ± 0.11 and -0.55 ± 0.11 mm Hg per 1 L/min for nasal and in-line sampling, respectively). Nasal cannula EtCO2 measurements were on average 4 mm Hg lower than in-line measurements. RVM measurements of MV change more rapidly and by a greater degree than capnography in response to respiratory changes in nonintubated patients. Earlier detection could enable earlier intervention that could potentially reduce frequency and severity of complications due to respiratory depression.

Monitoring Hospitalized Adult Patients for Opioid-Induced Sedation and Respiratory Depression.

PubMed

Jungquist, Carla R; Smith, Kirsten; Nicely, Kelly L Wiltse; Polomano, Rosemary C

2017-03-01

: Opioid analgesics are commonly administered to hospitalized patients to treat acute pain, but these drugs put patients at risk for serious adverse events, such as unintended advancing sedation, respiratory depression, and death. Nurses play an important role in keeping patients safe by making clinical decisions about the frequency and intensity with which patients receiving IV and epidural opioids should be monitored. To make sound clinical judgments, nurses must be aware of the factors that place patients at elevated risk for adverse opioid-related effects and know how to screen and assess patients for these risks. The authors review the literature on unintended advancing sedation and respiratory depression associated with opioid administration and present evidence-based recommendations for clinical decision making and patient monitoring, using both nursing assessments and electronic technologies.

Evaluation of the Use of Capnography during the Transport of Critically Ill Mechanically Ventilated Patients.

DTIC Science & Technology

1992-12-15

DISCUSSION: Gervais et a13 demonstrated that respiratory alkalosis developed when ICU patients were manually ventilated, without 7 spirometric...developed a respiratory acidosis. Use of the non-invasive monitor, the capnograph prevented this adverse effect and resulted in inIproved patient safety...ventilation, all patients developed respiratory acidoses. Capnography uniformly prevented the development of respiratory acidosis during transport. We

[Monitoring respiratory syncytial virus through the Spanish influenza surveillance system, 2006-2014].

PubMed

Jiménez-Jorge, Silvia; Delgado-Sanz, Concepción; de Mateo, Salvador; Pozo, Francisco; Casas, Inmaculada; Larrauri, Amparo

2016-02-01

The aim of the study is to analyze the information on respiratory syncytial virus (RSV) obtained through the Spanish Influenza Surveillance System (SISS) and to study its usefulness as supplementary information for the characterization of influenza epidemics. The temporal patterns of both RSV and influenza viruses were analyzed by patterns comparing the weekly viral detection rates from 2006 to 2014. In general, the RSV circulation was characterized by showing a peak between 52-1 weeks, and circulated from 2 to 8 weeks before/prior to influenza viruses. RSV information obtained from the SISS is useful for the characterization of influenza epidemics in Spain. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

The olfactory bulb theta rhythm follows all frequencies of diaphragmatic respiration in the freely behaving rat

PubMed Central

Rojas-Líbano, Daniel; Frederick, Donald E.; Egaña, José I.; Kay, Leslie M.

2014-01-01

Sensory-motor relationships are part of the normal operation of sensory systems. Sensing occurs in the context of active sensor movement, which in turn influences sensory processing. We address such a process in the rat olfactory system. Through recordings of the diaphragm electromyogram (EMG), we monitored the motor output of the respiratory circuit involved in sniffing behavior, simultaneously with the local field potential (LFP) of the olfactory bulb (OB) in rats moving freely in a familiar environment, where they display a wide range of respiratory frequencies. We show that the OB LFP represents the sniff cycle with high reliability at every sniff frequency and can therefore be used to study the neural representation of motor drive in a sensory cortex. PMID:24966821

A Respiratory Marker Derived From Left Vagus Nerve Signals Recorded With Implantable Cuff Electrodes.

PubMed

Sevcencu, Cristian; Nielsen, Thomas N; Kjaergaard, Benedict; Struijk, Johannes J

2018-04-01

Left vagus nerve (LVN) stimulation (LVNS) has been tested for lowering the blood pressure (BP) in patients with resistant hypertension (RH). Whereas, closed-loop LVNS (CL-LVNS) driven by a BP marker may be superior to open-loop LVNS, there are situations (e.g., exercising) when hypertension is normal. Therefore, an ideal anti-RH CL-LVNS system requires a variable to avoid stimulation in such conditions, for example, a respiratory marker ideally extracted from the LVN. As the LVN conducts respiratory signals, this study aimed to investigate if such signals can be recorded using implantable means and if a marker to monitor respiration could be derived from such recordings. The experiments were performed in 14 anesthetized pigs. Five pigs were subjected to changes of the respiratory frequency and nine to changes of the respiratory volume. The LVN electroneurogram (VENG) was recorded using two cuff electrodes and the respiratory cycles (RC) using a pressure transducer. To separate the afferent and efferent VENGs, vagotomy was performed between the cuffs in the first group of pigs. The VENG was squared to derive respiration-related neural profiles (RnPs) and their correlation with the RCs was investigated in regard to timing and magnitude parameters derived from the two waveforms. The RnPs were morphologically similar with the RCs and the average RnPs represented accurate copies of the average RCs. Consequently, the lung inflation/deflation RC and RnP components had the same duration, the respiratory frequency changes affected in the same way both waveforms and the RnP amplitude increased linearly with the lung inflation in all tested pigs (R 2 values between 0.85 and 0.99). The RnPs comprise information regarding the timing and magnitude of the respiratory parameters. As those LVN profiles were derived using implantable means, this study indicates that the RnPs could serve as respiratory markers in implantable systems. © 2017 International Neuromodulation Society.

Autonomic dysfunction with early respiratory syncytial virus-related infection.

PubMed

Stock, Claire; Teyssier, Georges; Pichot, Vincent; Goffaux, Philippe; Barthelemy, Jean-Claude; Patural, Hugues

2010-08-25

Apparent life-threatening events (ALTE) and/or prolonged apnoea have been well-documented during respiratory syncytial virus (RSV) infection in infants less than 2 months of age but fundamental mechanisms remain unclear. The possibility of a central origin for the development of severe cardiac and respiratory events encouraged us, to explore the autonomic nervous system (ANS) profile of infected infants, since ANS activity may contribute to the constellation of symptoms observed during severe forms of RSV bronchiolitis. Eight infants (2 preterm and 6 full-term) less than 2 months of age and presenting with severe and apnoeic forms of RSV infection were evaluated using non-invasive electrophysiological monitoring obtained simultaneously for approximately 2 consecutive hours, including a quiet sleep period. Eight control subjects, paired for gestational and postnatal age, were also evaluated. ANS status was monitored using electrocardiogram recordings and quantified through a frequency-domain analysis of heart rate variability (HRV). This included sympathetic (VLF and LF) and parasympathetic (HF) indices as well as a measure of baroreflex sensitivity (BRS) obtained using non-invasive continuous arterial pressure. Regardless of gestational and postnatal age, heart rate variability components (Ptot, VLF, LF, and HF) and baroreflex components (alpha LF, alpha HF and sBR) were found to be significantly lower in the RSV-infected group than in the control group (p<0.05). RSV infection in neonates is associated with profound central autonomic dysfunction. The potentially fatal consequence stresses the importance of maintaining prolonged cardiopulmonary monitoring. Copyright 2010 Elsevier B.V. All rights reserved.

Pattern of deposition of stainless steel welding fume particles inhaled into the respiratory systems of Sprague-Dawley rats exposed to a novel welding fume generating system.

PubMed

Yu, I J; Kim, K J; Chang, H K; Song, K S; Han, K T; Han, J H; Maeng, S H; Chung, Y H; Park, S H; Chung, K H; Han, J S; Chung, H K

2000-07-27

In order to investigate occupational diseases related to welding fume exposure, such as nasal septum perforation, pneumoconiosis and manganese intoxication, we built a welding fume exposure system that included a welding fume generator, exposure chamber and fume collector. The fume concentrations in the exposure chamber were monitored every 15 min during a 2-h exposure. Fume (mg/m(3)) concentrations of major metals, including Fe, Mn, Cr, and Ni were found to be consistently maintained. An acute inhalation toxicity study was conducted by exposing male Sprague-Dawley rats to the welding fumes generated in this apparatus by stainless steel arc welding. The rats were exposed in the inhalation chamber to a welding fume with a concentration of 62 mg/m(3) total suspended particulates for 4 h. Animals were sacrificed at 4 h and at 1, 3, 7, 10, and 14 days after exposure. Histopathological examinations were conducted on the animals' upper respiratory tracts, including the nasal pathway and the conducting airway, and on the gas exchange region including the alveolar ducts, alveolar sacs, and alveoli. Diameters of fume particles varied from 0.02 to 0.81 microm and were distributed log normally, with a mean diameter of 0.1 microm and geometric standard deviation of 1.42. Rats exposed to the welding fume for 4 h did not show any significant respiratory system toxicity. The mean particle diameter of 0.1 microm resulted in little adsorption of the welding fume particles in the upper respiratory tract. Particle adsorption took place principally in the lower respiratory tracts, including bronchioles, alveolar ducts, alveolar sacs, and alveoli.

On-Road Chemical Transformation as an Important Mechanism of NO2 Formation

EPA Science Inventory

Nitrogen dioxide (NO2) not only is linked with a number of adverse effects on the respiratory system, but also contributes to the formation of ground-level ozone (O3) and fine particulate matter (PM2.5) pollution. NO2 levels near major roads have been monitored as part of the one...

The control effect of histamine on body temperature and respiratory function in IgE-dependent systemic anaphylaxis.

PubMed

Makabe-Kobayashi, Yoko; Hori, Yoshio; Adachi, Tetsuya; Ishigaki-Suzuki, Satsuki; Kikuchi, Yoshihiro; Kagaya, Yutaka; Shirato, Kunio; Nagy, András; Ujike, Azusa; Takai, Toshiyuki; Watanabe, Takehiko; Ohtsu, Hiroshi

2002-08-01

The systemic anaphylaxis reaction comprises various symptoms, including hypotension, changes in respiration pattern, and hypothermia. To elucidate the role of histamine in each of these symptoms, we induced the passive systemic anaphylaxis reaction in histidine decarboxylase gene knockout (HDC [-/-]) mice, which lack histamine. HDC(-/-) mice were generated by knocking out the HDC gene, which codes for the unique histamine-synthesizing enzyme. Twenty-four hours after the injection of IgE, HDC(+/+) and HDC(-/-) mice were injected with allergen and body temperature, blood pressure, and respiratory function were monitored in each mouse. Blood pressure dropped in both the HDC(-/-) mice and the HDC(+/+) mice. In contrast, respiratory frequency dropped and the expiratory respiration time was elongated only in the HDC(+/+) mice. Body temperature was decreased in the HDC(+/+) mice and was practically unchanged in the HDC(-/-) mice. Histamine receptor antagonists blocked the body temperature drop in the HDC(+/+) mice. Intravenous histamine induced similar patterns of body temperature decrease in the HDC(+/+) mice and the HDC(-/-) mice. Mast cell-deficient W/W (v) mice did not show the decrease in body temperature; this suggests that the histamine that contributed to the decrease in body temperature was derived from mast cells. According to the results of this investigation, in the passive systemic anaphylaxis reaction, respiratory frequency, expiratory time, and body temperature are shown to be controlled by the activity of histamine, but its contribution to blood pressure is negligible.

An Official American Thoracic Society Workshop Report: Climate Change and Human Health

PubMed Central

Pinkerton, Kent E.; Rom, William N.; Akpinar-Elci, Muge; Balmes, John R.; Bayram, Hasan; Brandli, Otto; Hollingsworth, John W.; Kinney, Patrick L.; Margolis, Helene G.; Martin, William J.; Sasser, Erika N.; Smith, Kirk R.; Takaro, Tim K.

2012-01-01

This document presents the proceedings from the American Thoracic Society Climate Change and Respiratory Health Workshop that was held on May 15, 2010, in New Orleans, Louisiana. The purpose of the one-day meeting was to address the threat to global respiratory health posed by climate change. Domestic and international experts as well as representatives of international respiratory societies and key U.S. federal agencies convened to identify necessary research questions concerning climate change and respiratory health and appropriate mechanisms and infrastructure needs for answering these questions. After much discussion, a breakout group compiled 27 recommendations for physicians, researchers, and policy makers. These recommendations are listed under main issues that the workshop participants deemed of key importance to respiratory health. Issues include the following: (1) the health impacts of climate change, with specific focus on the effect of heat waves, air pollution, and natural cycles; (2) mitigation and adaptation measures to be taken, with special emphasis on recommendations for the clinical and research community; (3) recognition of challenges specific to low-resource countries when coping with respiratory health and climate change; and (4) priority research infrastructure needs, with special discussion of international needs for cooperating with present and future environmental monitoring and alert systems. PMID:22421581

A Non-Invasive Multichannel Hybrid Fiber-Optic Sensor System for Vital Sign Monitoring

PubMed Central

Fajkus, Marcel; Nedoma, Jan; Martinek, Radek; Vasinek, Vladimir; Nazeran, Homer; Siska, Petr

2017-01-01

In this article, we briefly describe the design, construction, and functional verification of a hybrid multichannel fiber-optic sensor system for basic vital sign monitoring. This sensor uses a novel non-invasive measurement probe based on the fiber Bragg grating (FBG). The probe is composed of two FBGs encapsulated inside a polydimethylsiloxane polymer (PDMS). The PDMS is non-reactive to human skin and resistant to electromagnetic waves, UV absorption, and radiation. We emphasize the construction of the probe to be specifically used for basic vital sign monitoring such as body temperature, respiratory rate and heart rate. The proposed sensor system can continuously process incoming signals from up to 128 individuals. We first present the overall design of this novel multichannel sensor and then elaborate on how it has the potential to simplify vital sign monitoring and consequently improve the comfort level of patients in long-term health care facilities, hospitals and clinics. The reference ECG signal was acquired with the use of standard gel electrodes fixed to the monitored person’s chest using a real-time monitoring system for ECG signals with virtual instrumentation. The outcomes of these experiments have unambiguously proved the functionality of the sensor system and will be used to inform our future research in this fast developing and emerging field. PMID:28075341

Proposal of Screening Method of Sleep Disordered Breathing Using Fiber Grating Vision Sensor

NASA Astrophysics Data System (ADS)

Aoki, Hirooki; Nakamura, Hidetoshi; Nakajima, Masato

Every conventional respiration monitoring technique requires at least one sensor to be attached to the body of the subject during measurement, thereby imposing a sense of restraint that results in aversion against measurements that would last over consecutive days. To solve this problem, we developed a respiration monitoring system for sleepers, and it uses a fiber-grating vision sensor, which is a type of active image sensor to achieve non-contact respiration monitoring. In this paper, we verified the effectiveness of the system, and proposed screening method of the sleep disordered breathing. It was shown that our system could equivalently measure the respiration with thermistor and accelerograph. And, the respiratory condition of sleepers can be grasped by our screening method in one look, and it seems to be useful for the support of the screening of sleep disordered breathing.

Cardiopulmonary data-acquisition system

NASA Technical Reports Server (NTRS)

Crosier, W. G.; Reed, R. A.

1981-01-01

Computerized system controls and monitors bicycle and treadmill cardiovascular stress tests. It acquires and reduces stress data and displays heart rate, blood pressure, workload, respiratory rate, exhaled-gas composition, and other variables. Data are printed on hard-copy terminal every 30 seconds for quick operator response to patient. Ergometer workload is controlled in real time according to experimental protocol. Collected data are stored directly on tape in analog form and on floppy disks in digital form for later processing.

[Excess respiratory diseases in children and elderly people in a community of Santiago with high particulate air pollution].

PubMed

Prieto C, María José; Mancilla F, Pedro; Astudillo O, Pedro; Reyes P, Alvaro; Román A, Oscar

2007-02-01

The relationship between air pollution and health damage has been sufficiently documented. In station "R" of the air quality monitoring system, located in a community of Metropolitan Santiago (Cerro Navia), the Chilean standard of 150 microg/m3, averaged in 24 hours, for particles with a diameter of 10 micrometers or less (PM10), has been exceeded more days than in the rest of the city stations. To investigate if the population living near that station has a higher proportion of lower respiratory infections than the Metropolitan Region (MR) as a whole. An outpatient clinic located near station "R" (Centro Albertz), was implemented as a sentinel center according to UNICEF methodology, used since 1992 by the Acute Respiratory Infections National Program. Daily information was collected between May and December 2004. Monitoring data included total number of consults by children less than 15 years old for lower respiratory tract infections, pneumonia, obstructive bronchitis syndrome in children and by adults over 64 years old for lower airway disease, chronic obstructive pulmonary disease (COPD), and pneumonia. Results were compared with those of the rest of MR. Compared with the MR, children from the sentinel clinic had a significantly higher proportion of consults for obstructive bronchial syndrome (20.1% and 26.4% respectively, in p<0.01) and pneumonia (1.3 and 2.7% respectively, p<0.01). In the elderly, the average consults for lower airway disease were 17% in the sentinel clinic and 12.2% in MR (p<0.04). Children and elderly subjects at the sentinel clinic had a significantly higher proportion of respiratory infections (pneumonia and obstructive bronchial syndrome in children and lower airway disease in the elderly) as compared to the Metropolitan Region.

A microcomputer-based daily living activity recording system.

PubMed

Matsuoka, Shingo; Yonezawa, Yoshiharu; Maki, Hiromichi; Ogawa, Hidekuni; Hahn, Allen W; Thayer, Julian F; Caldwell, W Morton

2003-01-01

A new daily living activity recording system has been developed for monitoring health conditions and living patterns, such as respiration, posture, activity/rest ratios and general activity level. The system employs a piezoelectric sensor, a dual axis accelerometer, two low-power active filters, a low-power 8-bit single chip microcomputer and a 128 MB compact flash memory. The piezoelectric sensor, whose electrical polarization voltage is produced by mechanical strain, detects body movements. Its high-frequency output components reflect body movements produced by walking and running activities, while the low frequency components are mainly respiratory. The dual axis accelerometer detects, from body X and Y tilt angles, whether the patient is standing, sitting or lying down (prone, supine, left side or right side). The detected respiratory, behavior and posture signals are stored by the compact flash memory. After recording, these data are downloaded to a desktop computer and analyzed.

OFSETH: smart medical textile for continuous monitoring of respiratory motions under magnetic resonance imaging.

PubMed

De Jonckheere, J; Narbonneau, F; Jeanne, M; Kinet, D; Witt, J; Krebber, K; Paquet, B; Depre, A; Logier, R

2009-01-01

The potential impact of optical fiber sensors embedded into medical textiles for the continuous monitoring of the patient during Magnetic Resonance Imaging is presented. We report on two pure optical sensing technologies for respiratory movements monitoring - a macro bending sensor and a Bragg grating sensor, designed to measure the elongation due to abdominal and thoracic motions during breathing. We demonstrate that the two sensors can successfully sense textile elongation between, 0% and 3%, while maintaining the stretching properties of the textile substrates for a good comfort of the patient.

Use of multi-objective air pollution monitoring sites and online air pollution monitoring system for total health risk assessment in Hyderabad, India.

PubMed

Anjaneyulu, Y; Jayakumar, I; Hima Bindu, V; Sagareswar, G; Mukunda Rao, P V; Rambabu, N; Ramani, K V

2005-08-01

A consensus has been emerging among public health experts in developing countries that air pollution, even at current ambient levels, aggravates respiratory and cardiovascular diseases and leads to premature mortality. Recent studies have also presented well-founded theories concerning the biological mechanisms involved and the groups of people that are probably more susceptible to health effects caused or exacerbated by inhalation of ambient particulate matter (PM.). On the basis of prognostic studies carried out in Center for Environment, JNT University, Hyderabad "it has been estimated that in Hyderabad some 1,700 to 3,000 people per year die prematurely as a result of inhaling PM". These figures reflect only the effects of acute exposure to air pollution. If the long-term effects of chronic exposure are taken into account, 10,000-15,000 people a year could die prematurely in Hyderabad. This estimate of the chronic effects is based on other studies, which are not completely comparable with the Hyderabad situation. While the study designs and analyses in these other studies may indeed be different or irrelevant to Hyderabad, the fact they were carried out in other countries is irrelevant. Taking into account these considerations, a model for total health risk assessment for the city of Hyderabad, and its state of Andhra Pradesh in India has been developed using a multi-objective air pollution monitoring network and online and real time air pollution monitoring stations. For the model studies a number of potential monitoring sites were screened for general and site-specific criteria in a geographic information system (GIS) environment that may, on a local basis, affect the representativeness of the data collected. Local features that may affect either the chemical or meteorological parameters are evaluated to assure a minimum of interference. Finally, for monitoring air pollution, an online and real-time monitoring system was designed using advanced electrochemical sensor systems (sulphur dioxide, oxides of nitrogen, carbon monoxide, hydrocarbons, ozone, mercaptans and hydrogen sulphide) and a particulate matter analyzer (total suspended particulate matter TSPM), PM2.5 and PM10). The sensor and data acquisition systems are programmed to monitor pollution levels at 1/2 hour durations during peak hours and at 1-hour intervals at other times. Presently, extensive statistical and numerical simulations are being carried out at our center to correlate the individuals living in the monitored areas with respiratory infections with air pollution.

Use of Multi-Objective Air Pollution Monitoring Sites and Online Air Pollution Monitoring System for Total Health Risk Assessment in Hyderabad, India

PubMed Central

Anjaneyulu, Y.; Jayakumar, I.; Bindu, V. Hima; Sagareswar, G.; Rao, P.V. Mukunda; Rambabu, N.; Ramani, K. V.

2005-01-01

A consensus has been emerging among public health experts in developing countries that air pollution, even at current ambient levels, aggravates respiratory and cardiovascular diseases and leads to premature mortality. Recent studies have also presented well-founded theories concerning the biological mechanisms involved and the groups of people that are probably more susceptible to health effects caused or exacerbated by inhalation of ambient particulate matter (PM.). On the basis of prognostic studies carried out in Center for Environment, JNT University, Hyderabad “it has been estimated that in Hyderabad some 1,700 to 3,000 people per year die prematurely as a result of inhaling PM”. These figures reflect only the effects of acute exposure to air pollution. If the long-term effects of chronic exposure are taken into account, 10,000–15,000 people a year could die prematurely in Hyderabad. This estimate of the chronic effects is based on other studies, which are not completely comparable with the Hyderabad situation. While the study designs and analyses in these other studies may indeed be different or irrelevant to Hyderabad, the fact they were carried out in other countries is irrelevant. Taking into account these considerations, a model for total health risk assessment for the city of Hyderabad, and its state of Andhra Pradesh in India has been developed using a multi-objective air pollution monitoring network and online and real time air pollution monitoring stations. For the model studies a number of potential monitoring sites were screened for general and site-specific criteria in a geographic information system (GIS) environment that may, on a local basis, affect the representativeness of the data collected. Local features that may affect either the chemical or meteorological parameters are evaluated to assure a minimum of interference. Finally, for monitoring air pollution, an online and real-time monitoring system was designed using advanced electrochemical sensor systems (sulphur dioxide, oxides of nitrogen, carbon monoxide, hydrocarbons, ozone, mercaptans and hydrogen sulphide) and a particulate matter analyzer (total suspended particulate matter TSPM), PM2.5 and PM10). The sensor and data acquisition systems are programmed to monitor pollution levels at ½ hour durations during peak hours and at 1-hour intervals at other times. Presently, extensive statistical and numerical simulations are being carried out at our center to correlate the individuals living in the monitored areas with respiratory infections with air pollution. PMID:16705838

State-of-the-Art Sensor Technology in Spain: Invasive and Non-Invasive Techniques for Monitoring Respiratory Variables

PubMed Central

Domingo, Christian; Blanch, Lluis; Murias, Gaston; Luján, Manel

2010-01-01

The interest in measuring physiological parameters (especially arterial blood gases) has grown progressively in parallel to the development of new technologies. Physiological parameters were first measured invasively and at discrete time points; however, it was clearly desirable to measure them continuously and non-invasively. The development of intensive care units promoted the use of ventilators via oral intubation ventilators via oral intubation and mechanical respiratory variables were progressively studied. Later, the knowledge gained in the hospital was applied to out-of-hospital management. In the present paper we review the invasive and non-invasive techniques for monitoring respiratory variables. PMID:22399898

State-of-the-art sensor technology in Spain: invasive and non-invasive techniques for monitoring respiratory variables.

PubMed

Domingo, Christian; Blanch, Lluis; Murias, Gaston; Luján, Manel

2010-01-01

The interest in measuring physiological parameters (especially arterial blood gases) has grown progressively in parallel to the development of new technologies. Physiological parameters were first measured invasively and at discrete time points; however, it was clearly desirable to measure them continuously and non-invasively. The development of intensive care units promoted the use of ventilators via oral intubation ventilators via oral intubation and mechanical respiratory variables were progressively studied. Later, the knowledge gained in the hospital was applied to out-of-hospital management. In the present paper we review the invasive and non-invasive techniques for monitoring respiratory variables.

Novel tools for blood inflammatory markers detection in monitoring air pollution-induced cardio-respiratory symptoms.

PubMed

Coccini, Teresa; Manzo, Luigi; De Simone, Uliana; Acerbi, Davide; Roda, Elisa

2012-01-01

There is strong epidemiological evidence that air pollution exposure (short- and long-term, i.e. < 24 hr to 3 weeks, and year/s) is related to exacerbation of cardiovascular and respiratory diseases. Data from toxicological and basic science/molecular studies, controlled animal and human exposures and human panel studies have demonstrated several mechanisms by which particle exposure may both trigger acute events as well as prompt the chronic development of cardiovascular diseases. These pollutant-mediated biological mechanisms are supporting the potential use of haematic (inflammation/coagulation/oxidative stress) markers of effects in cardio-respiratory diseases. Various examples from in vitro, in vivo and epidemiological investigations are reported, together with some novel technologies that should provide with new tools for research in these diseases and improve the knowledge about any linkage of local and systemic inflammation and clinical features of these diseases (in particular COPD), including lung function, exacerbations, disease progression, and mortality.

Controlling Legionella and Pseudomonas aeruginosa re-growth in therapeutic spas: implementation of physical disinfection treatments, including UV/ultrafiltration, in a respiratory hydrotherapy system.

PubMed

Leoni, E; Sanna, T; Zanetti, F; Dallolio, L

2015-12-01

The study aimed to assess the efficacy of an integrated water safety plan (WSP) in controlling Legionella re-growth in a respiratory hydrotherapy system located in a spa centre, supplied with sulphurous water, which was initially colonized by Legionella pneumophila. Heterotrophic plate counts, Pseudomonas aeruginosa, Legionella spp. were detected in water samples taken 6-monthly from the hydrotherapy equipment (main circuit, entry to benches, final outlets). On the basis of the results obtained by the continuous monitoring and the changes in conditions, the original WSP, including physical treatments of water and waterlines, environmental surveillance and microbiological monitoring, was integrated introducing a UV/ultrafiltration system. The integrated treatment applied to the sulphurous water (microfiltration/UV irradiation/ultrafiltration), waterlines (superheated stream) and distal outlets (descaling/disinfection of nebulizers and nasal irrigators), ensured the removal of Legionella spp. and P. aeruginosa and a satisfactory microbiological quality over time. The environmental surveillance was successful in evaluating the hazard and identifying the most suitable preventive strategies to avoid Legionella re-growth. Ultrafiltration is a technology to take into account in the control of microbial contamination of therapeutic spas, since it does not modify the chemical composition of the water, thus allowing it to retain its therapeutic properties.

[Gastro-esophageal reflux and chronic respiratory diseases].

PubMed

Dirou, S; Germaud, P; Bruley des Varannes, S; Magnan, A; Blanc, F-X

2015-12-01

Gastroesophageal reflux disease (GERD) frequently occurs in association with chronic respiratory diseases although the casual link is not always clear. Several pathophysiological and experimental factors are considered to support a role for GERD in respiratory disease. Conversely, respiratory diseases and bronchodilator treatment can themselves exacerbate GERD. When cough or severe asthma is being investigated, GERD does not need to be systematically looked for and a therapeutic test with proton pump inhibitors is not always recommended. pH impedance monitoring is now the reference diagnostic tool to detect non acid reflux, a form of reflux for which proton pump inhibitor treatment is ineffective. Recent data have shown a potential role of GERD in idiopathic pulmonary fibrosis and bronchiolitis obliterans following lung transplantation, leading to discussions about the place of surgery in this context. However, studies using pH impedance monitoring are still needed to better understand and manage the association between GERD and chronic respiratory diseases. Copyright © 2015 SPLF. Published by Elsevier Masson SAS. All rights reserved.

Professional figures in intermediate intensive units.

PubMed

Quadri, A; Simoni, P; Clini, E; Errera, D; Foglio, K; Vitacca, M; Schena, M

1994-12-01

In Italy, respiratory intermediate intensive care units (IICUs) are not yet considered as autonomous hospital departments. The IICU of the Rehabilitation Department of the Medical Centre of Gussago (12 monitored beds) provides care for respiratory and cardiac patients. Ventilatory assistance and noninvasive modalities both in treatment and monitoring suggest a multidisciplinary approach to the patient. Highly professional figures should, therefore, be singled out to provide care in a respiratory IICU. The medical staff is composed of one anaesthesiologist, one cardiologist and one pulmonologist, who can integrate care when respiratory complications occur in a cardiological patient, or when cardiac events affect a respiratory patient. Nurses are capable of specific activities, especially when ventilatory assistance is required. The presence of a physiotherapist reduces the nursing workload, especially for ventilated individuals. The psychological aspect is undertaken by a specialist. Finally, an expert in nutrition provides an individualized dietary regimen. Our 4 year experience encourages such a multidisciplinary approach. An ideal integration of the professional activities should provide adequate and individual care for patients admitted to an IICU.

[Application of continuous intra-arterial blood gas monitoring system "Paratrend 7" for pulmonary lavage of a patient with alveolar proteinosis].

PubMed

Harigae, M; Hirose, Y; Gamo, M; Hirose, M; Fujiwara, C; Matsuo, K

1999-03-01

We applied a continuous intra-arterial blood gas monitoring system (Paratrend 7) to a patient with pulmonary alveolar proteinosis during pulmonary lavage. Lavage was performed under general anesthesia with one lung ventilation. We inserted the sensor of Patatrend 7 through a 20 G catheter into the radial artery, and monitored pH, PaCO2 and PaO2 continuously throughout the procedure. SpO2 and EtCO2 were also monitored. Saline 1000-1500 ml was instilled and drained repeatedly by volume limited methods. PaO2 values by Paratrend 7 increased during instillation and decreased during drainage of the irrigating fluid. In contrast, PaCO2 value by Paratrend 7 decreased slightly during instillation and increased during drainage. The change of SpO2 was almost the same as that by Paratrend 7, but the response time of pulse oxymetry was a little quicker than Paratrend 7. During the lavage procedure, respiratory and circulatory condition changed very rapidly, and it is necessary to monitor blood gas change intensively. Paratrend 7 is useful as a perioperative monitoring system, but pulse oxymetry might be sufficient during pulmonary lavage considering its cost.

PUNCS: Towards Predictive Understanding of Nitrogen Cycling in Soils

DOE Office of Scientific and Technical Information (OSTI.GOV)

Loeffler, Frank E.; Konstantinidis, Konstantinos T.; Sanford, Robert A.

In anoxic environments, the major nitrate/nitrite-consuming processes are respiratory ammonification (also known as dissimilatory nitrate reduction to ammonium) and denitrification (i.e., the formation of the gaseous products N 2O and N 2). Respiratory ammonification oxidizes more carbon per mole of nitrate than denitrification and generates a cation (NH 4+), which is retained in soils and bioavailable for plants. Thus, these processes have profoundly different impacts on N retention and greenhouse gas (CO 2, N 2O) emissions. Microbes capable of respiratory ammonification or denitrification coexist but the environmental controls over these competing nitrate/nitrite-reducing processes are largely unknown. With the current levelmore » of understanding, predictions under what environmental conditions respiratory ammonification activity predominates leading to N-retention rather than N-loss are tenuous. Further, the diversity of genes encoding the ammonium-forming nitrite reductase NrfA is poorly defined hampering the development of tools to assess and monitor this activity in environmental systems. Incomplete denitrification leads to N 2O, a gas implicated in ozone layer destruction and climate change. The conversion of the greenhouse gas N 2O to benign N 2 is catalyzed by N 2O reductase, the characteristic enzyme system of complete denitrifiers. Thus, efforts to estimate N 2O conversion to N 2 have focused on the well-characterized denitrifier nosZ genes; however, our understanding of the diversity of genes and organisms contributing to N 2O consumption is incomplete. This paucity of information limits the development of more accurate, predictive models for C- and N-fluxes and greenhouse gas emissions. A comprehensive analysis of the key catalyst of respiratory ammonification, ammonia-forming nitrite reductase NrfA, revealed the evolutionary history of nrfA and identified novel diagnostic features, allowing optimized primer design for nrfA monitoring. Further, a novel group of functional “atypical” nosZ genes was found indicating that a much broader diversity of genes and organisms contribute to consumption of N 2O. The atypical nosZ genes are distributed in soil ecosystems and often outnumber their typical counterparts, emphasizing their potential role in N 2O consumption in soils and possibly other environments. Kinetic studies revealed that organisms with atypical NosZ exhibit significantly higher affinity to N 2O, indicating that the relative activity of bacteria with typical versus atypical NosZ control N 2O emissions and determine a soil’s N 2O sink capacity. Collectively, the discoveries made under the PUNCS project improve understanding of N- and associated C-cycling processes in soils, enable the design of enhanced monitoring tools, and allow a larger research community to generate comprehensive datasets required to generate Earth System Models with higher predictive power.« less

Biomonitoring with Wireless Communications

DOE Office of Scientific and Technical Information (OSTI.GOV)

Budinger, Thomas F.

2003-03-01

This review is divided into three sections: technologies for monitoring physiological parameters; biosensors for chemical assays and wireless communications technologies including image transmissions. Applications range from monitoring high risk patients for heart, respiratory activity and falls to sensing levels of physical activity in military, rescue, and sports personnel. The range of measurements include, heart rate, pulse wave form, respiratory rate, blood oxygen, tissue pCO2, exhaled carbon dioxide and physical activity. Other feasible measurements will employ miniature chemical laboratories on silicon or plastic chips. The measurements can be extended to clinical chemical assays ranging from common blood assays to protein ormore » specialized protein measurements (e.g., troponin, creatine, and cytokines such as TNF and IL6). Though the feasibility of using wireless technology to communicate vital signs has been demonstrated 32 years ago (1) it has been only recently that practical and portable devices and communications net works have become generally available for inexpensive deployment of comfortable and affordable devices and systems.« less

High correlation of Middle East respiratory syndrome spread with Google search and Twitter trends in Korea.

PubMed

Shin, Soo-Yong; Seo, Dong-Woo; An, Jisun; Kwak, Haewoon; Kim, Sung-Han; Gwack, Jin; Jo, Min-Woo

2016-09-06

The Middle East respiratory syndrome coronavirus (MERS-CoV) was exported to Korea in 2015, resulting in a threat to neighboring nations. We evaluated the possibility of using a digital surveillance system based on web searches and social media data to monitor this MERS outbreak. We collected the number of daily laboratory-confirmed MERS cases and quarantined cases from May 11, 2015 to June 26, 2015 using the Korean government MERS portal. The daily trends observed via Google search and Twitter during the same time period were also ascertained using Google Trends and Topsy. Correlations among the data were then examined using Spearman correlation analysis. We found high correlations (>0.7) between Google search and Twitter results and the number of confirmed MERS cases for the previous three days using only four simple keywords: "MERS", " ("MERS (in Korean)"), " ("MERS symptoms (in Korean)"), and " ("MERS hospital (in Korean)"). Additionally, we found high correlations between the Google search and Twitter results and the number of quarantined cases using the above keywords. This study demonstrates the possibility of using a digital surveillance system to monitor the outbreak of MERS.

[Infant morbidity caused by respiratory diseases and its relation with the air pollution in Juarez City, Chihuahua, Mexico].

PubMed

Hernández-Cadena, Leticia; Barraza-Villarreal, Albino; Ramírez-Aguilar, Matiana; Moreno-Macías, Hortencia; Miller, Paul; Carbajal-Arroyo, Luz Aurora; Romieu, Isabelle

2007-01-01

To assess the impact of atmospheric pollutants on the respiratory health of children of different age groups in Juarez City, Chihuahua, Mexico. Data on emergency room visits between 1997 and 2001 for respiratory diseases in children less than 17 years old were obtained from hospitals in the Juarez City belonging to the Mexican Social Security Institute (IMSS). Diseases were classified into three groups according to ICD 9th and 10th codes: a) upper respiratory diseases, b) lower respiratory diseases, and c) asthma attacks. This information was stratified by age group (< = 5 years and > 5 years). Daily air pollution data (ozone and PM10) and weather conditions were obtained from the Monitoring Network System in Juarez City. Statistical analysis was carried out using a Generalized Additive Model assuming a Poisson distribution. Ozone concentrations, but not PM 10, were statistically associated with emergency room visits for respiratory diseases, mainly among children 5 years old or younger. In this group, an increase of 20 ppb 1-hr maximum for ozone was associated with an increase of 8.3% in the number of emergency room visits for upper respiratory diseases, with a 3-day exposure lag; and an increase of 12.7% in the number of emergency room visits for lower respiratory diseases when considering a 4-day exposure lag in a maximum 8-hr mobile average. The largest effect for the complete sample and for the group 6 to 16 years of age was observed for 3-day lag (5.1% for an increase of 20 ppb 1-hr maximum for ozone). For the 6 to 16 year old group we did not find a significant effect. The wide range of risk is quite important and might represent a substantial cost for the health system as well as for the society. Our results emphasize the need to implement preventive and control measures for air pollution and avoid the worsening of the present situation.

Catalytic Activity and Proton Translocation of Reconstituted Respiratory Complex I Monitored by Surface-Enhanced Infrared Absorption Spectroscopy.

PubMed

Gutiérrez-Sanz, Oscar; Forbrig, Enrico; Batista, Ana P; Pereira, Manuela M; Salewski, Johannes; Mroginski, Maria A; Götz, Robert; De Lacey, Antonio L; Kozuch, Jacek; Zebger, Ingo

2018-05-22

Respiratory complex I (CpI) is a key player in the way organisms obtain energy, being an energy transducer, which couples nicotinamide adenine dinucleotide (NADH)/quinone oxidoreduction with proton translocation by a mechanism that remains elusive so far. In this work, we monitored the function of CpI in a biomimetic, supported lipid membrane system assembled on a 4-aminothiophenol (4-ATP) self-assembled monolayer by surface-enhanced infrared absorption spectroscopy. 4-ATP serves not only as a linker molecule to a nanostructured gold surface but also as pH sensor, as indicated by concomitant density functional theory calculations. In this way, we were able to monitor NADH/quinone oxidoreduction-induced transmembrane proton translocation via the protonation state of 4-ATP, depending on the net orientation of CpI molecules induced by two complementary approaches. An associated change of the amide I/amide II band intensity ratio indicates conformational modifications upon catalysis which may involve movements of transmembrane helices or other secondary structural elements, as suggested in the literature [ Di Luca , Proc. Natl. Acad. Sci. U.S.A. , 2017 , 114 , E6314 - E6321 ].

SU-G-JeP4-03: Anomaly Detection of Respiratory Motion by Use of Singular Spectrum Analysis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kotoku, J; Kumagai, S; Nakabayashi, S

Purpose: The implementation and realization of automatic anomaly detection of respiratory motion is a very important technique to prevent accidental damage during radiation therapy. Here, we propose an automatic anomaly detection method using singular value decomposition analysis. Methods: The anomaly detection procedure consists of four parts:1) measurement of normal respiratory motion data of a patient2) calculation of a trajectory matrix representing normal time-series feature3) real-time monitoring and calculation of a trajectory matrix of real-time data.4) calculation of an anomaly score from the similarity of the two feature matrices. Patient motion was observed by a marker-less tracking system using a depthmore » camera. Results: Two types of motion e.g. cough and sudden stop of breathing were successfully detected in our real-time application. Conclusion: Automatic anomaly detection of respiratory motion using singular spectrum analysis was successful in the cough and sudden stop of breathing. The clinical use of this algorithm will be very hopeful. This work was supported by JSPS KAKENHI Grant Number 15K08703.« less

Lung Injury; Relates to Real-Time Endoscopic Monitoring of Single Cells Respiratory Health in Lung

DTIC Science & Technology

2017-09-01

AWARD NUMBER: W81XWH-16-1-0253 TITLE: Lung Injury; Relates to Real- Time Endoscopic Monitoring of Single Cells Respiratory Health in Lung...and should not be construed as an official Department of the Army position, policy or decision unless so designated by other documentation. REPORT...response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and

[Concepts and monitoring of pulmonary mechanic in patients under ventilatory support in intensive care unit].

PubMed

Faustino, Eduardo Antonio

2007-06-01

In mechanical ventilation, invasive and noninvasive, the knowledge of respiratory mechanic physiology is indispensable to take decisions and into the efficient management of modern ventilators. Monitoring of pulmonary mechanic parameters is been recommended from all the review works and clinical research. The objective of this study was review concepts of pulmonary mechanic and the methods used to obtain measures in the bed side, preparing a rational sequence to obtain this data. It was obtained bibliographic review through data bank LILACS, MedLine and PubMed, from the last ten years. This review approaches parameters of resistance, pulmonary compliance and intrinsic PEEP as primordial into comprehension of acute respiratory failure and mechanic ventilatory support, mainly in acute respiratory distress syndrome (ARDS) and in chronic obstructive pulmonary disease (COPD). Monitoring pulmonary mechanics in patients under mechanical ventilation in intensive care units gives relevant informations and should be implemented in a rational and systematic way.

Pulmonary health effects of agriculture.

PubMed

Nordgren, Tara M; Bailey, Kristina L

2016-03-01

Occupational exposures in the agricultural industry are associated with numerous lung diseases, including chronic obstructive pulmonary disease, asthma, hypersensitivity pneumonitis, lung cancer, and interstitial lung diseases. Efforts are ongoing to ascertain contributing factors to these negative respiratory outcomes and improve monitoring of environmental factors leading to disease. In this review, recently published studies investigating the deleterious effects of occupational exposures in the agricultural industry are discussed. Occupational exposures to numerous agricultural environment aerosols, including pesticides, fungi, and bacteria are associated with impaired respiratory function and disease. Increases in certain farming practices, including mushroom and greenhouse farming, present new occupational exposure concerns. Improved detection methods may provide opportunities to better monitor safe exposure levels to known lung irritants. In the agricultural industry, occupational exposures to organic and inorganic aerosols lead to increased risk for lung disease among workers. Increased awareness of respiratory risks and improved monitoring of agricultural environments are necessary to limit pulmonary health risks to exposed populations.

Development of the algorithm of measurement data and tomographic section reconstruction results processing for evaluating the respiratory activity of the lungs using the multi-angle electric impedance tomography

NASA Astrophysics Data System (ADS)

Aleksanyan, Grayr; Shcherbakov, Ivan; Kucher, Artem; Sulyz, Andrew

2018-04-01

Continuous monitoring of the patient's breathing by the method of multi-angle electric impedance tomography allows to obtain images of conduction change in the chest cavity during the monitoring. Direct analysis of images is difficult due to the large amount of information and low resolution images obtained by multi-angle electrical impedance tomography. This work presents a method for obtaining a graph of respiratory activity of the lungs based on the results of continuous lung monitoring using the multi-angle electrical impedance tomography method. The method makes it possible to obtain a graph of the respiratory activity of the left and right lungs separately, as well as a summary graph, to which it is possible to apply methods of processing the results of spirography.

Noninvasive health condition monitoring device for workers at high altitudes conditions.

PubMed

Aqueveque, Pablo; Gutierrez, Cristopher; Saavedra, Francisco; Pino, Esteban J

2016-08-01

This work presents the design and implementation of a continuous monitoring device to control the health state of workers, for instance miners, at high altitudes. The extreme ambient conditions are harmful for peoples' health; therefore a continuous control of the workers' vital signs is necessary. The developed system includes physiological variables: electrocardiogram (ECG), respiratory activity and body temperature (BT), and ambient variables: ambient temperature (AT) and relative humidity (RH). The noninvasive sensors are incorporated in a t-shirt to deliver a functional device, and maximum comfort to the users. The device is able to continuously calculate heart rate (HR) and respiration rate (RR), and establish a wireless data transmission to a central monitoring station.

Wireless physiological monitoring system for psychiatric patients.

PubMed

Rademeyer, A J; Blanckenberg, M M; Scheffer, C

2009-01-01

Patients in psychiatric hospitals that are sedated or secluded are at risk of death or injury if they are not continuously monitored. Some psychiatric patients are restless and aggressive, and hence the monitoring device should be robust and must transmit the data wirelessly. Two devices, a glove that measures oxygen saturation and a dorsally-mounted device that measures heart rate, skin temperature and respiratory rate were designed and tested. Both devices connect to one central monitoring station using two separate Bluetooth connections, ensuring a completely wireless setup. A Matlab graphical user interface (GUI) was developed for signal processing and monitoring of the vital signs of the psychiatric patient. Detection algorithms were implemented to detect ECG arrhythmias such as premature ventricular contraction and atrial fibrillation. The prototypes were manufactured and tested in a laboratory setting on healthy volunteers.

Pervasive technology in Neonatal Intensive Care Unit: a prototype for newborns unobtrusive monitoring.

PubMed

Ciani, Oriana; Piccini, Luca; Parini, Sergio; Rullo, Alessia; Bagnoli, Franco; Marti, Patrizia; Andreoni, Giuseppe

2008-01-01

Pervasive computing research is introducing new perspectives in a wide range of applications, including healthcare domain. In this study we explore the possibility to realize a prototype of a system for unobtrusive recording and monitoring of multiple biological parameters on premature newborns hospitalized in the Neonatal Intensive Care Unit (NICU). It consists of three different units: a sensitized belt for Electrocardiogram (ECG) and chest dilatation monitoring, augmented with extrinsic transducers for temperature and respiratory activity measure, a device for signals pre-processing, sampling and transmission through Bluetooth(R) (BT) technology to a remote PC station and a software for data capture and post-processing. Preliminary results obtained by monitoring babies just discharged from the ward demonstrated the feasibility of the unobtrusive monitoring on this kind of subjects and open a new scenario for premature newborns monitoring and developmental cares practice in NICU.

The Evaluation of a Noninvasive Respiratory Volume Monitor in Pediatric Patients Undergoing General Anesthesia.

PubMed

Gomez-Morad, Andrea D; Cravero, Joseph P; Harvey, Brian C; Bernier, Rachel; Halpin, Erin; Walsh, Brian; Nasr, Viviane G

2017-12-01

Pediatric patients following surgery are at risk for respiratory compromise such as hypoventilation and hypoxemia depending on their age, comorbidities, and type of surgery. Quantitative measurement of ventilation in nonintubated infants/children is a difficult and inexact undertaking. Current respiratory assessment in nonintubated patients relies on oximetry data, respiratory rate (RR) monitors, and subjective clinical assessment, but there is no objective measure of respiratory parameters that could be utilized to predict early respiratory compromise. New advances in technology and digital signal processing have led to the development of an impedance-based respiratory volume monitor (RVM, ExSpiron, Respiratory Motion, Inc, Waltham, MA). The RVM has been shown to provide accurate real-time, continuous, noninvasive measurements of tidal volume (TV), minute ventilation (MV), and RR in adult patients.In this prospective observational study, our primary aim was to determine whether the RVM accurately measures TV, RR, and MV in pediatric patients. A total of 72 pediatric patients (27 females, 45 males), ASA I to III, undergoing general anesthesia with endotracheal intubation were enrolled. After endotracheal intubation, continuous data of MV, TV, and RR were recorded from the RVM and an in-line monitoring spirometer (NM3 monitor, Phillips Healthcare). RVM and NM3 measurements of MV, TV, and RR were compared during a 10-minute period prior to the incision ("Presurgery") and a 10-minute period after the end of surgery ("Postsurgery"). Relative errors were calculated over 1-minute segment within each 10-minute period. Bias, precision, and accuracy were calculated using Bland-Altman analyses and paired-difference equivalence tests were performed. Combined across the Presurgery and Postsurgery periods, the RVM's mean measurement bias (RVM - NM3 measurement) for MV was -3.8% (95% limits of agreement) (±1.96 SD): (-19.9% to 12.2%), for TV it was -4.9 (-21.0% to 11.3%), and for RR it was 1.1% (-4.1% to 6.2%). The mean measurement accuracies for MV, TV, and RR were 11.9%, 12.0%, and 4.2% (0.6 breaths/min), respectively. Note that lower accuracy numbers correspond to more accurate RVM measurements. The equivalence tests rejected the null hypothesis that the RVM and NM3 have different mean values and conclude with 90% power that the measurements of MV, TV, and RR from the RVM and NM3 are equivalent within ±10%. Our data indicate acceptable agreement between RVM and NM3 measurements in pediatric mechanically-ventilated patients. Future studies assessing the capability of the RVM to detect respiratory compromise in other clinical settings are needed.

Detection of severe respiratory disease epidemic outbreaks by CUSUM-based overcrowd-severe-respiratory-disease-index model.

PubMed

Polanco, Carlos; Castañón-González, Jorge Alberto; Macías, Alejandro E; Samaniego, José Lino; Buhse, Thomas; Villanueva-Martínez, Sebastián

2013-01-01

A severe respiratory disease epidemic outbreak correlates with a high demand of specific supplies and specialized personnel to hold it back in a wide region or set of regions; these supplies would be beds, storage areas, hemodynamic monitors, and mechanical ventilators, as well as physicians, respiratory technicians, and specialized nurses. We describe an online cumulative sum based model named Overcrowd-Severe-Respiratory-Disease-Index based on the Modified Overcrowd Index that simultaneously monitors and informs the demand of those supplies and personnel in a healthcare network generating early warnings of severe respiratory disease epidemic outbreaks through the interpretation of such variables. A post hoc historical archive is generated, helping physicians in charge to improve the transit and future allocation of supplies in the entire hospital network during the outbreak. The model was thoroughly verified in a virtual scenario, generating multiple epidemic outbreaks in a 6-year span for a 13-hospital network. When it was superimposed over the H1N1 influenza outbreak census (2008-2010) taken by the National Institute of Medical Sciences and Nutrition Salvador Zubiran in Mexico City, it showed that it is an effective algorithm to notify early warnings of severe respiratory disease epidemic outbreaks with a minimal rate of false alerts.

Detection of Severe Respiratory Disease Epidemic Outbreaks by CUSUM-Based Overcrowd-Severe-Respiratory-Disease-Index Model

PubMed Central

Castañón-González, Jorge Alberto; Macías, Alejandro E.; Samaniego, José Lino; Buhse, Thomas; Villanueva-Martínez, Sebastián

2013-01-01

A severe respiratory disease epidemic outbreak correlates with a high demand of specific supplies and specialized personnel to hold it back in a wide region or set of regions; these supplies would be beds, storage areas, hemodynamic monitors, and mechanical ventilators, as well as physicians, respiratory technicians, and specialized nurses. We describe an online cumulative sum based model named Overcrowd-Severe-Respiratory-Disease-Index based on the Modified Overcrowd Index that simultaneously monitors and informs the demand of those supplies and personnel in a healthcare network generating early warnings of severe respiratory disease epidemic outbreaks through the interpretation of such variables. A post hoc historical archive is generated, helping physicians in charge to improve the transit and future allocation of supplies in the entire hospital network during the outbreak. The model was thoroughly verified in a virtual scenario, generating multiple epidemic outbreaks in a 6-year span for a 13-hospital network. When it was superimposed over the H1N1 influenza outbreak census (2008–2010) taken by the National Institute of Medical Sciences and Nutrition Salvador Zubiran in Mexico City, it showed that it is an effective algorithm to notify early warnings of severe respiratory disease epidemic outbreaks with a minimal rate of false alerts. PMID:24069063

Non-contact and Unrestrained Respiration Monitoring System for Sleeping Person Using Near-infrared Bright Spots Matrix Irradiation

NASA Astrophysics Data System (ADS)

Aoki, Hirooki; Aoki, Hiroichi; Nakajima, Masato

Measurement of biological information appears to be an effective method to obtain an understanding of health conditions measures to maintain and improve the health of elderly people. However, every conventional bioinstrumentation technique imposes a sense of restraint that results in aversion against measurements that would last over consecutive days. To solve this problem, we propose a system for monitoring the respiration of sleepers, and it uses a fiber grating vision sensor, which is a type of optical range finder, to achieve non-contact and unrestrained monitoring. The signals obtained by the system include the respiration rate, shifts of the ventilation, and the body movement interval of the sleeper. The information enables to investigate the stability of the sleeper throughout the night. We examined the measuring accuracy, validity, and effectiveness of our proposed system. And all-night monitoring performed at elderly care facility revealed that respiratory disturbances during sleep occurred in many of the residents and that sleep apnea is a common syndrome, especially among residents who have senile dementia or have had a stroke. We were able to carry out the all-night monitoring with this system for a total of about 370 times, according to our schedule, without experiencing any failure, accident, or interruption. Our proposed system is highly effective for monitoring elderly dementia patients who are likely to become uncooperative during measurement with existing monitoring methods that use certain amounts of restraint.

Respiratory Acid-Base Disorders in the Critical Care Unit.

PubMed

Hopper, Kate

2017-03-01

The incidence of respiratory acid-base abnormalities in the critical care unit (CCU) is unknown, although respiratory alkalosis is suspected to be common in this population. Abnormal carbon dioxide tension can have many physiologic effects, and changes in Pco 2 may have a significant impact on outcome. Monitoring Pco 2 in CCU patients is an important aspect of critical patient assessment, and identification of respiratory acid-base abnormalities can be valuable as a diagnostic tool. Treatment of respiratory acid-base disorders is largely focused on resolution of the primary disease, although mechanical ventilation may be indicated in cases with severe respiratory acidosis. Published by Elsevier Inc.

Low minute ventilation episodes during anesthesia recovery following intraperitoneal surgery as detected by a non-invasive respiratory volume monitor.

PubMed

Cavalcante, Alexandre N; Martin, Yvette N; Sprung, Juraj; Imsirovic, Jasmin; Weingarten, Toby N

2017-12-20

An electrical impedance-based noninvasive respiratory volume monitor (RVM) accurately reports minute volume, tidal volume and respiratory rate. Here we used the RVM to quantify the occurrence of and evaluate the ability of clinical factors to predict respiratory depression in the post-anesthesia care unit (PACU). RVM generated respiratory data were collected from spontaneously breathing patients following intraperitoneal surgeries under general anesthesia admitted to the PACU. Respiratory depression was defined as low minute ventilation episode (LMVe, < 40% predicted minute ventilation for at least 2 min). We evaluated for associations between clinical variables including minute ventilation prior to opioid administration and LMVe following the first PACU administration of opioid. Also assessed was a low respiratory rate (< 8 breaths per minute) as a proxy for LMVe. Of 107 patients, 38 (36%) had LMVe. Affected patients had greater intraoperative opioid dose, P = 0.05. PACU opioids were administered to 45 (42.1%) subjects, of which 27 (25.2%) had LMVe (P = 0.42) within 30 min following opioid. Pre-opioid minute ventilation < 70% of predicted normal value was associated with LMVe, P < 0.01, (sensitivity = 100%, specificity = 81%).Low respiratory rate was a poor predictor of LMVe (sensitivity = 11.8%). Other clinical variables (e.g., obstructive sleep apnea) were not found to be predictors of LMVe. Using RVM we identified that mild, clinically nondetectable, respiratory depression prior to opioid administration in the PACU was associated with the development of substantial subsequent respiratory depression during the PACU stay.

Respiratory viruses, symptoms, and inflammatory markers in acute exacerbations and stable chronic obstructive pulmonary disease.

PubMed

Seemungal, T; Harper-Owen, R; Bhowmik, A; Moric, I; Sanderson, G; Message, S; Maccallum, P; Meade, T W; Jeffries, D J; Johnston, S L; Wedzicha, J A

2001-11-01

The effects of respiratory viral infection on the time course of chronic obstructive pulmonary disease (COPD) exacerbation were examined by monitoring changes in systemic inflammatory markers in stable COPD and at exacerbation. Eighty-three patients with COPD (mean [SD] age, 66.6 [7.1] yr, FEV(1), 1.06 [0.61] L) recorded daily peak expiratory flow rate and any increases in respiratory symptoms. Nasal samples and blood were taken for respiratory virus detection by culture, polymerase chain reaction, and serology, and plasma fibrinogen and serum interleukin-6 (IL-6) were determined at stable baseline and exacerbation. Sixty-four percent of exacerbations were associated with a cold occurring up to 18 d before exacerbation. Seventy-seven viruses (39 [58.2%] rhinoviruses) were detected in 66 (39.2%) of 168 COPD exacerbations in 53 (64%) patients. Viral exacerbations were associated with frequent exacerbators, colds with increased dyspnea, a higher total symptom count at presentation, a longer median symptom recovery period of 13 d, and a tendency toward higher plasma fibrinogen and serum IL-6 levels. Non-respiratory syncytial virus (RSV) respiratory viruses were detected in 11 (16%), and RSV in 16 (23.5%), of 68 stable COPD patients, with RSV detection associated with higher inflammatory marker levels. Respiratory virus infections are associated with more severe and frequent exacerbations, and may cause chronic infection in COPD. Prevention and early treatment of viral infections may lead to a decreased exacerbation frequency and morbidity associated with COPD.

The newborn oxygram: automated processing of transcutaneous oxygen data.

PubMed

Horbar, J D; Clark, J T; Lucey, J F

1980-12-01

Hypoxemic and hyperoxemic episodes are common in newborns with respiratory disorders. We have developed a microprocessor-based data system for use with transcutaneous oxygen (TcPO2) monitors in an attempt to quantitate these episodes. The amount of time spent by an infant in each of ten preset TcPO2 ranges can be automatically recorded. These data are referred to as the oxygram. Fourteen newborn infants were monitored for a total of 552 hours using this system. They spent a mean of 2.96% of the time with a TcPO2 less than or equal to 40 torr and 0.26% of the time with a TcPO2 greater than 100 torr. Representative oxygrams are presented. Clinical and research applications of the data system are discussed.

IMPACT OF SULPHUR DIOXIDE ON THE RESPIRATORY SYSTEM OF TBILISI POPULATION.

PubMed

Vepkhvadze, N; Kiladze, N; Khorbaladze, M; Kochoradze, T; Kugoti, I

2017-04-01

The possible relationship between levels of sulphur dioxide (SO2) in the air and the rate of respiratory diseases has been studied. Results of monitoring of main contaminants of outdoor air were analyzed and they are reflected in Environmental Report 2015. Information on morbidity by respiratory system diseases of Tbilisi population is has been taken from 2011-2015 reports of the National Center of Disease Control. Identified that there is no consistent correlation between sulphur dioxide concentration in the air and respiratory system disease rates in the population, including children. Obtained data demonstrated that during the study period maximum SO2 concentration was registered in 2015 - 0,14 mg/m3 (exceeding almost 3 times maximum permissible concentration - 0,5 mg/m3) and in the same year high morbidity rates are registered (incidence -18106,08), though the lowest rates are registered in 2011 (0,09 mg/m3), when incidence of respiratory system diseases in this period (13103.2) exceeds the rates registered in 2012, 2013 and 2014 (12736.4, 11336.3, 13009.0 accordingly). There is no direct correlation between the morbidity rates of 0-15 year old children and SO2 concentration. Maximum incidence rate is registered in 2015 (48487.0) and in the same year is also registered maximum concentration of SO2 (0,14 mg/m3), whereas the lowest rate is registered in 2013 (35538,70), when SO2 concentration in 2013 is lower only by 0.02 mg/m3 compared to the concentration in 2015. Direct correlation between morbidity with asthma in children and concentration of SO2 was not identified. Prevalence of asthma is minimal in 2014 (65,4), maximal in 2012 (207,1), whereas SO2 concentration in 2014 (0,13 mg/m3) exceeds the concentration in 2012 (0,12 mg/m3). It has to be considered, that besides SO2 there are many small intensity adverse factors, which are also risk factors for development of respiratory diseases. Isolated action of these factors with certain concentrations may not demonstrate any adverse effects on human health, but the combined effect of their action is stronger and obviously will affect general health and specifically - respiratory system. Implementation of urgent measures for further improvement of their ambient air quality has been recommended, which will be the basis for minimizing of many chronic diseases.

Low Power Wearable Systems for Continuous Monitoring of Environment and Health for Chronic Respiratory Disease

PubMed Central

Dieffenderfer, James; Goodell, Henry; Mills, Steven; McKnight, Michael; Yao, Shanshan; Lin, Feiyan; Beppler, Eric; Bent, Brinnae; Lee, Bongmook; Misra, Veena; Zhu, Yong; Oralkan, Omer; Strohmaier, Jason; Muth, John; Peden, David; Bozkurt, Alper

2016-01-01

We present our efforts towards enabling a wearable sensor system that allows for the correlation of individual environmental exposures to physiologic and subsequent adverse health responses. This system will permit a better understanding of the impact of increased ozone levels and other pollutants on chronic asthma conditions. We discuss the inefficiency of existing commercial off-the-shelf components to achieve continuous monitoring and our system-level and nano-enabled efforts towards improving the wearability and power consumption. Our system consists of a wristband, a chest patch, and a handheld spirometer. We describe our preliminary efforts to achieve a sub-milliwatt system ultimately powered by the energy harvested from thermal radiation and motion of the body with the primary contributions being an ultra-low power ozone sensor, an volatile organic compounds sensor, spirometer, and the integration of these and other sensors in a multimodal sensing platform. The measured environmental parameters include ambient ozone concentration, temperature, and relative humidity. Our array of sensors also assesses heart rate via photoplethysmography and electrocardiography, respiratory rate via photoplethysmography, skin impedance, three-axis acceleration, wheezing via a microphone, and expiratory airflow. The sensors on the wristband, chest patch, and spirometer consume 0.83, 0.96, and 0.01 milliwatts respectively. The data from each sensor is continually streamed to a peripheral data aggregation device and is subsequently transferred to a dedicated server for cloud storage. Future work includes reducing the power consumption of the system-on-chip including radio to reduce the entirety of each described system in the sub-milliwatt range. PMID:27249840

Low-Power Wearable Systems for Continuous Monitoring of Environment and Health for Chronic Respiratory Disease.

PubMed

Dieffenderfer, James; Goodell, Henry; Mills, Steven; McKnight, Michael; Yao, Shanshan; Lin, Feiyan; Beppler, Eric; Bent, Brinnae; Lee, Bongmook; Misra, Veena; Zhu, Yong; Oralkan, Omer; Strohmaier, Jason; Muth, John; Peden, David; Bozkurt, Alper

2016-09-01

We present our efforts toward enabling a wearable sensor system that allows for the correlation of individual environmental exposures with physiologic and subsequent adverse health responses. This system will permit a better understanding of the impact of increased ozone levels and other pollutants on chronic asthma conditions. We discuss the inefficiency of existing commercial off-the-shelf components to achieve continuous monitoring and our system-level and nano-enabled efforts toward improving the wearability and power consumption. Our system consists of a wristband, a chest patch, and a handheld spirometer. We describe our preliminary efforts to achieve a submilliwatt system ultimately powered by the energy harvested from thermal radiation and motion of the body with the primary contributions being an ultralow-power ozone sensor, an volatile organic compounds sensor, spirometer, and the integration of these and other sensors in a multimodal sensing platform. The measured environmental parameters include ambient ozone concentration, temperature, and relative humidity. Our array of sensors also assesses heart rate via photoplethysmography and electrocardiography, respiratory rate via photoplethysmography, skin impedance, three-axis acceleration, wheezing via a microphone, and expiratory airflow. The sensors on the wristband, chest patch, and spirometer consume 0.83, 0.96, and 0.01 mW, respectively. The data from each sensor are continually streamed to a peripheral data aggregation device and are subsequently transferred to a dedicated server for cloud storage. Future work includes reducing the power consumption of the system-on-chip including radio to reduce the entirety of each described system in the submilliwatt range.

Role of the vagal afferents in substance P-induced respiratory responses in anaesthetized rabbits.

PubMed

Prabhakar, N R; Runold, M; Yamamoto, Y; Lagercrantz, H; Cherniack, N S; von Euler, C

1987-09-01

Since substance P (SP)-like immunoreactivity has been demonstrated in vagal sensory fibres of bronchopulmonary origin, it was considered of interest to (1) characterize the pattern of responses to SP injected into the pulmonary as well as the systemic arterial system, and (2) assess the types of vagal afferents that are affected by SP. Experiments were performed on 15 pentobarbital-anaesthetized, spontaneously breathing rabbits. Efferent phrenic nerve activity was monitored as an index of central respiratory neural output. Intra-atrial injections of SP into the pulmonary circulation (100 ng kg-1) increased the respiratory rate, and peak integrated phrenic amplitude by 47 +/- 8 and 40 +/- 4%, respectively, above the controls. In addition, SP elicited augmented breaths (ABs) within 2-3 s in 67% of the trials. In contrast to right atrial injections, no ABs and no significant changes in respiratory rate were observed in response to intra-aortic injections of SP (100 ng kg-1). Tidal phrenic activity rise after aortic injections of SP was significantly less as compared with right atrial administrations of SP. Since both routes of administration decreased the arterial blood pressure to the same extent, these respiratory responses were not likely secondary to cardiovascular changes. After administration of an SP antagonist (D-Arg-D-Trp7,9, Leu11, SP), respiratory responses to SP were significantly attenuated. Also, the rate of occurrence of ABs elicited by releasing the tracheal occlusions was reduced (control 95 vs. 14% SP antagonist). Bilateral vagotomy abolished the tachypnoeic response and reduced the magnitude of the phrenic nerve increments caused by right atrial injection of SP.(ABSTRACT TRUNCATED AT 250 WORDS)

Gas Sensor for Volatile Anesthetic Agents Based on Raman Scattering

NASA Astrophysics Data System (ADS)

Schlüter, Sebastian; Popovska-Leipertz, Nadejda; Seeger, Thomas; Leipertz, Alfred

Continuous monitoring of respiratory and anesthetic gases during a surgery is of vital importance for the patient safety. Commonly the gas composition is determined by gas chromatography or a combination of IR-spectroscopy and electrochemical sensors. This study presents a concept for an optical sensor based on spontaneous Raman scattering which offers several advantages compared to established systems. All essential components can be detected simultaneously, no sample preparation is necessary and it provides fast response times. To reach the performance of a commonly used gas monitor signal gain has to be increased e.g. by using a multi pass setup.

Respiratory Disease in Relation to Outdoor Air Pollution in Kanpur, India

PubMed Central

Liu, Hai-Ying; Bartonova, Alena; Schindler, Martin; Sharma, Mukesh; Behera, Sailesh N.; Katiyar, Kamlesh; Dikshit, Onkar

2013-01-01

ABSTRACT This paper examines the effect of outdoor air pollution on respiratory disease in Kanpur, India, based on data from 2006. Exposure to air pollution is represented by annual emissions of sulfur dioxide (SO2), particulate matter (PM), and nitrogen oxides (NOx) from 11 source categories, established as a geographic information system (GIS)-based emission inventory in 2 km × 2 km grid. Respiratory disease is represented by number of patients who visited specialist pulmonary hospital with symptoms of respiratory disease. The results showed that (1) the main sources of air pollution are industries, domestic fuel burning, and vehicles; (2) the emissions of PM per grid are strongly correlated to the emissions of SO2 and NOx; and (3) there is a strong correlation between visits to a hospital due to respiratory disease and emission strength in the area of residence. These results clearly indicate that appropriate health and environmental monitoring, actions to reduce emissions to air, and further studies that would allow assessing the development in health status are necessary. [Supplementary materials are available for this article. Go to the publisher's online edition of Archives of Environmental & Occupational Health for material on emission of SO2, PM, NOx from various sources, and total number of inhabitants, total number of patients in grid squares covering the Kanpur city.] PMID:23697693

Influence of respiratory physiotherapy on gastro-oesophageal reflux in infants: A systematic review.

PubMed

Van Ginderdeuren, Filip; Kerckhofs, Eric; Deneyer, Michel; Vanlaethem, Sylvie; Vandenplas, Yvan

2015-09-01

To provide a survey on the literature concerning the influence of respiratory physiotherapy on gastro-oesophageal reflux (GOR) in infants and young children. Electronic databases (Pubmed, Web of Science, PEDro) and reference lists of articles and narrative reviews were searched. Articles were included when infants and small children underwent oesophageal pH monitoring or pH-multichannel intraluminal impedance monitoring while respiratory physiotherapy was administered. Descriptive analysis was performed and two researchers scored the methodological quality of these studies. Out of 985 articles, seven (six English, one French) have been included, In total 277 patients were involved, 71 with cystic fibrosis. Depending on the technique used, four studies showed GOR to be aggravated during therapy, three studies reported no effect. The evidence is not conclusive on whether respiratory physiotherapy induces or aggravates GOR in infants and small children. Age, disease, and treatment options play an important role. More specific research, also focussing on the influence of respiratory physiotherapy on non-acid reflux and the impact of recently developed airway clearance techniques (ACT's) on GOR is necessary. © 2015 Wiley Periodicals, Inc.

Acute Lung Injury: Making Injured Lungs Perform Better and Rebuilding Healthy Lungs

DTIC Science & Technology

2010-07-01

Informed consent will be obtained by the study coordinator/respiratory therapist from legally authorized representatives (defined as a subject’s...will be identified by the primary intensive care unit team, who will notify the study coordinator/respiratory therapist . The study coordinator is a...registered respiratory therapist with human subjects research training and qualifications for obtaining consent, clinical monitoring, arterial blood

[Long-term oxygen therapy (LTOT)--what should physicians, homecare-providers and health insurance companies know?].

PubMed

Koehler, U; Hildebrandt, O; Jerrentrup, L; Koehler, K-I; Kianinejad, P; Sohrabi, K; Schäfer, H; Kenn, K

2014-03-01

Long-term oxygen treatment (LTOT) has been demonstrated to improve prognosis in patients with chronic respiratory insufficiency. In terms of pathogenesis, improved oxygenation, reduction of pulmonary artery pressure as well as reduction of respiratory work are important. Since there are considerable differences between the LTOT systems, individually tailored therapy is needed. In particular, the mobility aspects of the patients must be taken into consideration. It is important to distinguish between stationary/mobile devices with a liquid oxygen system and stationary/mobile devices with oxygen concentrator. Oxygen titration should be performed in relation to rest and activity phases (e. g. 6 minute walk test) as well as in relation to the sleep phase. Employing devices with demand-controlled valves should be critically examined. This can be undertaken only under physician orders and requires continuous monitoring. © Georg Thieme Verlag KG Stuttgart · New York.

Measurement and monitoring of electrocardiogram belt tension in premature infants for assessment of respiratory function

PubMed Central

Ciaccio, Edward J; Hiatt, Mark; Hegyi, Thomas; Drzewiecki, Gary M

2007-01-01

Background Monitoring of the electrocardiogram (ECG) in premature infants with conventional adhesive-backed electrodes can harm their sensitive skin. Use of an electrode belt prevents skin irritation, but the effect of belt pressure on respiratory function is unknown. A strain gauge sensor is described which measures applied belt tension. Method The device frame was comprised of an aluminum housing and slide to minimize the device weight. Velcro tabs connected housing and slide to opposite tabs located at the electrode belt ends. The slide was connected to a leaf spring, to which were bonded two piezoresistive transducers in a half-bridge circuit configuration. The device was tested for linearity and calibrated. The effect on infant respiratory function of constant belt tension in the normal range (30 g–90 g) was determined. Results The mechanical response to a step input was second order (fn = 401 Hz, ζ = 0.08). The relationship between applied tension and output voltage was linear in the range 25–225 gm of applied tension (r2 = 0.99). Measured device sensitivity was 2.18 mV/gm tension using a 5 V bridge excitation voltage. When belt tension was increased in the normal range from 30 gm to 90 gm, there was no significant change in heart rate and most respiratory functions during monitoring. At an intermediate level of tension of 50 gm, pulmonary resistance and work of breathing significantly decreased. Conclusion The mechanical and electrical design of a device for monitoring electrocardiogram electrode belt tension is described. Within the typical range of application tension, cardiovascular and respiratory function are not substantially negatively affected by electrode belt force. PMID:17445262

Measurement and monitoring of electrocardiogram belt tension in premature infants for assessment of respiratory function.

PubMed

Ciaccio, Edward J; Hiatt, Mark; Hegyi, Thomas; Drzewiecki, Gary M

2007-04-19

Monitoring of the electrocardiogram (ECG) in premature infants with conventional adhesive-backed electrodes can harm their sensitive skin. Use of an electrode belt prevents skin irritation, but the effect of belt pressure on respiratory function is unknown. A strain gauge sensor is described which measures applied belt tension. The device frame was comprised of an aluminum housing and slide to minimize the device weight. Velcro tabs connected housing and slide to opposite tabs located at the electrode belt ends. The slide was connected to a leaf spring, to which were bonded two piezoresistive transducers in a half-bridge circuit configuration. The device was tested for linearity and calibrated. The effect on infant respiratory function of constant belt tension in the normal range (30 g-90 g) was determined. The mechanical response to a step input was second order (fn = 401 Hz, zeta = 0.08). The relationship between applied tension and output voltage was linear in the range 25-225 gm of applied tension (r2 = 0.99). Measured device sensitivity was 2.18 mV/gm tension using a 5 V bridge excitation voltage. When belt tension was increased in the normal range from 30 gm to 90 gm, there was no significant change in heart rate and most respiratory functions during monitoring. At an intermediate level of tension of 50 gm, pulmonary resistance and work of breathing significantly decreased. The mechanical and electrical design of a device for monitoring electrocardiogram electrode belt tension is described. Within the typical range of application tension, cardiovascular and respiratory function are not substantially negatively affected by electrode belt force.

Cardiovascular and systemic effects of gastric dilatation and volvulus in dogs.

PubMed

Sharp, Claire R; Rozanski, Elizabeth A

2014-09-01

Gastric dilatation and volvulus (GDV) is a common emergency condition in large and giant breed dogs that is associated with high morbidity and mortality. Dogs with GDV classically fulfill the criteria for the systemic inflammatory response syndrome (SIRS) and can go on to develop multiple organ dysfunction syndrome (MODS). Previously reported organ dysfunctions in dogs with GDV include cardiovascular, respiratory, gastrointestinal, coagulation and renal dysfunction. Cardiovascular manifestations of GDV include shock, cardiac arrhythmias and myocardial dysfunction. Respiratory dysfunction is also multifactorial, with contributory factors including decreased respiratory excursion due to gastric dilatation, decreased pulmonary perfusion and aspiration pneumonia. Gastrointestinal dysfunction includes gastric necrosis and post-operative gastrointestinal upset such as regurgitation, vomiting, and ileus. Coagulation dysfunction is another common feature of MODS in dogs with GDV. Disseminated intravascular coagulation can occur, putting them at risk of complications associated with thrombosis in the early hypercoagulable state and hemorrhage in the subsequent hypocoagulable state. Acute kidney injury, acid-base and electrolyte disturbances are also reported in dogs with GDV. Understanding the potential for systemic effects of GDV allows the clinician to monitor patients astutely and detect such complications early, facilitating early intervention to maximize the chance of successful management. Copyright © 2014 Elsevier Inc. All rights reserved.

Evaluation of the novel respiratory virus surveillance program: Pediatric Early Warning Sentinel Surveillance (PEWSS).

PubMed

Armour, Patricia A; Nguyen, Linh M; Lutman, Michelle L; Middaugh, John P

2013-01-01

Infections caused by respiratory viruses are associated with recurrent epidemics and widespread morbidity and mortality. Routine surveillance of these pathogens is necessary to determine virus activity, monitor for changes in circulating strains, and plan for public health preparedness. The Southern Nevada Health District in Las Vegas, Nevada, recruited five pediatric medical practices to serve as sentinel sites for the Pediatric Early Warning Sentinel Surveillance (PEWSS) program. Sentinel staff collected specimens throughout the year from ill children who met the influenza-like illness case definition and submitted specimens to the Southern Nevada Public Health Laboratory for molecular testing for influenza and six non-influenza viruses. Laboratory results were analyzed and reported to the medical and general communities in weekly bulletins year-round. PEWSS data were also used to establish viral respiratory seasonal baselines and in influenza vaccination campaigns. The surveillance program was evaluated using the Centers for Disease Control and Prevention's (CDC's) Updated Guidelines for Evaluating Public Health Surveillance Systems. PEWSS met three of six program usefulness criteria and seven of nine surveillance system attributes, which exceeded the CDC Guidelines evaluation criteria for a useful and complete public health surveillance program. We found that PEWSS is a useful and complete public health surveillance system that is simple, flexible, accessible, and stable.

Evaluation of the Novel Respiratory Virus Surveillance Program: Pediatric Early Warning Sentinel Surveillance (PEWSS)

PubMed Central

Nguyen, Linh M.; Lutman, Michelle L.; Middaugh, John P.

2013-01-01

Objectives Infections caused by respiratory viruses are associated with recurrent epidemics and widespread morbidity and mortality. Routine surveillance of these pathogens is necessary to determine virus activity, monitor for changes in circulating strains, and plan for public health preparedness. The Southern Nevada Health District in Las Vegas, Nevada, recruited five pediatric medical practices to serve as sentinel sites for the Pediatric Early Warning Sentinel Surveillance (PEWSS) program. Methods Sentinel staff collected specimens throughout the year from ill children who met the influenza-like illness case definition and submitted specimens to the Southern Nevada Public Health Laboratory for molecular testing for influenza and six non-influenza viruses. Results Laboratory results were analyzed and reported to the medical and general communities in weekly bulletins year-round. PEWSS data were also used to establish viral respiratory seasonal baselines and in influenza vaccination campaigns. The surveillance program was evaluated using the Centers for Disease Control and Prevention's (CDC's) Updated Guidelines for Evaluating Public Health Surveillance Systems. PEWSS met three of six program usefulness criteria and seven of nine surveillance system attributes, which exceeded the CDC Guidelines evaluation criteria for a useful and complete public health surveillance program. Conclusion We found that PEWSS is a useful and complete public health surveillance system that is simple, flexible, accessible, and stable. PMID:23997308

Advances in Remote Respiratory Assessments for People with Chronic Obstructive Pulmonary Disease: A Systematic Review.

PubMed

Baroi, Sidney; McNamara, Renae J; McKenzie, David K; Gandevia, Simon; Brodie, Matthew A

2018-06-01

Chronic obstructive pulmonary disease (COPD) is a leading cause of mortality. Advances in remote technologies and telemedicine provide new ways to monitor respiratory function and improve chronic disease management. However, telemedicine does not always include remote respiratory assessments, and the current state of knowledge for people with COPD has not been evaluated. Systematically review the use of remote respiratory assessments in people with COPD, including the following questions: What devices have been used? Can acute exacerbations of chronic obstructive pulmonary disease (AECOPD) be predicted by using remote devices? Do remote respiratory assessments improve health-related outcomes? The review protocol was registered (PROSPERO 2016:CRD42016049333). MEDLINE, EMBASE, and COMPENDEX databases were searched for studies that included remote respiratory assessments in people with COPD. A narrative synthesis was then conducted by two reviewers according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Fifteen studies met the inclusion criteria. Forced expiratory volume assessed daily by using a spirometer was the most common modality. Other measurements included resting respiratory rate, respiratory sounds, and end-tidal carbon dioxide level. Remote assessments had high user satisfaction. Benefits included early detection of AECOPD, improved health-related outcomes, and the ability to replace hospital care with a virtual ward. Remote respiratory assessments are feasible and when combined with sufficient organizational backup can improve health-related outcomes in some but not all cohorts. Future research should focus on the early detection, intervention, and rehabilitation for AECOPD in high-risk people who have limited access to best care and investigate continuous as well as intermittent monitoring.

Monitoring Indoor Air Quality for Enhanced Occupational Health.

PubMed

Pitarma, Rui; Marques, Gonçalo; Ferreira, Bárbara Roque

2017-02-01

Indoor environments are characterized by several pollutant sources. Because people spend more than 90% of their time in indoor environments, several studies have pointed out the impact of indoor air quality on the etiopathogenesis of a wide number of non-specific symptoms which characterizes the "Sick Building Syndrome", involving the skin, the upper and lower respiratory tract, the eyes and the nervous system, as well as many building related diseases. Thus, indoor air quality (IAQ) is recognized as an important factor to be controlled for the occupants' health and comfort. The majority of the monitoring systems presently available is very expensive and only allow to collect random samples. This work describes the system (iAQ), a low-cost indoor air quality monitoring wireless sensor network system, developed using Arduino, XBee modules and micro sensors, for storage and availability of monitoring data on a web portal in real time. Five micro sensors of environmental parameters (air temperature, humidity, carbon monoxide, carbon dioxide and luminosity) were used. Other sensors can be added for monitoring specific pollutants. The results reveal that the system can provide an effective indoor air quality assessment to prevent exposure risk. In fact, the indoor air quality may be extremely different compared to what is expected for a quality living environment. Systems like this would have benefit as public health interventions to reduce the burden of symptoms and diseases related to "sick buildings".

Development of unconstrained heartbeat and respiration measurement system with pneumatic flow.

PubMed

Kurihara, Yosuke; Watanabe, Kajiro

2012-12-01

The management of health through daily monitoring of heartbeat and respiration signals is of major importance for early diagnosis to prevent diseases of the respiratory and circulatory system. However, such daily health monitoring is possible only if the monitoring system is physically and psychologically noninvasive. In this paper, an unconstrained method of measuring heartbeat and respiration signals, by using a thermistor to measure the air flows from the air mattress to an air tube accompanying the subject's heartbeat and respiration, is proposed. The SN ratio with interference by opening and closing of a door as environmental noise was compared with that obtained by the conventional condenser microphone method. As a result, the SN ratios with the condenser microphone method were 26.6 ± 4.2 dB for heartbeat and 27.8 ± 3.0 dB for respiration, whereas with the proposed method they were 34.9 ± 3.1 dB and 42.1 ± 2.5 dB, respectively.

Nitrogen dioxide and respiratory illness in children. Part I: Health outcomes

DOE Office of Scientific and Technical Information (OSTI.GOV)

Samet, J.M.; Lambert, W.E.; Skipper, B.J.

1993-06-01

We have carried out a prospective cohort study to test the hypothesis that exposure to nitrogen dioxide increases the incidence and severity of respiratory infections during the first 18 months of life. Between January 1988 and June 1990, 1,315 infants were enrolled into the study at birth and followed with prospective surveillance for the occurrence of respiratory infections and monitoring of nitrogen dioxide concentrations in their homes. The subjects were healthy infants from homes without smokers; they were selected with stratification by type of cooking stove at a ratio of four to one for gas and electric stoves. Illness experiencemore » was monitored by a daily diary of symptoms completed by the mother and a telephone interview conducted every two weeks. Illnesses with wheezing or wet cough were classified as involving the lower respiratory tract; all other respiratory illnesses were designated as involving the upper respiratory tract. Exposure to nitrogen dioxide was estimated by two-week average concentrations measured in the subjects' bedrooms with passive samplers. This analysis is limited to the 1,205 subjects completing at least one month of observation; of these, 823 completed the full protocol, contributing 82.8% of the total number of days during which the subjects were under observation. Incidence rates for all respiratory illnesses, all upper respiratory illness, all lower respiratory illnesses, and lower respiratory illness further divided into those with any wheezing, or wet cough without wheezing, were examined within strata of nitrogen dioxide exposure at the time of the illness, nitrogen dioxide exposure during the prior month, and type of cooking stove. Consistent trends of increasing illness incidence rates with increasing exposure to nitrogen dioxide were not evident for either the lagged or unlagged exposure variables.« less

Premature awakening and underuse of neuromuscular monitoring in a registry of patients with butyrylcholinesterase deficiency.

PubMed

Thomsen, J L; Nielsen, C V; Palmqvist, D F; Gätke, M R

2015-07-01

Patients with butyrylcholinesterase (BChE) deficiency can experience prolonged paralysis after receiving suxamethonium or mivacurium. We hypothesized that patients suspected of BChE deficiency had a higher risk of being awakened while paralysed and having respiratory complications if neuromuscular monitoring was not applied before awakening. We retrospectively included patients referred to the Danish Cholinesterase Research Unit between 2004 and 2012 on suspicion of BChE deficiency. We collected data on genotype, BChE activity, neuromuscular blocking agents administered, neuromuscular monitoring, and postoperative respiratory complications, defined as arterial oxygen desaturation <90%, assisted ventilation, reintubation of the trachea, and pulmonary aspiration. Patients were classified as prematurely awakened if anaesthesia had been terminated while the patient was still paralysed. We included 123 patients. Neuromuscular monitoring was applied before awakening in 48 (39%) patients. A nerve stimulator was never used or only after attempted awakening in the remaining 75 (61%) patients. Premature awakening occurred in 75 (100%) and 14 (29%) of the unmonitored and monitored patients, respectively (P<0.001, Fisher's exact test). In 11 of the monitored patients, the results of neuromuscular monitoring were interpreted as equipment failure or were disregarded. Respiratory complications occurred in 19 (25%) and five (10%) of the unmonitored and monitored patients, respectively (P=0.06). Patients with BChE deficiency are at higher risk of being awakened while paralysed if neuromuscular monitoring is not applied or used; neuromuscular monitoring is recommended whenever a neuromuscular blocking agent is administered. © The Author 2015. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

A Time-Stratified Case-Crossover Study of Ambient Ozone Exposure and Emergency Department Visits for Specific Respiratory Diagnoses in California (2005–2008)

PubMed Central

Malig, Brian J.; Pearson, Dharshani L.; Chang, Yun Brenda; Broadwin, Rachel; Basu, Rupa; Green, Rochelle S.; Ostro, Bart

2015-01-01

Background: Studies have explored ozone’s connection to asthma and total respiratory emergency department visits (EDVs) but have neglected other specific respiratory diagnoses despite hypotheses relating ozone to respiratory infections and allergic responses. Objective: We examined relationships between ozone and EDVs for respiratory visits, including specifically acute respiratory infections (ARI), asthma, pneumonia, chronic obstructive pulmonary disease (COPD), and upper respiratory tract inflammation (URTI). Methods: We conducted a multi-site time-stratified case-crossover study of ozone exposures for approximately 3.7 million respiratory EDVs from 2005 through 2008 among California residents living within 20 km of an ozone monitor. Conditional logistic regression was used to estimate associations by climate zone. Random effects meta-analysis was then applied to estimate pooled excess risks (ER). Effect modification by season, distance from the monitor and individual demographic characteristics (i.e., age, race/ethnicity, sex, and payment method), and confounding by other gaseous air pollutants were also investigated. Meta-regression was utilized to explore how climate zone–level meteorological, demographic, and regional differences influenced estimates. Results: We observed ozone-associated increases in all respiratory, asthma, and ARI visits, which were slightly larger in the warm season [asthma ER per 10-ppb increase in mean of same and previous 3 days ozone exposure (lag03) = 2.7%, 95% CI: 1.5, 3.9; ARI ERlag03 = 1.4%, 95% CI: 0.8, 1.9]. EDVs for pneumonia, COPD, and URTI were also significantly associated with ozone exposure over the whole year, but typically more consistently so during the warm season. Conclusions: Short-term ozone exposures among California residents living near an ozone monitor were positively associated with EDVs for asthma, ARI, pneumonia, COPD, and URTI from 2005 through 2008. Those associations were typically larger and more consistent during the warm season. Our findings suggest that these outcomes should be considered when evaluating the potential health benefits of reducing ozone concentrations. Citation: Malig BJ, Pearson DL, Chang YB, Broadwin R, Basu R, Green RS, Ostro B. 2016. A time-stratified case-crossover study of ambient ozone exposure and emergency department visits for specific respiratory diagnoses in California (2005–2008). Environ Health Perspect 124:745–753; http://dx.doi.org/10.1289/ehp.1409495 PMID:26647366

Respiratory problems in children with Down syndrome.

PubMed

Pandit, Chetan; Fitzgerald, Dominic A

2012-03-01

Down syndrome is associated with a significant health burden, which is particularly apparent in young children who will frequently present with cardiac and respiratory problems. Respiratory presentations include problems related to structural abnormalities of the airways and lungs, glue ears, recurrent lower respiratory tract infections and obstructive sleep apnoea. These conditions are readily identifiable and able to be treated. An awareness of the breadth of respiratory problems and a plan to monitor patients with Down syndrome for their development has the potential to improve outcomes. © 2011 The Authors. Journal of Paediatrics and Child Health © 2011 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Basic principles of respiratory function monitoring in ventilated newborns: A review.

PubMed

Schmalisch, Gerd

2016-09-01

Respiratory monitoring during mechanical ventilation provides a real-time picture of patient-ventilator interaction and is a prerequisite for lung-protective ventilation. Nowadays, measurements of airflow, tidal volume and applied pressures are standard in neonatal ventilators. The measurement of lung volume during mechanical ventilation by tracer gas washout techniques is still under development. The clinical use of capnography, although well established in adults, has not been embraced by neonatologists because of technical and methodological problems in very small infants. While the ventilatory parameters are well defined, the calculation of other physiological parameters are based upon specific assumptions which are difficult to verify. Incomplete knowledge of the theoretical background of these calculations and their limitations can lead to incorrect interpretations with clinical consequences. Therefore, the aim of this review was to describe the basic principles and the underlying assumptions of currently used methods for respiratory function monitoring in ventilated newborns and to highlight methodological limitations. Copyright © 2016 Elsevier Ltd. All rights reserved.

Optical recording from respiratory pattern generator of fetal mouse brainstem reveals a distributed network.

PubMed

Eugenin, J; Nicholls, J G; Cohen, L B; Muller, K J

2006-01-01

Unfailing respiration depends on neural mechanisms already present in mammals before birth. Experiments were made to determine how inspiratory and expiratory neurons are grouped in the brainstem of fetal mice. A further aim was to assess whether rhythmicity arises from a single pacemaker or is generated by multiple sites in the brainstem. To measure neuronal firing, a fluorescent calcium indicator dye was applied to embryonic central nervous systems isolated from mice. While respiratory commands were monitored electrically from third to fifth cervical ventral roots, activity was measured optically over areas containing groups of respiratory neurones, or single neurones, along the medulla from the facial nucleus to the pre-Bötzinger complex. Large optical signals allowed recordings to be made during individual respiratory cycles. Inspiratory and expiratory neurones were intermingled. A novel finding was that bursts of activity arose in a discrete area intermittently, occurring during some breaths, but failing in others. Raised CO2 partial pressure or lowered pH increased the frequency of respiration; neurons then fired reliably with every cycle. Movies of activity revealed patterns of activation of inspiratory and expiratory neurones during successive respiratory cycles; there was no evidence for waves spreading systematically from region to region. Our results suggest that firing of neurons in immature respiratory circuits is a stochastic process, and that the rhythm does not depend on a single pacemaker. Respiratory circuits in fetal mouse brainstem appear to possess a high safety factor for generating rhythmicity, which may or may not persist as development proceeds.

Absolute electrical impedance tomography (aEIT) guided ventilation therapy in critical care patients: simulations and future trends.

PubMed

Denaï, Mouloud A; Mahfouf, Mahdi; Mohamad-Samuri, Suzani; Panoutsos, George; Brown, Brian H; Mills, Gary H

2010-05-01

Thoracic electrical impedance tomography (EIT) is a noninvasive, radiation-free monitoring technique whose aim is to reconstruct a cross-sectional image of the internal spatial distribution of conductivity from electrical measurements made by injecting small alternating currents via an electrode array placed on the surface of the thorax. The purpose of this paper is to discuss the fundamentals of EIT and demonstrate the principles of mechanical ventilation, lung recruitment, and EIT imaging on a comprehensive physiological model, which combines a model of respiratory mechanics, a model of the human lung absolute resistivity as a function of air content, and a 2-D finite-element mesh of the thorax to simulate EIT image reconstruction during mechanical ventilation. The overall model gives a good understanding of respiratory physiology and EIT monitoring techniques in mechanically ventilated patients. The model proposed here was able to reproduce consistent images of ventilation distribution in simulated acutely injured and collapsed lung conditions. A new advisory system architecture integrating a previously developed data-driven physiological model for continuous and noninvasive predictions of blood gas parameters with the regional lung function data/information generated from absolute EIT (aEIT) is proposed for monitoring and ventilator therapy management of critical care patients.

Automatic detection of respiration rate from ambulatory single-lead ECG.

PubMed

Boyle, Justin; Bidargaddi, Niranjan; Sarela, Antti; Karunanithi, Mohan

2009-11-01

Ambulatory electrocardiography is increasingly being used in clinical practice to detect abnormal electrical behavior of the heart during ordinary daily activities. The utility of this monitoring can be improved by deriving respiration, which previously has been based on overnight apnea studies where patients are stationary, or the use of multilead ECG systems for stress testing. We compared six respiratory measures derived from a single-lead portable ECG monitor with simultaneously measured respiration air flow obtained from an ambulatory nasal cannula respiratory monitor. Ten controlled 1-h recordings were performed covering activities of daily living (lying, sitting, standing, walking, jogging, running, and stair climbing) and six overnight studies. The best method was an average of a 0.2-0.8 Hz bandpass filter and RR technique based on lengthening and shortening of the RR interval. Mean error rates with the reference gold standard were +/-4 breaths per minute (bpm) (all activities), +/-2 bpm (lying and sitting), and +/-1 breath per minute (overnight studies). Statistically similar results were obtained using heart rate information alone (RR technique) compared to the best technique derived from the full ECG waveform that simplifies data collection procedures. The study shows that respiration can be derived under dynamic activities from a single-lead ECG without significant differences from traditional methods.

Signatures of subacute potentially catastrophic illness in the intensive care unit: model development and validation

PubMed Central

Moss, Travis J.; Lake, Douglas E.; Forrest Calland, J; Enfield, Kyle B; Delos, John B.; Fairchild, Karen D.; Randall Moorman, J.

2016-01-01

Objective Patients in intensive care units are susceptible to subacute, potentially catastrophic illnesses such as respiratory failure, sepsis, and hemorrhage that present as severe derangements of vital signs. More subtle physiologic signatures may be present before clinical deterioration, when treatment might be more effective. We performed multivariate statistical analyses of bedside physiologic monitoring data to identify such early, subclinical signatures of incipient life-threatening illness. Design We report a study of model development and validation of a retrospective observational cohort using resampling (TRIPOD Type 1b internal validation), and a study of model validation using separate data (Type 2b internal/external validation). Setting University of Virginia Health System (Charlottesville), a tertiary-care, academic medical center. Patients Critically ill patients consecutively admitted between January 2009 and June 2015 to either the neonatal, surgical/trauma/burn, or medical intensive care units with available physiologic monitoring data. Interventions None. Measurements and Main Results We analyzed 146 patient-years of vital sign and electrocardiography waveform time series from the bedside monitors of 9,232 ICU admissions. Calculations from 30-minute windows of the physiologic monitoring data were made every 15 minutes. Clinicians identified 1,206 episodes of respiratory failure leading to urgent, unplanned intubation, sepsis, or hemorrhage leading to multi-unit transfusions from systematic, individual chart reviews. Multivariate models to predict events up to 24 hours prior had internally-validated C-statistics of 0.61 to 0.88. In adults, physiologic signatures of respiratory failure and hemorrhage were distinct from each other but externally consistent across ICUs. Sepsis, on the other hand, demonstrated less distinct and inconsistent signatures. Physiologic signatures of all neonatal illnesses were similar. Conclusions Subacute, potentially catastrophic illnesses in 3 diverse ICU populations have physiologic signatures that are detectable in the hours preceding clinical detection and intervention. Detection of such signatures can draw attention to patients at highest risk, potentially enabling earlier intervention and better outcomes. PMID:27452809

Modulation of MMP-2 and MMP-9 in Churg-Strauss syndrome respiratory mucosa: potential monitoring parameters.

PubMed

Leone, A; Uzzo, M L; Gerbino, A; Tortorici, S; Tralongo, P; Cappello, F; Incandela, S; Spatola, G F; Jurjus, A R

2014-01-01

Churg-Strauss (CSS) syndrome is rare and of unknown etiology. It is associated with vasculitis, blood eosinophilia and granulomatosis, and affects multiple organs and systems at various stages of the disease. Specific diagnostic and monitoring tests are not yet available. This study aims to assess the changes in MMP-2 and MMP-9 along with the histopathological alterations in two cases of CSS, as possible potential diagnostic and monitoring criteria. Two adult male patients were diagnosed with CSS in the otorhinolaryngology clinic in the University of Palermo, based on multiple clinical and histopathologic criteria. Biopsies of respiratory mucosa were taken after the consent of the patients, processed for routine histopathology and immunohistochemistry as well as quantitative polymerase chain reaction (qPCR). Similar biopsies were also taken from a non- CSS patient. The Assessment of MMP-2 and MMP-9 was performed using both immunohistochemistry and qPCR techniques. Histopathological alterations in the respiratory mucosa were consistent with vasculitis and granulomatous tissue formation, in addition to inflammatory cell infiltration with abundance of eosinophils. Immunohistochemistry assay performed on the samples derived from the two CSS patients showed a relative and remarkable increase of both MMP-2 and MMP-9 compared to controls. Such an increase was consistent with the qPCR results which depicted a significant increase between 20 and 30% for both MMP-2 and MMP-9, respectively. Since the secretion of MMPs is an essential step in angiogenesis, could these enzymatic factors be used as parameters to diagnose or monitor the evolution of CSS? The small number of samples analyzed in this study does not allow us to suggest a general statement correlating the increase in expression of MMP-2 and MMP-9 to the appearance or evolution of vasculitis; it is only speculative.

Signatures of Subacute Potentially Catastrophic Illness in the ICU: Model Development and Validation.

PubMed

Moss, Travis J; Lake, Douglas E; Calland, J Forrest; Enfield, Kyle B; Delos, John B; Fairchild, Karen D; Moorman, J Randall

2016-09-01

Patients in ICUs are susceptible to subacute potentially catastrophic illnesses such as respiratory failure, sepsis, and hemorrhage that present as severe derangements of vital signs. More subtle physiologic signatures may be present before clinical deterioration, when treatment might be more effective. We performed multivariate statistical analyses of bedside physiologic monitoring data to identify such early subclinical signatures of incipient life-threatening illness. We report a study of model development and validation of a retrospective observational cohort using resampling (Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis type 1b internal validation) and a study of model validation using separate data (type 2b internal/external validation). University of Virginia Health System (Charlottesville), a tertiary-care, academic medical center. Critically ill patients consecutively admitted between January 2009 and June 2015 to either the neonatal, surgical/trauma/burn, or medical ICUs with available physiologic monitoring data. None. We analyzed 146 patient-years of vital sign and electrocardiography waveform time series from the bedside monitors of 9,232 ICU admissions. Calculations from 30-minute windows of the physiologic monitoring data were made every 15 minutes. Clinicians identified 1,206 episodes of respiratory failure leading to urgent unplanned intubation, sepsis, or hemorrhage leading to multi-unit transfusions from systematic individual chart reviews. Multivariate models to predict events up to 24 hours prior had internally validated C-statistics of 0.61-0.88. In adults, physiologic signatures of respiratory failure and hemorrhage were distinct from each other but externally consistent across ICUs. Sepsis, on the other hand, demonstrated less distinct and inconsistent signatures. Physiologic signatures of all neonatal illnesses were similar. Subacute potentially catastrophic illnesses in three diverse ICU populations have physiologic signatures that are detectable in the hours preceding clinical detection and intervention. Detection of such signatures can draw attention to patients at highest risk, potentially enabling earlier intervention and better outcomes.

Biosurveillance Technology: Providing Situational Awareness through Increased Information Sharing

DTIC Science & Technology

2011-09-01

Sri Lanka, there are “separate vertical programmes [sic] to control and monitor malaria , filariasis, leprosy, respiratory diseases, human rabies...Biohazard Detection System CAP Common Alerting Protocol CDC Centers for Disease Control and Prevention CDC HAN Centers for Disease Control and Prevention...LCDHD Preparedness Program running, I always had complete and total faith that you had everything under control and you would excel at every task. To

MultiSense: A Multimodal Sensor Tool Enabling the High-Throughput Analysis of Respiration.

PubMed

Keil, Peter; Liebsch, Gregor; Borisjuk, Ljudmilla; Rolletschek, Hardy

2017-01-01

The high-throughput analysis of respiratory activity has become an important component of many biological investigations. Here, a technological platform, denoted the "MultiSense tool," is described. The tool enables the parallel monitoring of respiration in 100 samples over an extended time period, by dynamically tracking the concentrations of oxygen (O 2 ) and/or carbon dioxide (CO 2 ) and/or pH within an airtight vial. Its flexible design supports the quantification of respiration based on either oxygen consumption or carbon dioxide release, thereby allowing for the determination of the physiologically significant respiratory quotient (the ratio between the quantities of CO 2 released and the O 2 consumed). It requires an LED light source to be mounted above the sample, together with a CCD camera system, adjusted to enable the capture of analyte-specific wavelengths, and fluorescent sensor spots inserted into the sample vial. Here, a demonstration is given of the use of the MultiSense tool to quantify respiration in imbibing plant seeds, for which an appropriate step-by-step protocol is provided. The technology can be easily adapted for a wide range of applications, including the monitoring of gas exchange in any kind of liquid culture system (algae, embryo and tissue culture, cell suspensions, microbial cultures).

Estimation of respiratory rhythm during night sleep using a bio-radar

NASA Astrophysics Data System (ADS)

Tataraidze, Alexander; Anishchenko, Lesya; Alekhin, Maksim; Korostovtseva, Lyudmila; Sviryaev, Yurii

2014-05-01

An assessment of bio-radiolocation monitoring of respiratory rhythm during sleep is given. Full-night respiratory inductance plethysmography (RIP) and bio-radiolocation (BRL) records were collected simultaneously in a sleep laboratory. Polysomnography data from 5 subjects without sleep breathing disorders were used. A multi-frequency bioradar with step frequency modulation was applied. It has 8 operating frequencies ranging from 3.6 to 4.0 GHz. BRL data are recorded in two quadratures. Respiratory cycles were detected in time domain. Obtained data was used for the evaluation of correlation between BRL and RIP respiration rate estimates. Strong correlation between corresponding time series was revealed. BRL method is reliably implemented for estimation of respiratory rhythm and respiratory rate variability during full night sleep.

Elucidative analysis and sequencing of two respiratory health monitoring methods to study the impact of varying atmospheric composition on human health

NASA Astrophysics Data System (ADS)

Awasthi, Amit; Hothi, Navjot; Kaur, Prabhjot; Singh, Nirankar; Chakraborty, Monojit; Bansal, Sangeeta

2017-12-01

Atmospheric composition of ambient air consists of different gases in definite proportion that affect the earth's climate and its ecological system. Due to varied anthropogenic reasons, this composition is changed, which ultimately have an impact on the health of living beings. For survival, the human respiratory system is one of the sensitive systems, which is easily and closely affected by the change in atmospheric composition of an external environment. Many studies have been conducted to quantify the effects of atmospheric pollution on human health by using different approaches. This article presents different scenario of studies conducted to evaluate the effects on different human groups. Differences between the studies conducted using spirometry and survey methods are presented in this article to extract a better sequence between these two methodologies. Many studies have been conducted to measure the respiratory status by evaluating the respiratory symptoms and hospital admissions. Limited numbers of studies are found with repeated spirometry on the same subjects for long duration to nullify the error arising due to decrease in efforts by the same subjects during manoeuvre of pulmonary function tests. Present study reveals the importance of methodological sequencing in order to obtain more authentic and reliable results. This study suggests that impacts of deteriorating atmospheric composition on human health can be more significantly studied if spirometry is done after survey analysis. The article also proposes that efficiency and authenticity of surveys involving health impacts will increase, if medical data information of patients is saved in hospitals in a proper format.

Determination of prospective displacement-based gate threshold for respiratory-gated radiation delivery from retrospective phase-based gate threshold selected at 4D CT simulation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Vedam, S.; Archambault, L.; Starkschall, G.

2007-11-15

Four-dimensional (4D) computed tomography (CT) imaging has found increasing importance in the localization of tumor and surrounding normal structures throughout the respiratory cycle. Based on such tumor motion information, it is possible to identify the appropriate phase interval for respiratory gated treatment planning and delivery. Such a gating phase interval is determined retrospectively based on tumor motion from internal tumor displacement. However, respiratory-gated treatment is delivered prospectively based on motion determined predominantly from an external monitor. Therefore, the simulation gate threshold determined from the retrospective phase interval selected for gating at 4D CT simulation may not correspond to the deliverymore » gate threshold that is determined from the prospective external monitor displacement at treatment delivery. The purpose of the present work is to establish a relationship between the thresholds for respiratory gating determined at CT simulation and treatment delivery, respectively. One hundred fifty external respiratory motion traces, from 90 patients, with and without audio-visual biofeedback, are analyzed. Two respiratory phase intervals, 40%-60% and 30%-70%, are chosen for respiratory gating from the 4D CT-derived tumor motion trajectory. From residual tumor displacements within each such gating phase interval, a simulation gate threshold is defined based on (a) the average and (b) the maximum respiratory displacement within the phase interval. The duty cycle for prospective gated delivery is estimated from the proportion of external monitor displacement data points within both the selected phase interval and the simulation gate threshold. The delivery gate threshold is then determined iteratively to match the above determined duty cycle. The magnitude of the difference between such gate thresholds determined at simulation and treatment delivery is quantified in each case. Phantom motion tests yielded coincidence of simulation and delivery gate thresholds to within 0.3%. For patient data analysis, differences between simulation and delivery gate thresholds are reported as a fraction of the total respiratory motion range. For the smaller phase interval, the differences between simulation and delivery gate thresholds are 8{+-}11% and 14{+-}21% with and without audio-visual biofeedback, respectively, when the simulation gate threshold is determined based on the mean respiratory displacement within the 40%-60% gating phase interval. For the longer phase interval, corresponding differences are 4{+-}7% and 8{+-}15% with and without audio-visual biofeedback, respectively. Alternatively, when the simulation gate threshold is determined based on the maximum average respiratory displacement within the gating phase interval, greater differences between simulation and delivery gate thresholds are observed. A relationship between retrospective simulation gate threshold and prospective delivery gate threshold for respiratory gating is established and validated for regular and nonregular respiratory motion. Using this relationship, the delivery gate threshold can be reliably estimated at the time of 4D CT simulation, thereby improving the accuracy and efficiency of respiratory-gated radiation delivery.« less

Determination of prospective displacement-based gate threshold for respiratory-gated radiation delivery from retrospective phase-based gate threshold selected at 4D CT simulation.

PubMed

Vedam, S; Archambault, L; Starkschall, G; Mohan, R; Beddar, S

2007-11-01

Four-dimensional (4D) computed tomography (CT) imaging has found increasing importance in the localization of tumor and surrounding normal structures throughout the respiratory cycle. Based on such tumor motion information, it is possible to identify the appropriate phase interval for respiratory gated treatment planning and delivery. Such a gating phase interval is determined retrospectively based on tumor motion from internal tumor displacement. However, respiratory-gated treatment is delivered prospectively based on motion determined predominantly from an external monitor. Therefore, the simulation gate threshold determined from the retrospective phase interval selected for gating at 4D CT simulation may not correspond to the delivery gate threshold that is determined from the prospective external monitor displacement at treatment delivery. The purpose of the present work is to establish a relationship between the thresholds for respiratory gating determined at CT simulation and treatment delivery, respectively. One hundred fifty external respiratory motion traces, from 90 patients, with and without audio-visual biofeedback, are analyzed. Two respiratory phase intervals, 40%-60% and 30%-70%, are chosen for respiratory gating from the 4D CT-derived tumor motion trajectory. From residual tumor displacements within each such gating phase interval, a simulation gate threshold is defined based on (a) the average and (b) the maximum respiratory displacement within the phase interval. The duty cycle for prospective gated delivery is estimated from the proportion of external monitor displacement data points within both the selected phase interval and the simulation gate threshold. The delivery gate threshold is then determined iteratively to match the above determined duty cycle. The magnitude of the difference between such gate thresholds determined at simulation and treatment delivery is quantified in each case. Phantom motion tests yielded coincidence of simulation and delivery gate thresholds to within 0.3%. For patient data analysis, differences between simulation and delivery gate thresholds are reported as a fraction of the total respiratory motion range. For the smaller phase interval, the differences between simulation and delivery gate thresholds are 8 +/- 11% and 14 +/- 21% with and without audio-visual biofeedback, respectively, when the simulation gate threshold is determined based on the mean respiratory displacement within the 40%-60% gating phase interval. For the longer phase interval, corresponding differences are 4 +/- 7% and 8 +/- 15% with and without audiovisual biofeedback, respectively. Alternatively, when the simulation gate threshold is determined based on the maximum average respiratory displacement within the gating phase interval, greater differences between simulation and delivery gate thresholds are observed. A relationship between retrospective simulation gate threshold and prospective delivery gate threshold for respiratory gating is established and validated for regular and nonregular respiratory motion. Using this relationship, the delivery gate threshold can be reliably estimated at the time of 4D CT simulation, thereby improving the accuracy and efficiency of respiratory-gated radiation delivery.

Respiratory Health Effects of Ultrafine Particles in Children: A Literature Review

PubMed Central

Heinzerling, Amy; Hsu, Joy; Yip, Fuyuen

2015-01-01

By convention, airborne particles ≤0.1 μm (100 nm) are defined as ultrafine particles (UFPs). UFPs can comprise a large number of particles in particulate matter with aerodynamic diameters ≤2.5 μm (PM2.5). Despite the documented respiratory health effects of PM2.5 and concerns that UFPs might be more toxic than larger particular matter, the effects of UFPs on the respiratory system are not well-described. Even less is known about the respiratory health effects of UFPs among particularly vulnerable populations including children. We reviewed studies examining respiratory health effects of UFPs in children and identified 12 relevant articles. Most (8/12) studies measured UFP exposure using central ambient monitors, and we found substantial heterogeneity in UFP definitions and study designs. No long-term studies were identified. In single pollutant models, UFPs were associated with incident wheezing, current asthma, lower spirometric values, and asthma-related emergency department visits among children. Also, higher exhaled nitric oxide levels were positively correlated with UFP dose among children with asthma or allergy to house dust mites in 1 study. Multivariate models accounting for potential co-pollutant confounding yielded no statistically significant results. Although evidence for a relationship between UFPs and children's respiratory is accumulating, the literature remains inconclusive. Interpretation of existing data is constrained by study heterogeneity, limited accounting for UFP spatial variation, and lack of significant findings from multi-pollutant models. PMID:26783373

Automated graphic assessment of respiratory activity is superior to pulse oximetry and visual assessment for the detection of early respiratory depression during therapeutic upper endoscopy.

PubMed

Vargo, John J; Zuccaro, Gregory; Dumot, John A; Conwell, Darwin L; Morrow, J Brad; Shay, Steven S

2002-06-01

Recommendations from the American Society of Anesthesiologists suggest that monitoring for apnea using the detection of exhaled carbon dioxide (capnography) is a useful adjunct in the assessment of ventilatory status of patients undergoing sedation and analgesia. There are no data on the utility of capnography in GI endoscopy, nor is the frequency of abnormal ventilatory activity during endoscopy known. The aims of this study were to determine the following: (1) the frequency of abnormal ventilatory activity during therapeutic upper endoscopy, (2) the sensitivity of observation and pulse oximetry in the detection of apnea or disordered respiration, and (3) whether capnography provides an improvement over accepted monitoring techniques. Forty-nine patients undergoing therapeutic upper endoscopy were monitored with standard methods including pulse oximetry, automated blood pressure measurement, and visual assessment. In addition, graphic assessment of respiratory activity with sidestream capnography was performed in all patients. Endoscopy personnel were blinded to capnography data. Episodes of apnea or disordered respiration detected by capnography were documented and compared with the occurrence of hypoxemia, hypercapnea, hypotension, and the recognition of abnormal respiratory activity by endoscopy personnel. Comparison of simultaneous respiratory rate measurements obtained by capnography and by auscultation with a pretracheal stethoscope verified that capnography was an excellent indicator of respiratory rate when compared with the reference standard (auscultation) (r = 0.967, p < 0.001). Fifty-four episodes of apnea or disordered respiration occurred in 28 patients (mean duration 70.8 seconds). Only 50% of apnea or disordered respiration episodes were eventually detected by pulse oximetry. None were detected by visual assessment (p < 0.0010). Apnea/disordered respiration occurs commonly during therapeutic upper endoscopy and frequently precedes the development of hypoxemia. Potentially important abnormalities in respiratory activity are undetected with pulse oximetry and visual assessment.

Novel health monitoring method using an RGB camera.

PubMed

Hassan, M A; Malik, A S; Fofi, D; Saad, N; Meriaudeau, F

2017-11-01

In this paper we present a novel health monitoring method by estimating the heart rate and respiratory rate using an RGB camera. The heart rate and the respiratory rate are estimated from the photoplethysmography (PPG) and the respiratory motion. The method mainly operates by using the green spectrum of the RGB camera to generate a multivariate PPG signal to perform multivariate de-noising on the video signal to extract the resultant PPG signal. A periodicity based voting scheme (PVS) was used to measure the heart rate and respiratory rate from the estimated PPG signal. We evaluated our proposed method with a state of the art heart rate measuring method for two scenarios using the MAHNOB-HCI database and a self collected naturalistic environment database. The methods were furthermore evaluated for various scenarios at naturalistic environments such as a motion variance session and a skin tone variance session. Our proposed method operated robustly during the experiments and outperformed the state of the art heart rate measuring methods by compensating the effects of the naturalistic environment.

Evaluation of Ultrasound-Based Sensor to Monitor Respiratory and Non-Respiratory Movement and Timing in Infants

PubMed Central

Heldt, Gregory P.; Ward, Raymond J.

2016-01-01

Goal To describe and validate a non-contacting sensor that used reflected ultrasound to separately monitor respiratory, non-respiratory, and caretaker movements of infants. Methods An In-Phase and Quadrature (I&Q) detection scheme provided adequate bandwidth, in conjunction with post-detection filtering, to separate the 3 types of movement. The respiratory output was validated by comparing it to the electrical activity of the diaphragm (Edi) obtained from an infant ventilator in 11 infants. The non-respiratory movement output was compared to movement detected by miniature accelerometers attached to the wrists, ankles, and heads of 7 additional infants. Caretaker movement was compared to visual observations annotated in the recordings. Results The respiratory rate determined by the sensor was equivalent to that from the Edi signal. The sensor could detect the onset of inspiration significantly earlier than the Edi signal (23+/−69ms). Non-respiratory movement was identified with an agreement of 0.9 with the accelerometers. It potentially interfered with the respiratory output an average of 4.7+/− 4.5% and 14.9+/1 15% of the time in infants not requiring or on ventilatory support, respectively. Caretaker movements were identified with 98% sensitivity and specificity. The sensor outputs were independent of body coverings or position. Conclusion This single, non-contacting sensor can independently quantify these three types of movement. Significance It is feasible to use the sensor as trigger for synchronizing mechanical ventilators to spontaneous breathing, to quantify overall movement, to determine sleep state, to detect seizures, and to document the amount and effects of caretaker activity in infants. PMID:26276983

Polysomnography versus limited respiratory monitoring and nurse-led titration to optimise non-invasive ventilation set-up: a pilot randomised clinical trial.

PubMed

Patout, Maxime; Arbane, Gill; Cuvelier, Antoine; Muir, Jean Francois; Hart, Nicholas; Murphy, Patrick Brian

2018-03-30

Polysomnography (PSG) is recommended for non-invasive ventilation (NIV) set-up in patients with chronic respiratory failure. In this pilot randomised clinical trial, we compared the physiological effectiveness of NIV set-up guided by PSG to limited respiratory monitoring (LRM) and nurse-led titration in patients with COPD-obstructive sleep apnoea (OSA) overlap. The principal outcome of interest was change in daytime arterial partial pressure of carbon dioxide (PaCO 2 ) at 3 months. Fourteen patients with daytime PaCO 2 >6 kPa and body mass index >30 kg/m 2 were recruited. At 3 months, PaCO 2 was reduced by -0.88 kPa (95% CI -1.52 to -0.24 kPa) in the LRM group and by -0.36 kPa (95% CI -0.96 to 0.24 kPa) in the PSG group. These pilot data provide support to undertake a clinical trial investigating the clinical effectiveness of attended limited respiratory monitoring and PSG to establish NIV in patients with COPD-OSA overlap. Results, NCT02444806. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The development and use of respirator response functions as part of a workplace exposure monitoring program for control of potential respiratory hazards.

PubMed

Maxim, L D; Allshouse, J N; Chen, S H; Treadway, J; Venturin, D

1998-04-01

The traditional hierarchy of measures for control of potential respiratory hazards in the workplace includes (in order of preference) engineering controls, workplace practices, and use of respiratory protection. Although third in this hierarchy, respirators can be an important component of the control mix-particularly for difficult-to-control jobs, as an interim measure (pending implementation of other controls), and in cases where exposure is intermittent. One of the problems associated with the use of respirators as a control measure is that valid and adequate data on respirator usage are often not available. Absent these data it is difficult to determine the practical effectiveness of respirators and exposure calculations which include the protective effect of respirators are speculative. This paper presents models (and appropriate statistical fitting techniques) suitable for quantification of respirator usage and defines three potentially useful measures of effectiveness for a respirator program. These models are illustrated with monitoring data on refractory ceramic fiber (RCF) developed as part of a Consent Agreement between the RCF industry and the U.S. Environmental Protection Agency. For this substance there are extensive and comprehensive monitoring data available. The models and methods of analysis may prove applicable for other potential respiratory hazards in the workplace. Copyright 1998 Academic Press.

Comparison of Respiratory Disease Prevalence among Voluntary Monitoring Systems for Pig Health and Welfare in the UK.

PubMed

Eze, J I; Correia-Gomes, C; Borobia-Belsué, J; Tucker, A W; Sparrow, D; Strachan, D W; Gunn, G J

2015-01-01

Surveillance of animal diseases provides information essential for the protection of animal health and ultimately public health. The voluntary pig health schemes, implemented in the United Kingdom, are integrated systems which capture information on different macroscopic disease conditions detected in slaughtered pigs. Many of these conditions have been associated with a reduction in performance traits and consequent increases in production costs. The schemes are the Wholesome Pigs Scotland in Scotland, the BPEX Pig Health Scheme in England and Wales and the Pig Regen Ltd. health and welfare checks done in Northern Ireland. This report set out to compare the prevalence of four respiratory conditions (enzootic pneumonia-like lesions, pleurisy, pleuropneumonia lesions and abscesses in the lung) assessed by these three Pig Health Schemes. The seasonal variations and year trends associated with the conditions in each scheme are presented. The paper also highlights the differences in prevalence for each condition across these schemes and areas where further research is needed. A general increase in the prevalence of enzootic pneumonia like lesions was observed in Scotland, England and Wales since 2009, while a general decrease was observed in Northern Ireland over the years of the scheme. Pleurisy prevalence has increased since 2010 in all three schemes, whilst pleuropneumonia has been decreasing. Prevalence of abscesses in the lung has decreased in England, Wales and Northern Ireland but has increased in Scotland. This analysis highlights the value of surveillance schemes based on abattoir pathology monitoring of four respiratory lesions. The outputs at scheme level have significant value as indicators of endemic and emerging disease, and for producers and herd veterinarians in planning and evaluating herd health control programs when comparing individual farm results with national averages.

Human quarantine: Toward reducing infectious pressure on chimpanzees at the Taï Chimpanzee Project, Côte d'Ivoire.

PubMed

Grützmacher, Kim; Keil, Verena; Leinert, Vera; Leguillon, Floraine; Henlin, Arthur; Couacy-Hymann, Emmanuel; Köndgen, Sophie; Lang, Alexander; Deschner, Tobias; Wittig, Roman M; Leendertz, Fabian H

2018-01-01

Due to their genetic relatedness, great apes are highly susceptible to common human respiratory pathogens. Although most respiratory pathogens, such as human respiratory syncytial virus (HRSV) and human metapneumovirus (HMPV), rarely cause severe disease in healthy human adults, they are associated with considerable morbidity and mortality in wild great apes habituated to humans for research or tourism. To prevent pathogen transmission, most great ape projects have established a set of hygiene measures ranging from keeping a specific distance, to the use of surgical masks and establishment of quarantines. This study investigates the incidence of respiratory symptoms and human respiratory viruses in humans at a human-great ape interface, the Taï Chimpanzee Project (TCP) in Côte d'Ivoire, and consequently, the effectiveness of a 5-day quarantine designed to reduce the risk of potential exposure to human respiratory pathogens. To assess the impact of quarantine as a preventative measure, we monitored the quarantine process and tested 262 throat swabs for respiratory viruses, collected during quarantine over a period of 1 year. Although only 1 subject tested positive for a respiratory virus (HRSV), 17 subjects developed symptoms of infection while in quarantine and were subsequently kept from approaching the chimpanzees, preventing potential exposure in 18 cases. Our results suggest that quarantine-in combination with monitoring for symptoms-is effective in reducing the risk of potential pathogen exposure. This research contributes to our understanding of how endangered great apes can be protected from human-borne infectious disease. © 2017 Wiley Periodicals, Inc.

A compact ECG R-R interval, respiration and activity recording system.

PubMed

Yoshimura, Takahiro; Yonezawa, Yoshiharu; Maki, Hiromichi; Ogawa, Hidekuni; Hahn, Allen W; Thayer, Julian F; Caldwell, W Morton

2003-01-01

An ECG R-R interval, respiration and activity recording system has been developed for monitoring variability of heart rate and respiratory frequency during daily life. The recording system employs a variable gain instrumentation amplifier, an accelerometer, a low power 8-bit single-chip microcomputer and a 1024 KB EEPROM. It is constructed on three ECG chest electrodes. The R-R interval and respiration are detected from the ECG. Activity during walking and running is calculated from an accelerator. The detected data are stored in an EEPROM and after recording, are downloaded to a desktop computer for analysis.

Respiratory complications from nasal packing: systematic review.

PubMed

Rotenberg, Brian; Tam, Samantha

2010-10-01

Patients with posterior nasal packing are thought to be at high risk for the development of respiratory complications. Controversy exists regarding the evidence in that regard; consequently, the level of vital sign monitoring required for these patients is unclear. The objective of this article is to systematically review the literature describing respiratory complications from nasal packing. Literature published before July 2009 on Medline and Embase was eligible for inclusion. Original research and review articles whose major topic was nasal packing for epistaxis were included. Nonhuman studies and studies not published in English were excluded. Studies were evaluated for quality using a modified Downs and Black scale. Data regarding respiratory complications of nasal packing were extracted and summarized. Of the 262 studies retrieved, 14 met inclusion criteria (7 case series, 3 cohort studies, and 4 reviews). Six studies discussed pulmonary mechanics, three discussed sleep apnea, two reviews described complications of nasal packing, and three articles focused on the treatment of posterior epistaxis. There was a lack of high-quality literature describing adverse respiratory events following posterior packing. The literature regarding development of respiratory complications from posterior packing is mostly based on expert opinion or case series. There is some suggestion that sleep apnea may develop after placement posterior nasal packing, but the severity appears to be mild. Evidence is lacking to support the contention that all patients with posterior packing are at risk for developing adverse respiratory events or require admission to a monitored setting.

Evaluation of exercise-respiratory system modifications and integration schemes for physiological systems

NASA Technical Reports Server (NTRS)

Gallagher, R. R.

1974-01-01

Exercise subroutine modifications are implemented in an exercise-respiratory system model yielding improvement of system response to exercise forcings. A more physiologically desirable respiratory ventilation rate in addition to an improved regulation of arterial gas tensions and cerebral blood flow is observed. A respiratory frequency expression is proposed which would be appropriate as an interfacing element of the respiratory-pulsatile cardiovascular system. Presentation of a circulatory-respiratory system integration scheme along with its computer program listing is given. The integrated system responds to exercise stimulation for both nonstressed and stressed physiological states. Other integration possibilities are discussed with respect to the respiratory, pulsatile cardiovascular, thermoregulatory, and the long-term circulatory systems.

Broad-Range Direct Detection and Identification of Fungi by Use of the PLEX-ID PCR-Electrospray Ionization Mass Spectrometry (ESI-MS) System

PubMed Central

Simner, Patricia J.; Uhl, James R.; Hall, Leslie; Weber, Michelle M.; Walchak, Robert C.; Buckwalter, Seanne

2013-01-01

The PLEX-ID system is a novel technology that couples PCR amplification and electrospray ionization-mass spectrometry to identify pathogens directly in clinical specimens. The analytical performance of the PLEX-ID Broad Fungal assay was compared with that of traditional culture identification by using 91 characterized fungal culture isolates (64 manufacturer-claimed and 27 nonclaimed organisms) and directly by using 395 respiratory specimens. Discordant results were resolved by D2 large-subunit ribosomal DNA fungal sequencing. Environmental studies were performed to monitor for potential contamination. The PLEX-ID Broad Fungal assay correctly identified 95.6% (87/91) and 81.3% (74/91) of the culture isolates to the genus and species levels, respectively. Of the manufacturer-claimed organisms, 100% (64/64) and 92.2% (59/64) were correctly identified to the genus and species levels, respectively. Direct analysis of respiratory specimens resulted in 67.6% (267/395) and 66.6% (263/395) agreement with culture results to the genus and species levels, respectively, with 16.2% (64/395) of the results discordant with culture and 16.2% (64/395) not detected by the system. The majority (>95%) of the isolates not detected directly by the PLEX-ID system ultimately grew in low quantities in culture (≤20 colonies). In 20.3% (35/172) of the respiratory specimens where no growth was observed in culture, the PLEX-ID system identified a fungus, suggesting a potential increase in sensitivity over culture in some instances. The PLEX-ID system provides a rapid method for the detection of a broad array of fungi directly in respiratory specimens and has the potential of impacting turnaround times and patient care by reducing the need to wait for the growth of an organism in culture. PMID:23515540

Respiratory medicine of reptiles.

PubMed

Schumacher, Juergen

2011-05-01

Noninfectious and infectious causes have been implicated in the development of respiratory tract disease in reptiles. Treatment modalities in reptiles have to account for species differences in response to therapeutic agents as well as interpretation of diagnostic findings. Data on effective drugs and dosages for the treatment of respiratory diseases are often lacking in reptiles. Recently, advances have been made on the application of advanced imaging modalities, especially computed tomography for the diagnosis and treatment monitoring of reptiles. This article describes common infectious and noninfectious causes of respiratory disease in reptiles, including diagnostic and therapeutic regimen. Copyright © 2011 Elsevier Inc. All rights reserved.

Telemedicine in chronic obstructive pulmonary disease

PubMed Central

Vagheggini, Guido; Mazzoleni, Stefano; Vitacca, Michele

2016-01-01

Telemedicine is a medical application of advanced technology to disease management. This modality may provide benefits also to patients with chronic obstructive pulmonary disease (COPD). Different devices and systems are used. The legal problems associated with telemedicine are still controversial. Economic advantages for healthcare systems, though potentially high, are still poorly investigated. A European Respiratory Society Task Force has defined indications, follow-up, equipment, facilities, legal and economic issues of tele-monitoring of COPD patients including those undergoing home mechanical ventilation. Key points The costs of care assistance in chronic disease patients are dramatically increasing. Telemedicine may be a very useful application of information and communication technologies in high-quality healthcare services. Many remote health monitoring systems are available, ensuring safety, feasibility, effectiveness, sustainability and flexibility to face different patients’ needs. The legal problems associated with telemedicine are still controversial. National and European Union governments should develop guidelines and ethical, legal, regulatory, technical, administrative standards for remote medicine. The economic advantages, if any, of this new approach must be compared to a “gold standard” of homecare that is very variable among different European countries and within each European country. The efficacy of respiratory disease telemedicine projects is promising (i.e. to tailor therapeutic intervention; to avoid useless hospital and emergency department admissions, and reduce general practitioner and specialist visits; and to involve the patients and their families). Different programmes based on specific and local situations, and on specific diseases and levels of severity with a high level of flexibility should be utilised. A European Respiratory Society Task Force produced a statement on commonly accepted clinical criteria for indications, follow-up, equipment, facilities, legal and economic issues also of telemonitoring of ventilator-dependent chronic obstructive pulmonary disease patients. Much more research is needed before considering telemonitoring a real improvement in the management of these patients. Educational aims To clarify definitions of aspects of telemedicine To describe different tools of telemedicine To provide information on the main clinical results To define recommendations and limitations PMID:28210321

SLEEP - Williams wearing sleep net

NASA Image and Video Library

1998-05-12

STS090-377-011 (17 APRIL-3 MAY 1998) --- Astronaut Dafydd R. (Dave) Williams, mission specialist representing the Canadian Space Agency (CSA), accomplishes more than one purpose when he sleeps in this bunk aboard the Earth-orbiting Space Shuttle Columbia. Conducting a Neurolab sleep experiment, Williams wears equipment which includes a sleep net (mesh cap that monitors and records brain waves); a Respiratory Inductance Plethysmograph (RIP) suit for monitoring respiration; and an activity monitor -- a device (out of view) worn on the wrist to detect and record body movement. Data on brain waves, eye movements, respiration, heart rate, and oxygen concentration are routed to a portable data recorder. The entire system has capabilities similar to a fully equipped sleep laboratory on Earth. The sleeping bag is conventional Shuttle ware and not part of the experiment.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ahmed, Raef S.; Shen, Sui; Ove, Roger

We wanted to describe a technique for the implementation of intensity-modulated radiotherapy (IMRT) with a real-time position monitor (RPM) respiratory gating system for the treatment of pleural space with intact lung. The technique is illustrated by a case of pediatric osteosarcoma, metastatic to the pleura of the right lung. The patient was simulated in the supine position where a breathing tracer and computed tomography (CT) scans synchronized at end expiration were acquired using the RPM system. The gated CT images were used to define target volumes and critical structures. Right pleural gated IMRT delivered at end expiration was prescribed tomore » a dose of 44 Gy, with 55 Gy delivered to areas of higher risk via simultaneous integrated boost (SIB) technique. IMRT was necessary to avoid exceeding the tolerance of intact lung. Although very good coverage of the target volume was achieved with a shell-shaped dose distribution, dose over the targets was relatively inhomogeneous. Portions of target volumes necessarily intruded into the right lung, the liver, and right kidney, limiting the degree of normal tissue sparing that could be achieved. The radiation doses to critical structures were acceptable and well tolerated. With intact lung, delivering a relatively high dose to the pleura with acceptable doses to surrounding normal tissues using respiratory gated pleural IMRT is feasible. Treatment delivery during a limited part of the respiratory cycle allows for reduced CT target volume motion errors, with reduction in the portion of the planning margin that accounts for respiratory motion, and subsequent increase in the therapeutic ratio.« less

Lungs and Respiratory System

MedlinePlus

... Videos for Educators Search English Español Lungs and Respiratory System KidsHealth / For Teens / Lungs and Respiratory System ... didn't breathe, you couldn't live. Lungs & Respiratory System Basics Each day we breathe about 20, ...

Lungs and Respiratory System

MedlinePlus

... Videos for Educators Search English Español Lungs and Respiratory System KidsHealth / For Parents / Lungs and Respiratory System ... ll have taken at least 600 million breaths. Respiratory System Basics All of this breathing couldn't ...

Numerical simulation of volume-controlled mechanical ventilated respiratory system with 2 different lungs.

PubMed

Shi, Yan; Zhang, Bolun; Cai, Maolin; Zhang, Xiaohua Douglas

2017-09-01

Mechanical ventilation is a key therapy for patients who cannot breathe adequately by themselves, and dynamics of mechanical ventilation system is of great significance for life support of patients. Recently, models of mechanical ventilated respiratory system with 1 lung are used to simulate the respiratory system of patients. However, humans have 2 lungs. When the respiratory characteristics of 2 lungs are different, a single-lung model cannot reflect real respiratory system. In this paper, to illustrate dynamic characteristics of mechanical ventilated respiratory system with 2 different lungs, we propose a mathematical model of mechanical ventilated respiratory system with 2 different lungs and conduct experiments to verify the model. Furthermore, we study the dynamics of mechanical ventilated respiratory system with 2 different lungs. This research study can be used for improving the efficiency and safety of volume-controlled mechanical ventilation system. Copyright © 2016 John Wiley & Sons, Ltd.

Monitoring respiratory muscles.

PubMed

Nava, S

1998-12-01

The respiratory system consists of two main parts, the lung and the ventilatory pump. The latter consists of the bony structure of the thorax, the central respiratory controllers, the inspiratory and expiratory muscles, and the nerves innervating these muscles. Respiratory muscle fatigue occurs when respiratory muscle endurance is exceeded. Muscle fatigue is defined as a condition in which there is a reduction in the capacity for developing force and/or velocity of a muscle, resulting from muscle activity, and which is reversible by rest. The respiratory muscles are somewhat difficult to assess and the techniques employed are still relatively primitive. The most important methods of respiratory muscles function assessment are: 1) the vital capacity manoeuvre, which depends on maximum inspiratory and expiratory effort by the muscles and may be a useful indicator of respiratory muscle function; 2) radiological screening has been proposed for the detection of diaphragm paralysis. This may be helpful if the paralysis is unilateral, but bilateral paralysis is difficult to detect; and 3) respiratory muscles strength may be assessed with either voluntary or nonvoluntary manoeuvres. The function of the inspiratory muscles is assessed with 3 voluntary dependent manoeuvres. They are the so called Müller manoeuvre (or maximal inspiratory pressure), the sniff test and the combined test. All these three manoeuvres generate a pressure that is a reflection of complex interactions between several muscle groups since the efforts produce different mechanisms of activity of inspiratory and expiratory muscles. Two techniques are presently employed to assess diaphragm function, not being dependent on the patient's motivation: electrical phrenic nerve stimulation and cervical magnetic stimulation. Since it is less painful, magnetic cervical stimulation overcomes some of the difficulties encountered during electrical stimulation. With these two techniques recordings of diaphragmatic force are possible, and at the same time useful information about the conduction time of both phrenic nerves can be obtained.

Small particle aerosol inoculation of cowpox Brighton Red in rhesus monkeys results in a severe respiratory disease

DOE Office of Scientific and Technical Information (OSTI.GOV)

Johnson, Reed F.; Hammoud, Dima A.; Lackemeyer, Matthew G.

Cowpox virus (CPXV) inoculation of nonhuman primates (NHPs) has been suggested as an alternate model for smallpox (Kramski et al., 2010, PLoS One, 5, e10412). Previously, we have demonstrated that intrabronchial inoculation of CPXV-Brighton Red (CPXV-BR) into cynomolgus monkeys resulted in a disease that shared many similarities to smallpox; however, severe respiratory tract disease was observed (Smith et al., 2011, J. Gen. Virol.). Here we describe the course of disease after small particle aerosol exposure of rhesus monkeys using computed tomography (CT) to monitor respiratory disease progression. Subjects developed a severe respiratory disease that was uniformly lethal at 5.7 log{submore » 10} PFU of CPXV-BR. CT indicated changes in lung architecture that correlated with changes in peripheral blood monocytes and peripheral oxygen saturation. While the small particle aerosol inoculation route does not accurately mimic human smallpox, the data suggest that CT can be used as a tool to monitor real-time disease progression for evaluation of animal models for human diseases. - Highlights: • Small particle aerosol exposure of rhesus results in a severe respiratory disease. • CT findings correlated with peripheral oxygen saturation and monocyte increases. • Virus dissemination was limited and mainly confined to the respiratory tract. • CT provides insight into pathogenesis to aid development of animal models of disease.« less

Comparison of Remote Sensing and Fixed-Site Monitoring Approaches for Examining Air Pollution and Health in a National Study Population

NASA Technical Reports Server (NTRS)

Prud'homme, Genevieve; Dobbin, Nina A.; Sun, Liu; Burnet, Richard T.; Martin, Randall V.; Davidson, Andrew; Cakmak, Sabit; Villeneuve, Paul J.; Lamsal, Lok N.; vanDonkelaar, Aaron;

The effect of dental scaling noise during intravenous sedation on acoustic respiration rate (RRa™).

PubMed

Kim, Jung Ho; Chi, Seong In; Kim, Hyun Jeong; Seo, Kwang-Suk

2018-04-01

Respiration monitoring is necessary during sedation for dental treatment. Recently, acoustic respiration rate (RRa™), an acoustics-based respiration monitoring method, has been used in addition to auscultation or capnography. The accuracy of this method may be compromised in an environment with excessive noise. This study evaluated whether noise from the ultrasonic scaler affects the performance of RRa in respiratory rate measurement. We analyzed data from 49 volunteers who underwent scaling under intravenous sedation. Clinical tests were divided into preparation, sedation, and scaling periods; respiratory rate was measured at 2-s intervals for 3 min in each period. Missing values ratios of the RRa during each period were measuerd; correlation analysis and Bland-Altman analysis were performed on respiratory rates measured by RRa and capnogram. Respective missing values ratio from RRa were 5.62%, 8.03%, and 23.95% in the preparation, sedation, and scaling periods, indicating an increased missing values ratio in the scaling period (P < 0.001). Correlation coefficients of the respiratory rate, measured with two different methods, were 0.692, 0.677, and 0.562 in each respective period. Mean capnography-RRa biases in Bland-Altman analyses were -0.03, -0.27, and -0.61 in each respective period (P < 0.001); limits of agreement were -4.84-4.45, -4.89-4.15, and -6.18-4.95 (P < 0.001). The probability of missing respiratory rate values was higher during scaling when RRa was used for measurement. Therefore, the use of RRa alone for respiration monitoring during ultrasonic scaling may not be safe.

Polyvinylidene fluoride film based nasal sensor to monitor human respiration pattern: an initial clinical study.

PubMed

Roopa Manjunatha, G; Rajanna, K; Mahapatra, D Roy; Nayak, M M; Krishnaswamy, Uma Maheswari; Srinivasa, R

2013-12-01

Design and development of a piezoelectric polyvinylidene fluoride (PVDF) thin film based nasal sensor to monitor human respiration pattern (RP) from each nostril simultaneously is presented in this paper. Thin film based PVDF nasal sensor is designed in a cantilever beam configuration. Two cantilevers are mounted on a spectacle frame in such a way that the air flow from each nostril impinges on this sensor causing bending of the cantilever beams. Voltage signal produced due to air flow induced dynamic piezoelectric effect produce a respective RP. A group of 23 healthy awake human subjects are studied. The RP in terms of respiratory rate (RR) and Respiratory air-flow changes/alterations obtained from the developed PVDF nasal sensor are compared with RP obtained from respiratory inductance plethysmograph (RIP) device. The mean RR of the developed nasal sensor (19.65 ± 4.1) and the RIP (19.57 ± 4.1) are found to be almost same (difference not significant, p > 0.05) with the correlation coefficient 0.96, p < 0.0001. It was observed that any change/alterations in the pattern of RIP is followed by same amount of change/alterations in the pattern of PVDF nasal sensor with k = 0.815 indicating strong agreement between the PVDF nasal sensor and RIP respiratory air-flow pattern. The developed sensor is simple in design, non-invasive, patient friendly and hence shows promising routine clinical usage. The preliminary result shows that this new method can have various applications in respiratory monitoring and diagnosis.

Integrated circuits and electrode interfaces for noninvasive physiological monitoring.

PubMed

Ha, Sohmyung; Kim, Chul; Chi, Yu M; Akinin, Abraham; Maier, Christoph; Ueno, Akinori; Cauwenberghs, Gert

2014-05-01

This paper presents an overview of the fundamentals and state of the-art in noninvasive physiological monitoring instrumentation with a focus on electrode and optrode interfaces to the body, and micropower-integrated circuit design for unobtrusive wearable applications. Since the electrode/optrode-body interface is a performance limiting factor in noninvasive monitoring systems, practical interface configurations are offered for biopotential acquisition, electrode-tissue impedance measurement, and optical biosignal sensing. A systematic approach to instrumentation amplifier (IA) design using CMOS transistors operating in weak inversion is shown to offer high energy and noise efficiency. Practical methodologies to obviate 1/f noise, counteract electrode offset drift, improve common-mode rejection ratio, and obtain subhertz high-pass cutoff are illustrated with a survey of the state-of-the-art IAs. Furthermore, fundamental principles and state-of-the-art technologies for electrode-tissue impedance measurement, photoplethysmography, functional near-infrared spectroscopy, and signal coding and quantization are reviewed, with additional guidelines for overall power management including wireless transmission. Examples are presented of practical dry-contact and noncontact cardiac, respiratory, muscle and brain monitoring systems, and their clinical applications.

Evaluation of inter-observer agreement when using a clinical respiratory scoring system in pre-weaned dairy calves.

PubMed

Buczinski, S; Faure, C; Jolivet, S; Abdallah, A

2016-07-01

To determine inter-observer agreement for a clinical scoring system for the detection of bovine respiratory disease complex in calves, and the impact of classification of calves as sick or healthy based on different cut-off values. Two third-year veterinary students (Observer 1 and 2) and one post-graduate student (Observer 3) received 4 hours of training on scoring dairy calves for signs of respiratory disease, including rectal temperature, cough, eye and nasal discharge, and ear position. Observers 1 and 2 scored 40 pre-weaning dairy calves 24 hours apart (80 observations) over three visits to a calf-rearing facility, and Observers 1, 2 and 3 scored 20 calves on one visit. Inter-observer agreement was assessed using percentage of agreement (PA) and Kappa statistics for individual clinical signs, comparing Observers 1 and 2. Agreement between the three observers for total clinical score was assessed using cut-off values of ≥4, ≥5 and ≥6 to indicate unhealthy calves. Inter-observer PA for rectal temperature was 0.68, for cough 0.78, for nasal discharge 0.62, for eye discharge 0.63, and for ear position 0.85. Kappa values for all clinical signs indicated slight to fair agreement (<0.4), except temperature that had moderate agreement (0.6). The Fleiss' Kappa for total score, using cut-offs of ≥4, ≥5 and ≥6 to indicate unhealthy calves, was 0.35, 0.06 and 0.13, respectively, indicating slight to fair agreement. There was important inter-observer discrepancies in scoring clinical signs of respiratory disease, using relatively inexperienced observers. These disagreements may ultimately mean increased false negative or false positive diagnoses and incorrect treatment of cases. Visual assessment of clinical signs associated with bovine respiratory disease needs to be thoroughly validated when disease monitoring is based on the use of a clinical scoring system.

Comparison of the FBG sensor encapsulated into PDMS and FBG sensor glued on the plexiglass pad for respiratory and heart rate monitoring

NASA Astrophysics Data System (ADS)

Fajkus, Marcel; Nedoma, Jan; Martinek, Radek; Walendziuk, Wojciech

2017-08-01

Authors of this article focused on the use of fiber-optic technology for monitoring heart and respiratory rate of the human body. The article describes an innovative method of encapsulating fiber Bragg grating (FBG) into polymer polydimethylsiloxane (PDMS) and comparison of this measuring probe with an FBG sensor glued on the plexiglass pad. The team of authors offers a solution which is basically focused on the monitoring of long-term ill patients with a minimum of physical movement load. Real data were acquired from a group of 10 volunteers with their written consent in the laboratory environment. Acquired data was compared by the Bland-Altman method.

The analysis of volatile organic compounds in exhaled breath and biomarkers in exhaled breath condensate in children - clinical tools or scientific toys?

PubMed

van Mastrigt, E; de Jongste, J C; Pijnenburg, M W

2015-07-01

Current monitoring strategies for respiratory diseases are mainly based on clinical features, lung function and imaging. As airway inflammation is the hallmark of many respiratory diseases in childhood, noninvasive methods to assess the presence and severity of airway inflammation might be helpful in both diagnosing and monitoring paediatric respiratory diseases. At present, the measurement of fractional exhaled nitric oxide is the only noninvasive method available to assess eosinophilic airway inflammation in clinical practice. We aimed to evaluate whether the analysis of volatile organic compounds (VOCs) in exhaled breath (EB) and biomarkers in exhaled breath condensate (EBC) is helpful in diagnosing and monitoring respiratory diseases in children. An extensive literature search was conducted in Medline, Embase and PubMed on the analysis and applications of VOCs in EB and EBC in children. We retrieved 1165 papers, of which nine contained original data on VOCs in EB and 84 on biomarkers in EBC. These were included in this review. We give an overview of the clinical applications in childhood and summarize the methodological issues. Several VOCs in EB and biomarkers in EBC have the potential to distinguish patients from healthy controls and to monitor treatment responses. Lack of standardization of collection methods and analysis techniques hampers the introduction in clinical practice. The measurement of metabolomic profiles may have important advantages over detecting single markers. There is a lack of longitudinal studies and external validation to reveal whether EB and EBC analysis have added value in the diagnostic process and follow-up of children with respiratory diseases. In conclusion, the use of VOCs in EB and biomarkers in EBC as markers of inflammatory airway diseases in children is still a research tool and not validated for clinical use. © 2014 John Wiley & Sons Ltd.

Pattern of resolution of tachypnoea and fever in childhood pneumonia.

PubMed

Muhe, L

1998-02-01

Acute lower respiratory infections (ALRI) account for one fifth of deaths among children below five years of age and pneumonia is responsible for about 70% of all ALRI deaths. Interventions with antibiotics have shown reduction in pneumonia case-fatality rates. However, there is room for further reduction of deaths from pneumonia through improved monitoring and follow up system. We studied the pattern of resolution of tachypnoea and fever among 108 children who presented to our outpatient clinic with non-severe pneumonia and among 102 children who were admitted for severe pneumonia. We found that tachypnoea was present in 18% and 23% after 72 hours of initiation of antibiotics and fever resolved completely after 48 hours and 72 hours of initiation of therapy in non-severe cases of pneumonia among children two to 11 months and 12 to 59 months of age respectively. Conversely, among cases of severe pneumonia on day 5 of initiation of treatment, tachypnoea and fever were present in 65% and 51% respectively in children two to 11 months old and in 53% and 60% respectively in children 12 to 59 months old. Respiratory rate increased with increase in body temperature at an average rate of four breaths per minute for every 1 degree C rise. Our study suggests that body temperature and respiratory rate can be used to monitor the clinical course of non-severe pneumonia. Further research is needed to identify other clinical signs that will help the health worker to decide improvement in attacks of severe pneumonia.

Effects of treatment on respiratory rate, serum natriuretic peptide concentration, and Doppler echocardiographic indices of left ventricular filling pressure in dogs with congestive heart failure secondary to degenerative mitral valve disease and dilated cardiomyopathy.

PubMed

Schober, Karsten E; Hart, Taye M; Stern, Joshua A; Li, Xiaobai; Samii, Valerie F; Zekas, Lisa J; Scansen, Brian A; Bonagura, John D

2011-08-15

To evaluate the effects of treatment on respiratory rate, serum natriuretic peptide concentrations, and Doppler echocardiographic indices of left ventricular filling pressure in dogs with congestive heart failure (CHF) secondary to degenerative mitral valve disease (MVD) and dilated cardiomyopathy (DCM). Prospective cohort study. 63 client-owned dogs. Physical examination, thoracic radiography, analysis of natriuretic peptide concentrations, and Doppler echocardiography were performed twice, at baseline (examination 1) and 5 to 14 days later (examination 2). Home monitoring of respiratory rate was performed by the owners between examinations. In dogs with MVD, resolution of CHF was associated with a decrease in respiratory rate, serum N-terminal probrain natriuretic peptide (NT-proBNP) concentration, and diastolic functional class and an increase of the ratio of peak velocity of early diastolic transmitral flow to peak velocity of early diastolic lateral mitral annulus motion (E:Ea Lat). In dogs with DCM, resolution of CHF was associated with a decrease in respiratory rate and serum NT-proBNP concentration and significant changes in 7 Doppler echocardiographic variables, including a decrease of E:Ea Lat and the ratio of peak velocity of early diastolic transmitral flow to isovolumic relaxation time. Only respiratory rate predicted the presence of CHF at examination 2 with high accuracy. Resolution of CHF was associated with predictable changes in respiratory rate, serum NT-proBNP concentration, and selected Doppler echocardiographic variables in dogs with DCM and MVD. Home monitoring of respiratory rate was simple and was the most useful in the assessment of successful treatment of CHF.

What do Children Aged Four to Seven Know about the Digestive System and the Respiratory System of the Human Being and of Other Animals?

NASA Astrophysics Data System (ADS)

Garcia-Barros, Susana; Martínez-Losada, Cristina; Garrido, María

2011-10-01

The object of this paper is to learn what little children know about the inside of their bodies before they have studied these particular aspects at school. The data for our project were collected by means of drawings made by 342 Spanish children aged four to seven. They were required to depict where the food, drink, and air which enter their bodies go. In addition to this, we intend to study how the ideas of children evolve during three consecutive years. For this purpose, a group of 32 subjects was monitored. Our findings show that the children recognise specific organs in their own bodies which they associate with the intake of food and air. Furthermore, they usually extrapolate those organs to other animals they are familiar with. Their ideas about the digestive system are more adequate than the ones about the respiratory system, though their ideas improve as they become older, above all those concerning the digestive system. Taking these findings as a basis, this paper suggests some points to be taken into consideration for teaching purposes.

Mobile nocturnal long-term monitoring of wheezing and cough.

PubMed

Gross, Volker; Reinke, Christian; Dette, Frank; Koch, Roland; Vasilescu, Dragos; Penzel, Thomas; Koehler, Ulrich

2007-02-01

Changes in normal lung sounds are an important sign of pathophysiological processes in the bronchial system and lung tissue. For the diagnosis of bronchial asthma, coughing and wheezing are important symptoms that indicate the existence of obstruction. In particular, nocturnal long-term acoustic monitoring and assessment make sense for qualitative and quantitative detection and documentation. Previous methods used for lung function diagnosis require active patient cooperation that is not possible during sleep. We developed a mobile device based on the CORSA standard that allows the recording of respiratory sounds throughout the night. To date, we have recorded 133 patients with different diagnoses (80 male, 53 female), of whom 38 were children. In 68 of the patients we could detect cough events and in 87 we detected wheezing. The recording method was tolerated by all participating adults and children. Our mobile system allows non-invasive and cooperation-independent nocturnal monitoring of acoustic symptoms in the domestic environment, especially at night, when most ailments occur.

Lung-Kidney Cross-Talk in the Critically Ill Patient.

PubMed

Husain-Syed, Faeq; Slutsky, Arthur S; Ronco, Claudio

2016-08-15

Discoveries have emerged highlighting the complex nature of the interorgan cross-talk between the kidney and the lung. Vascular rigidity, neurohormonal activation, tissue hypoxia, and abnormal immune cell signaling have been identified as common pathways leading to the development and progression of chronic kidney disease. However, our understanding of the causal relationships between lung injury and kidney injury is not precise. This review discusses a number of features and mechanisms of renal dysfunction in pulmonary disorders in relation to respiratory acidosis, impaired gas exchange, systemic congestion, respiratory support/replacement therapies, and other issues relevant to the clinical care of these patients. Biotrauma due to injurious ventilatory strategies can lead to the release of mediators into the lung, which may then translocate into the systemic circulation and cause end-organ dysfunction, including renal dysfunction. Right ventricular dysfunction and congestive states may contribute to alterations of renal perfusion and oxygenation, leading to diuretic resistance and recurrent hospitalization. In patients with concomitant respiratory failure, noninvasive ventilation represents a promising treatment option for the correction of impaired renal microcirculation and endothelial dysfunction. In patients requiring extracorporeal membrane oxygenation, short- and long-term monitoring of kidney function is warranted, as they are at highest risk of developing acute kidney injury and fluid overload.

Flexible piezoelectric nanogenerator in wearable self-powered active sensor for respiration and healthcare monitoring

NASA Astrophysics Data System (ADS)

Liu, Z.; Zhang, S.; Jin, Y. M.; Ouyang, H.; Zou, Y.; Wang, X. X.; Xie, L. X.; Li, Z.

2017-06-01

A wearable self-powered active sensor for respiration and healthcare monitoring was fabricated based on a flexible piezoelectric nanogenerator. An electrospinning poly(vinylidene fluoride) thin film on silicone substrate was polarized to fabricate the flexible nanogenerator and its electrical property was measured. When periodically stretched by a linear motor, the flexible piezoelectric nanogenerator generated an output open-circuit voltage and short-circuit current of up to 1.5 V and 400 nA, respectively. Through integration with an elastic bandage, a wearable self-powered sensor was fabricated and used to monitor human respiration, subtle muscle movement, and voice recognition. As respiration proceeded, the electrical output signals of the sensor corresponded to the signals measured by a physiological signal recording system with good reliability and feasibility. This self-powered, wearable active sensor has significant potential for applications in pulmonary function evaluation, respiratory monitoring, and detection of gesture and vocal cord vibration for the personal healthcare monitoring of disabled or paralyzed patients.

3D tissue-like assemblies: A novel approach to investigate virus-cell interactions.

PubMed

Goodwin, Thomas J; McCarthy, Maureen; Cohrs, Randall J; Kaufer, Benedikt B

2015-11-15

Virus-host cell interactions are most commonly analyzed in cells maintained in vitro as two-dimensional tissue cultures. However, these in vitro conditions vary quite drastically from the tissues that are commonly infected in vivo. Over the years, a number of systems have been developed that allow the establishment of three-dimensional (3D) tissue structures that have properties similar to their in vivo 3D counterparts. These 3D systems have numerous applications including drug testing, maintenance of large tissue explants, monitoring migration of human lymphocytes in tissues, analysis of human organ tissue development and investigation of virus-host interactions including viral latency. Here, we describe the establishment of tissue-like assemblies for human lung and neuronal tissue that we infected with a variety of viruses including the respiratory pathogens human parainfluenza virus type 3 (PIV3), respiratory syncytial virus (RSV) and SARS corona virus (SARS-CoV) as well as the human neurotropic herpesvirus, varicella-zoster virus (VZV). Copyright © 2015 Elsevier Inc. All rights reserved.

3D Tissue-Like Assemblies: A Novel Approach to Investigate Virus-Cell Interactions

PubMed Central

Goodwin, Thomas J.; McCarthy, Maureen; Cohrs, Randall J.; Kaufer, Benedikt B.

2017-01-01

Virus-host cell interactions are most commonly analyzed in cells maintained in vitro as two-dimensional tissue cultures. However, these in vitro conditions vary quite drastically from the tissues that are commonly infected in vivo. Over the years, a number of systems have been developed that allow the establishment of three-dimensional (3D) tissue structures that have properties similar to their in vivo 3D counterparts. These 3D systems have numerous applications including drug testing, maintenance of large tissue explants, monitoring migration of human lymphocytes in tissues, analysis of human organ tissue development and investigation of virus-host interactions including viral latency. Here, we describe the establishment of tissue-like assemblies for human lung and neuronal tissue that we infected with a variety of viruses including the respiratory pathogens human parainfluenza virus type 3 (PIV3), respiratory syncytial virus (RSV) and SARS corona virus (SARS-CoV) as well as the human neurotropic herpesvirus, varicella-zoster virus (VZV) PMID:25986169

Multicomponent Breath Analysis With Infrared Absorption Using Room-Temperature Quantum Cascade Lasers

PubMed Central

Shorter, Joanne H.; Nelson, David D.; Barry McManus, J.; Zahniser, Mark S.; Milton, Donald K.

2010-01-01

Breath analysis is a powerful noninvasive technique for the diagnosis and monitoring of respiratory diseases, including asthma and chronic obstructive pulmonary disease (COPD). Nitric oxide (NO) and carbon monoxide (CO) are markers of airway inflammation and can indicate the extent of respiratory diseases. We have developed a compact fast response laser system for analysis of multiple gases by infrared absorption. The instrument uses room temperature quantum cascade lasers to simultaneously measure NO, CO, carbon dioxide (CO2) and nitrous oxide (N2O) in exhaled breath. Four breath flow rates are employed to explore their exchange dynamics in the lungs and airways. We obtain 1-s detection precisions of 0.5-0.8 parts-per-billion (ppb) for NO, CO, and N2O with an instrument response time of less than 1 s. The breath analysis system has been demonstrated in a preliminary study of volunteers. It is currently deployed in a trial clinical study. PMID:20697459

Estimating respiratory rate from FBG optical sensors by using signal quality measurement.

PubMed

Yongwei Zhu; Maniyeri, Jayachandran; Fook, Victor Foo Siang; Haihong Zhang

2015-08-01

Non-intrusiveness is one of the advantages of in-bed optical sensor device for monitoring vital signs, including heart rate and respiratory rate. Estimating respiratory rate reliably using such sensors, however, is challenging, due to body movement, signal variation according to different subjects or body positions, etc. This paper presents a method for reliable respiratory rate estimation for FBG optical sensors by introducing signal quality estimation. The method estimates the quality of the signal waveform by detecting regularly repetitive patterns using proposed spectrum and cepstrum analysis. Multiple window sizes are used to cater for a wide range of target respiratory rates. Furthermore, the readings of multiple sensors are fused to derive a final respiratory rate. Experiments with 12 subjects and 2 body positions were conducted using polysomnography belt signal as groundtruth. The results demonstrated the effectiveness of the method.

Analyzing non-respiratory movements of the chest: methods and devices

NASA Astrophysics Data System (ADS)

Pariaszewska, Katarzyna; Młyńczak, Marcel; Cybulski, Gerard

2015-09-01

Respiration is the main reason of the chest movements. However, there are also non-respiratory ones, resulting from e.g. snoring, wheezing, stridor, throat clearing or coughing. They may exist sporadically, however should be examined in case when their incidences increase. Detecting non-respiratory movements is very important, because many of them are symptoms of respiratory diseases such as asthma, chronic obstructive pulmonary disease (COPD) or lung cancer. Assessment of the presence of non-respiratory movements could be important element of effective diagnosis. It is also necessary to provide quantitative and objective results for intra-subject studies. Most of these events generate vibroacoustic signals that contain components of sound and vibrations. This work provides the review of the solutions and devices for monitoring of the non-respiratory movements, primarily considering the accuracy of the chest movements' detection and distinguishing.

ROADWAYS AND CHILDREN'S RESPIRATORY HEALTH: LAND-USE REGRESSION VERSUS PROXIMITY MEASURES OF EXPOSURE ASSESSMENT IN AN EPIDEMIOLOGIC STUDY

EPA Science Inventory

Introduction: Previous studies of the respiratory health impact of mobile source air pollutants on children have relied heavily on simple exposure metrics such as proximity to roadways and traffic density near the home or school. Few studies have conducted area-wide monitoring of...

78 FR 21958 - Non-Competitive One-Year Extension With Funds for Black Lung/Coal Miner Clinics Program (H37...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-12

... Clinics Program supports projects that seek to prevent, monitor, and treat pulmonary and respiratory... 567,663 566,648 564,710 Coal Miners Respiratory Clinic of H37RH00049 KY 7/1/10 6/30/13 6/30/14 353,471...

A speculated cause of respiratory inhibition in infants.

PubMed

Minowa, Hideki; Arai, Ikuyo; Yasuhara, Hajime; Ebisu, Reiko; Ohgitani, Ayako

2018-10-01

In our previous studies, we documented that threatened premature labor and asymmetrical intrauterine growth restriction were risk factors for respiratory inhibition. The goal of this study was to determine the cause of respiratory inhibition by considering perinatal risk factors. We examined 1497 infants with a gestational age of 36 weeks or greater. All infants were monitored using pulse oximetry and examined via cranial sonography. Respiratory inhibition was defined as severe hypoxemia caused by respiratory inhibition immediately after crying or gastroesophageal reflux or as a respiratory pause during feeding. We examined the relationships between respiratory inhibition and perinatal factors and speculated on the cause of respiratory inhibition. The median gestational age, birth weight, Apgar score at 1 min, and Apgar score at 5 min of the subjects were 38.9 weeks, 2930 g, 8.0 points, and 9.0 points, respectively. Respiratory inhibition was observed in 422 infants. Lateral ventricle enlargement and increased echogenicity in the ganglionic eminence were observed in 417 and 516 infants, respectively. Respiratory inhibition was significantly correlated with shorter gestational periods, twin pregnancies, lateral ventricle enlargement, and increased echogenicity in the ganglionic eminence. We speculate that umbilical cord compression is a major cause of respiratory inhibition.

[Improved methods for monitoring sleep state and respiratory rhythm in freely moving rats].

PubMed

Wang, Qi-Min; Dong, Hui; Zhang, Cheng; Zhang, Yong-He; Ma, Jing; Wang, Guang-Fa

2014-01-01

To improve the method for monitoring sleep state and respiratory rhythm of SD rats, providing a solution for rats' chewing on the wires, signal loss and instability problems in the animal model of sleep apnea syndrome (SAS). We improved monitoring electrodes of both electrocorticogram (ECoG) and electromyogram (EMG), signal circuit and animal operation. Operation time was shortened and wound exposure time was reduced, which made it easier for postoperative recovery. The ECoG and EMG signals were more stable with sharp image, and signal circuit lines had better conductivity and material durability, achieving continuous monitoring for a long time and high success rate. We could precisely distinguish the sleep wake state and the sleep apnea events in rats according to these signals. The improved method is more reliable and practical to test the small animal model of SAS, and is more easily to operate and the signals are more stable.

Remote Respiration Monitoring Using Ultra-wideband Microwave Sensor

NASA Astrophysics Data System (ADS)

Higashikatsuragi, Kenji; Nakahata, Youichiro; Matsunami, Isamu; Kajiwara, Akihiro

Impulse based ultra-wideband radio has lately attracted considerable attention as medical monitoring sensor since it is expected to measure bio-signals of a patient on a bed such as respiration rate and heartbeat with a remote non-contact approach. It is also friendly to the environment including the human body due to the very low electromagnetic energy emission. Using conventional ranging scheme, however, high speed A/D device should be required in order to detect the small respiratory displacement. This paper suggests a respiratory monitoring scheme where the respiration rate is measured by observing the variation of the path strength from the patient. Therefore, it does not require high speed A/D. It also makes possible to design the simultaneous monitoring of multiple patients in hospital beds, for example. In this paper the measurements were conducted for various scenarios and the feasibility is discussed.

Using procalcitonin-guided algorithms to improve antimicrobial therapy in ICU patients with respiratory infections and sepsis.

PubMed

Schuetz, Philipp; Raad, Issam; Amin, Devendra N

2013-10-01

In patients with systemic bacterial infections hospitalized in ICUs, the inflammatory biomarker procalcitonin (PCT) has been shown to aid diagnosis, antibiotic stewardship, and risk stratification. Our aim is to summarize recent evidence about the utility of PCT in the critical care setting and discuss the potential benefits and limitations of PCT when used for clinical decision-making. A growing body of evidence supports PCT use to differentiate bacterial from viral respiratory infections (including influenza), to help risk stratify patients, and to guide decisions about optimal duration of antibiotic therapy. Different PCT protocols were evaluated for these and similar purposes in randomized controlled trials in patients with varying severities of predominantly respiratory tract infection and sepsis. These trials demonstrated effectiveness of monitoring PCT to de-escalate antibiotic treatment earlier without increasing rates of relapsing infections or other adverse outcomes. Although serial PCT measurement has shown value in risk stratification of ICU patients, PCT-guided antibiotic escalation protocols have not yet shown benefit for patients. Inclusion of PCT data in clinical algorithms improves individualized decision-making regarding antibiotic treatment in patients in critical care for respiratory infections or sepsis. Future research should focus on use of repeated PCT measurements to risk-stratify patients and guide treatment to improve their outcomes.

[Diagnostic values of bronchoscopy and multi-slice spiral CT for congenital dysplasia of the respiratory system in infants: a comparative study].

PubMed

Wang, Xing-Lu; Huang, Ying; Li, Qu-Bei; Dai, Ji-Hong

2013-09-01

To investigate and compare the diagnostic values of bronchoscopy and multi-slice spiral computed tomography (CT) for congenital dysplasia of the respiratory system in infants. Analysis was performed on the clinical data, bronchoscopic findings and multi-slice spiral CT findings of 319 infants (≤1 years old) who underwent bronchoscopy and/or multi-slice spiral CT and were diagnosed with congenital dysplasia of the respiratory system. A total of 476 cases of congenital dysplasia of the respiratory system were found in the 319 infants, including primary dysplasia of the respiratory system (392 cases) and compressive dysplasia of the respiratory system (84 cases). Of the 392 cases of primary dysplasia of the respiratory system, 225 (57.4%) were diagnosed by bronchoscopy versus 167 (42.6%) by multi-slice spiral CT. There were significant differences in etiological diagnosis between bronchoscopy and multi-slice spiral CT in infants with congenital dysplasia of the respiratory system (P<0.05). All 76 cases of primary dysplasia of the respiratory system caused by tracheobronchomalacia were diagnosed by bronchoscopy and all 17 cases of primary dysplasia of the respiratory system caused by lung tissue dysplasia were diagnosed by multi-slice spiral CT. Of the 84 cases of compressive dysplasia of the respiratory system, 74 cases were diagnosed by multi-slice spiral CT and only 10 cases were diagnosed by bronchoscopy. Compared with multi-slice spiral CT, bronchoscopy can detect primary dysplasia of the respiratory system more directly. Bronchoscopy is valuable in the confirmed diagnosis of tracheobronchomalacia. Multi-slice spiral CT has a higher diagnostic value for lung tissue dysplasia than bronchoscopy.

Canal Creek Study Area, Aberdeen Proving Ground, Edgewood Area, Maryland. Groundwater Monitoring Plan, Final Health and Safety Plan

DTIC Science & Technology

1993-10-01

100.00 _______________ Carbon tetrachloride 20,000.00 2 11.47 *Carbon disulfide 170.00 1 10.08 Chlorine 977,000.00 0.5 11.48 Chlorobenzene 192.00 75 9.07...SYMPTOMS AND EFFECTS Chlorine Strong irritant to eyes, mucous membranes, skin, and respiratory rn system; pulmonary edema; cough; lachrymator; nausea...sodium hypochlorite. Inorganic halogen salts are compounds containing halogens ( chlorine , bromine, fluorine) such as sodium chloride, potassium bromate

The obese patient undergoing nonbariatric surgery.

PubMed

Bluth, Thomas; Pelosi, Paolo; de Abreu, Marcelo Gama

2016-06-01

This article provides the reader with recent findings on the pathophysiology of comorbidities in the obese, as well as evidence-based treatment options to deal with perioperative respiratory challenges. Our understanding of obesity-associated asthma, obstructive sleep apnea, and obesity hypoventilation syndrome is still expanding. Routine screening for obstructive sleep apnea using the STOP-Bang score might identify high-risk patients that benefit from perioperative continuous positive airway pressure and close postoperative monitoring. Measures to most effectively support respiratory function during induction of and emergence from anesthesia include optimal patient positioning and use of noninvasive positive pressure ventilation. Appropriate mechanical ventilation settings are under investigation, so that only the use of protective low tidal volumes could be currently recommended. A multimodal approach consisting of adjuvants, as well as regional anesthesia/analgesia techniques reduces the need for systemic opioids and related respiratory complications. Anesthesia of obese patients for nonbariatric surgical procedures requires knowledge of typical comorbidities and their respective treatment options. Apart from cardiovascular diseases associated with the metabolic syndrome, awareness of any pulmonary dysfunction is of paramount. A multimodal analgesia approach may be useful to reduce postoperative pulmonary complications.

[The role of complementary examinations and home monitoring in patient at risk from apparent life threatening event, apneas and sudden infant death syndrome].

PubMed

Martínez Monseny, A; Bobillo Pérez, S; Martínez Planas, A; García García, J J

2015-08-01

Home apnea monitors detect abnormalities in cardiac and respiratory frequency, but their use in the diagnosis of respiratory -related sleep disturbances in children has not been demonstrated, as was originally thought. To describe the type of patients being monitored, for how long and their outcome. A retrospective descriptive study was conducted on patients with controlled home cardiorespiratory monitoring from October 2008 to September 2012 in the Outpatient department of a Maternity tertiary hospital. During the study period 88 patients were included, 58% of them were male, with a median age of 15.5 days, and followed up for a period of 4.7 months. The reason for monitoring was in a 20.5% due to a history of sudden death without finding underlying pathology in 20.5%, 25% due to apnea of prematurity, 20.5% due to apparent life-threatening event, and 14.8% due to choking. Other causes accounted for 19.3% (apnea/hypopnea, desaturation and periodic breathing). Of these last three groups, pathological events were observed in 50% of them: reflux disease (9), apnea of prematurity (2), neurological causes (3), and apnea of unknown cause (10). Suspected infant apnea is a cause for consultation that creates a great deal of concern to the family and the pediatrician. Home monitoring is useful in detecting changes in cardiac and respiratory frequency, but is necessary to limit its indications and ensure proper monitoring of these patients, avoiding the abuse of other tests or treatments. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

Using real-time syndromic surveillance systems to help explore the acute impact of the air pollution incident of March/April 2014 in England.

PubMed

Smith, Gillian E; Bawa, Zharain; Macklin, Yolande; Morbey, Roger; Dobney, Alec; Vardoulakis, Sotiris; Elliot, Alex J

2015-01-01

During March and early April 2014 there was widespread poor air quality across the United Kingdom. Public Health England used existing syndromic surveillance systems to monitor community health during the period. Short lived statistically significant rises in a variety of respiratory conditions, including asthma and wheeze, were detected. This incident has demonstrated the value of real-time syndromic surveillance systems, during an air pollution episode, for helping to explore the impact of poor air quality on community health in real-time. Crown Copyright © 2014. Published by Elsevier Inc. All rights reserved.

[Cystic Fibrosis Cloud database: An information system for storage and management of clinical and microbiological data of cystic fibrosis patients].

PubMed

Prieto, Claudia I; Palau, María J; Martina, Pablo; Achiary, Carlos; Achiary, Andrés; Bettiol, Marisa; Montanaro, Patricia; Cazzola, María L; Leguizamón, Mariana; Massillo, Cintia; Figoli, Cecilia; Valeiras, Brenda; Perez, Silvia; Rentería, Fernando; Diez, Graciela; Yantorno, Osvaldo M; Bosch, Alejandra

2016-01-01

The epidemiological and clinical management of cystic fibrosis (CF) patients suffering from acute pulmonary exacerbations or chronic lung infections demands continuous updating of medical and microbiological processes associated with the constant evolution of pathogens during host colonization. In order to monitor the dynamics of these processes, it is essential to have expert systems capable of storing and subsequently extracting the information generated from different studies of the patients and microorganisms isolated from them. In this work we have designed and developed an on-line database based on an information system that allows to store, manage and visualize data from clinical studies and microbiological analysis of bacteria obtained from the respiratory tract of patients suffering from cystic fibrosis. The information system, named Cystic Fibrosis Cloud database is available on the http://servoy.infocomsa.com/cfc_database site and is composed of a main database and a web-based interface, which uses Servoy's product architecture based on Java technology. Although the CFC database system can be implemented as a local program for private use in CF centers, it can also be used, updated and shared by different users who can access the stored information in a systematic, practical and safe manner. The implementation of the CFC database could have a significant impact on the monitoring of respiratory infections, the prevention of exacerbations, the detection of emerging organisms, and the adequacy of control strategies for lung infections in CF patients. Copyright © 2015 Asociación Argentina de Microbiología. Publicado por Elsevier España, S.L.U. All rights reserved.

A gated deep inspiration breath‐hold radiation therapy technique using a linear position transducer

PubMed Central

Denissova, Svetlana I.; Yewondwossen, Mammo H.; Andrew, John W.; Hale, Michael E.; Murphy, Carl H.; Purcell, Scott R.

2005-01-01

For patients with thoracic and abdominal lesions, respiration‐induced internal organ motion and deformations during radiation therapy are limiting factors for the administration of high radiation dose. To increase the dose to the tumor and to reduce margins, tumor movement during treatment must be minimized. Currently, several types of breath‐synchronized systems are in use. These systems include respiratory gating, deep inspiration breath‐hold, active breathing control, and voluntary breath‐hold. We used a linear position transducer (LPT) to monitor changes in a patient's abdominal cross‐sectional area. The LPT tracks changes in body circumference during the respiratory cycle using a strap connected to the LPT and wrapped around the patient's torso. The LPT signal is monitored by a computer that provides a real‐time plot of the patient's breathing pattern. In our technique, we use a CT study with multiple gated acquisitions. The Philips Medical Systems Q series CT imaging system is capable of operating in conjunction with a contrast injector. This allows a patient performing the deep inspiration breath‐hold maneuver to send a signal to trigger the CT scanner acquisitions. The LPT system, when interfaced to a LINAC, allows treatment to be delivered only during deep inspiration breath‐hold periods. Treatment stops automatically if the lung volume drops from a preset value. The whole treatment can be accomplished with 1 to 3 breath‐holds. This technique has been used successfully to combine automatically gated radiation delivery with the deep inspiration breath‐hold technique. This improves the accuracy of treatment for moving tumors, providing better target coverage, sparing more healthy tissue, and saving machine time. PACS numbers: 87.53.2j, 87.57.‐s PMID:15770197

Evaluation of exercise-respiratory system modifications and preliminary respiratory-circulatory system integration scheme

NASA Technical Reports Server (NTRS)

Gallagher, R. R.

1974-01-01

The respiratory control system, functioning as an independent system, is presented with modifications of the exercise subroutine. These modifications illustrate an improved control of ventilation rates and arterial and compartmental gas tensions. A very elementary approach to describing the interactions of the respiratory and circulatory system is presented.

Application of continuous monitoring of honeybee colonies

USDA-ARS?s Scientific Manuscript database

Monitoring physical variables associated with honey bee colonies, including weight, temperature, humidity, respiratory gases, vibration, acoustics and forager traffic, in a continuous manner is becoming feasible for most researchers as the cost and size of electronic sensors and dataloggers decrease...

Acute toxic effects of nerve agent VX on respiratory dynamics and functions following microinsillation inhalation exposure in guinea pigs.

PubMed

Rezk, Peter E; Graham, Jacob R; Moran, Theodore S; Gordon, Richard K; Sciuto, Alfred M; Doctor, Bhupendra P; Nambiar, Madhusoodana P

2007-03-01

Exposure to a chemical warfare nerve agent (CWNA) leads to severe respiratory distress, respiratory failure, or death if not treated. We investigated the toxic effects of nerve agent VX on the respiratory dynamics of guinea pigs following exposure to 90.4 mug/m3 of VX or saline by microinstillation inhalation technology for 10 min. Respiratory parameters were monitored by whole-body barometric plethysmography at 4, 24, and 48 h, 7 d, 18 d, and 4 wk after VX exposure. VX-exposed animals showed a significant decrease in the respiratory frequency (RF) at 24 and 48 h of recovery (p value .0329 and .0142, respectively) compared to the saline control. The tidal volume (TV) slightly increased in VX exposed animals at 24 and significantly at 48 h (p = .02) postexposure. Minute ventilation (MV) increased slightly at 4 h but was reduced at 24 h and remained unchanged at 48 h. Animals exposed to VX also showed an increase in expiratory (Te) and relaxation time (RT) at 24 and 48 h and a small reduction in inspiratory time (Ti) at 24 h. A significant increase in end expiratory pause (EEP) was observed at 48 h after VX exposure (p = .049). The pseudo lung resistance (Penh) was significantly increased at 4 h after VX exposure and remained slightly high even at 48 h. Time-course studies reveal that most of the altered respiratory dynamics returned to normal at 7 d after VX exposure except for EEP, which was high at 7 d and returned to normal at 18 d postexposure. After 1 mo, all the monitored respiratory parameters were within normal ranges. Bronchoalveolar lavage (BAL) 1 mo after exposure showed virtually no difference in protein levels, cholinesterase levels, cell number, and cell death in the exposed and control animals. These results indicate that sublethal concentrations of VX induce changes in respiratory dynamics and functions that over time return to normal levels.

Analysis of non-invasive FBG sensor for monitoring patient vital signs during MRI

NASA Astrophysics Data System (ADS)

Nedoma, Jan; Fajkus, Marcel; Martinek, Radek; Vasinek, Vladimir

2017-10-01

This article focuses on the analysis and verification of a non-invasive fiber Bragg grating (FBG) sensor used for the monitoring of a patient`s heart rate (HR) and respiratory rate (RR) in a magnetic resonance environment (MRI). Measuring heart and respiratory rate were carried out on a group of five volunteers with their written consent during MRI examinations. The type of the scanner used in the experiment was GE Signa HDxt 1.5T. The benefit of this article lies in the design of a sensor in the form of a sensor pad. The sensor is placed beneath a patient`s body lying supine. The purpose is to increase and improve the patient`s safety as well as to help doctors to predict panic and hyperventilation attacks of patients during MRI examinations. Provided Bland-Altman statistical analysis demonstrates the heart and respiratory rate detection with a satisfactory accuracy for all five volunteers.

Continuous positive airway pressure: Physiology and comparison of devices.

PubMed

Gupta, Samir; Donn, Steven M

2016-06-01

Nasal continuous positive airway pressure (CPAP) is increasingly used for respiratory support in preterm babies at birth and after extubation from mechanical ventilation. Various CPAP devices are available for use that can be broadly grouped into continuous flow and variable flow. There are potential physiologic differences between these CPAP systems and the choice of a CPAP device is too often guided by individual expertise and experience rather than by evidence. When interpreting the evidence clinicians should take into account the pressure generation sources, nasal interface, and the factors affecting the delivery of pressure, such as mouth position and respiratory drive. With increasing use of these devices, better monitoring techniques are required to assess the efficacy and early recognition of babies who are failing and in need of escalated support. Copyright © 2016 Elsevier Ltd. All rights reserved.

Baseline body temperatures, heart rates, and respiratory rates of moose in Alaska.

PubMed

Franzmann, A W; Schwartz, C C; Johnson, D C

1984-10-01

Baseline body temperatures (BT), heart rates (HR) and respiratory rates (RR) were obtained from Alaskan moose (Alces alces gigas Miller) at the Moose Research Center (MRC), Alaska. Excitability, seasons and drugs influenced the values to varying degrees. Excitability was the most influential factor. Safe expected ranges were: BT 38.4 to 38.9 C, HR 70 to 91 beats/min (b/min), and RR 13 to 40 respirations/min (r/min). These ranges incorporated all seasons, a central nervous system depressant drug and a paralyzing drug. Values which may be considered critical and an indication that corrective action should be taken include: BT 40.2 C, HR 102 b/min, and RR 40 r/min. It is recommended that persons trained in monitoring vital signs be on hand during moose capture and immobilization procedures.

Resveratrol as a potential therapeutic drug for respiratory system diseases.

PubMed

Zhu, Xiao-Dan; Lei, Xiao-Ping; Dong, Wen-Bin

2017-01-01

Respiratory system diseases are common and major ailments that seriously endanger human health. Resveratrol, a polyphenolic phytoalexin, is considered an anti-inflammatory, antioxidant, and anticancer agent. Thanks to its wide range of biological activities, resveratrol has become a hotspot in many fields, including respiratory system diseases. Indeed, research has demonstrated that resveratrol is helpful to relieve pulmonary function in the general population. Meanwhile, growing evidence indicates that resveratrol plays a protective role in respiratory system diseases. This review aimed to summarize the main protective effects of resveratrol in respiratory system diseases, including its anti-inflammatory, antiapoptotic, antioxidant, antifibrotic, antihypertensive, and anticancer activities. We found that resveratrol plays a protective role in the respiratory system through a variety of mechanisms, and so it may become a new drug for the treatment of respiratory system diseases.

The importance of toxicity in determining the impact of hazardous air pollutants on the respiratory health of children in Tennessee.

PubMed

Moore, Roberta J H; Hotchkiss, Julie L

2016-09-01

Respiratory diseases, exacerbated through point source pollution, are currently among the leading causes of hospitalization of children in the United States. This paper investigates the relationship between the proximity of hazardous air pollutants (HAPs) emitted from Toxic Release Inventory (TRI) facilities and the number of children diagnosed in hospitals with a respiratory disease in Tennessee. The importance of controlling for toxicity of those HAPs is of particular interest. Hospital discharge, socioeconomic, TRI emission, and HAP toxicity data are used to estimate, via Generalized Linear Methods, a logistic regression model describing the relationship between the percent of children living in a zip code area treated for respiratory illness and the average annual emissions over the previous 10 years of HAPs from TRI sites in that area. Controlling for area socioeconomic characteristics, we find that accounting for toxicity is important in uncovering the relationship between HAP emissions and respiratory health of children. A one standard deviation increase in toxicity-weighted emissions per 100 square miles is associated with an increase in the number of children diagnosed with asthma (chronic bronchitis) by about 1205 (260). The evidence suggests that, with a goal to improving children's respiratory health, monitoring the toxicity of chemicals being emitted is at least as important as simply monitoring total emission levels. This suggests that the EPA should consider making efforts toward establishing toxicity adjusted emission guidelines. Copyright © 2016 Elsevier Ltd. All rights reserved.

Developing and validating a new national remote health advice syndromic surveillance system in England.

PubMed

Harcourt, S E; Morbey, R A; Loveridge, P; Carrilho, L; Baynham, D; Povey, E; Fox, P; Rutter, J; Moores, P; Tiffen, J; Bellerby, S; McIntosh, P; Large, S; McMenamin, J; Reynolds, A; Ibbotson, S; Smith, G E; Elliot, A J

2017-03-01

Public Health England (PHE) coordinates a suite of real-time national syndromic surveillance systems monitoring general practice, emergency department and remote health advice data. We describe the development and informal evaluation of a new syndromic surveillance system using NHS 111 remote health advice data. NHS 111 syndromic indicators were monitored daily at national and local level. Statistical models were applied to daily data to identify significant exceedances; statistical baselines were developed for each syndrome and area using a multi-level hierarchical mixed effects model. Between November 2013 and October 2014, there were on average 19 095 NHS 111 calls each weekday and 43 084 each weekend day in the PHE dataset. There was a predominance of females using the service (57%); highest percentage of calls received was in the age group 1-4 years (14%). This system was used to monitor respiratory and gastrointestinal infections over the winter of 2013-14, the potential public health impact of severe flooding across parts of southern England and poor air quality episodes across England in April 2014. This new system complements and supplements the existing PHE syndromic surveillance systems and is now integrated into the routine daily processes that form this national syndromic surveillance service. © Crown copyright 2016.

Animal exposure during burn tests

NASA Technical Reports Server (NTRS)

Gaume, J. G.

1976-01-01

An animal exposure test system has been designed and fabricated for the purpose of collecting physiological and environmental (temperature) data from animal subjects exposed to combustion gases in large scale fire tests. The AETS consists of an open wire mesh, two-compartment cage, one containing an exercise wheel for small rodents, and the other containing one rat instrumented externally for electrocardiogram and respiration. The ECG and respiration sensors are located in a belt placed around the torso of the subject, electrode wires forming an umbilical to a connector in the top of the compartment. A cable extends from the connector to the power supply and signal conditioning electronics. These are connected to a dual-beam oscilloscope for real time monitoring and a magnetic tape recorder having three or more channels. Endpoints observed are bradycardia, cardiac arrhythmias, changes in respiratory pattern, respiratory arrest and cardiac arrest. The ECG record also appears to be a good method of monitoring animal activity as indicated by an increase in EMG noise superimposed on the record during increased activity of the torso musculature. Examples of the recordings are presented and discussed as to their significance regarding toxicity of fire gases.

Soft Stethoscope for Detecting Asthma Wheeze in Young Children

PubMed Central

Yu, Chun; Tsai, Tzu-Hsiu; Huang, Shi-Ing; Lin, Chii-Wann

2013-01-01

Asthma is a chronic disease that is commonly suffered by children. Asthmatic children have a lower quality of life than other children. Physicians and pediatricians recommend that parents record the frequency of attacks and their symptoms to help manage their children's asthma. However, the lack of a convenient device for monitoring the asthmatic condition leads to the difficulties in managing it, especially when it is suffered by young children. This work develops a wheeze detection system for use at home. A small and soft stethoscope was used to collect the respiratory sound. The wheeze detection algorithm was the Adaptive Respiratory Spectrum Correlation Coefficient (RSACC) algorithm, which has the advantages of high sensitivity/specificity and a low computational requirement. Fifty-nine sound files from eight young children (one to seven years old) were collected in the emergency room and analyzed. The results revealed that the system provided 88% sensitivity and 94% specificity in wheeze detection. In conclusion, this small soft stethoscope can be easily used on young children. A noisy environment does not affect the effectiveness of the system in detecting wheeze. Hence, the system can be used at home by parents who wish to evaluate and manage the asthmatic condition of their children. PMID:23744030

Soft stethoscope for detecting asthma wheeze in young children.

PubMed

Yu, Chun; Tsai, Tzu-Hsiu; Huang, Shi-Ing; Lin, Chii-Wann

2013-06-06

Asthma is a chronic disease that is commonly suffered by children. Asthmatic children have a lower quality of life than other children. Physicians and pediatricians recommend that parents record the frequency of attacks and their symptoms to help manage their children's asthma. However, the lack of a convenient device for monitoring the asthmatic condition leads to the difficulties in managing it, especially when it is suffered by young children. This work develops a wheeze detection system for use at home. A small and soft stethoscope was used to collect the respiratory sound. The wheeze detection algorithm was the Adaptive Respiratory Spectrum Correlation Coefficient (RSACC) algorithm, which has the advantages of high sensitivity/specificity and a low computational requirement. Fifty-nine sound files from eight young children (one to seven years old) were collected in the emergency room and analyzed. The results revealed that the system provided 88% sensitivity and 94% specificity in wheeze detection. In conclusion, this small soft stethoscope can be easily used on young children. A noisy environment does not affect the effectiveness of the system in detecting wheeze. Hence, the system can be used at home by parents who wish to evaluate and manage the asthmatic condition of their children.

[Hospital management of acute respiratory failure: the role of the pulmonologist and of the respiratory intensive care unit].

PubMed

Scala, Raffaele

2009-04-01

Acute respiratory failure (ARF) is one of the most common and severe urgencies of the modern medicine which may require the application of mechanical ventilation and a careful monitoring of the patient's conditions. With the popularity of non-invasive ventilation and the interest of the pulmonologist for the care of the respiratory critical patient, in Italy there has been the spreading of Respiratory Intensive Care Units (RICU), which are as intermediate specialist structures in terms of intensity of care between the General Intensive Care Unit and the ordinary ward. In this article, the author analysed the cultural, scientific and organizational aspects of the central role played by the pulmonologist who's working in the RICU in the complex intra-hospital multi-disciplinary management of ARF.

[Study on anti +Gx respiratory maneuver and its training method].

PubMed

Xue, Yue-ying; You, Guang-xing; Wu, Bin; Liu, Xing-hua; Lu, Sheng-qiang; Xie, Bao-sheng

2002-12-01

Objective. To study the anti +Gx respiratory maneuver and its training method. Method. Seven young male subjects undertook the anti +Gx respiratory maneuver training. Their +Gx tolerances were examined on human centrifuge before and after training. The change of respiratory type, breath rate, electrocardiogram, heart rate, arterial oxygen saturation (SaO2), subjective symptom and vision were real-time monitored during the +Gx tolerance examination. Result. Compared with pre-training, the +Gx tolerance increased after training (P<0.05). Dyspnea and chest pain disappeared or obviously lightened and the magnitude of decrease of SaO2 decreased significantly (P<0.05). Conclusion. The above results suggested that the anti +Gx respiratory maneuver can effectively eliminate or alleviate dyspnea and chest pain induced by +Gx stress and increase human +Gx tolerance.

Development of a Multisensory Wearable System for Monitoring Cigarette Smoking Behavior in Free-Living Conditions

PubMed Central

Imtiaz, Masudul Haider; Ramos-Garcia, Raul I.; Senyurek, Volkan Yusuf; Tiffany, Stephen; Sazonov, Edward

2017-01-01

This paper presents the development and validation of a novel multi-sensory wearable system (Personal Automatic Cigarette Tracker v2 or PACT2.0) for monitoring of cigarette smoking in free-living conditions. The contributions of the PACT2.0 system are: (1) the implementation of a complete sensor suite for monitoring of all major behavioral manifestations of cigarette smoking (lighting events, hand-to-mouth gestures, and smoke inhalations); (2) a miniaturization of the sensor hardware to enable its applicability in naturalistic settings; and (3) an introduction of new sensor modalities that may provide additional insight into smoking behavior e.g., Global Positioning System (GPS), pedometer and Electrocardiogram(ECG) or provide an easy-to-use alternative (e.g., bio-impedance respiration sensor) to traditional sensors. PACT2.0 consists of three custom-built devices: an instrumented lighter, a hand module, and a chest module. The instrumented lighter is capable of recording the time and duration of all lighting events. The hand module integrates Inertial Measurement Unit (IMU) and a Radio Frequency (RF) transmitter to track the hand-to-mouth gestures. The module also operates as a pedometer. The chest module monitors the breathing (smoke inhalation) patterns (inductive and bio-impedance respiratory sensors), cardiac activity (ECG sensor), chest movement (three-axis accelerometer), hand-to-mouth proximity (RF receiver), and captures the geo-position of the subject (GPS receiver). The accuracy of PACT2.0 sensors was evaluated in bench tests and laboratory experiments. Use of PACT2.0 for data collection in the community was validated in a 24 h study on 40 smokers. Of 943 h of recorded data, 98.6% of the data was found usable for computer analysis. The recorded information included 549 lighting events, 522/504 consumed cigarettes (from lighter data/self-registered data, respectively), 20,158/22,207 hand-to-mouth gestures (from hand IMU/proximity sensor, respectively) and 114,217/112,175 breaths (from the respiratory inductive plethysmograph (RIP)/bio-impedance sensor, respectively). The proposed system scored 8.3 ± 0.31 out of 10 on a post-study acceptability survey. The results suggest that PACT2.0 presents a reliable platform for studying of smoking behavior at the community level. PMID:29607211

Developing syndrome definitions based on consensus and current use

PubMed Central

Dowling, John N; Baer, Atar; Buckeridge, David L; Cochrane, Dennis; Conway, Michael A; Elkin, Peter; Espino, Jeremy; Gunn, Julia E; Hales, Craig M; Hutwagner, Lori; Keller, Mikaela; Larson, Catherine; Noe, Rebecca; Okhmatovskaia, Anya; Olson, Karen; Paladini, Marc; Scholer, Matthew; Sniegoski, Carol; Thompson, David; Lober, Bill

2010-01-01

Objective Standardized surveillance syndromes do not exist but would facilitate sharing data among surveillance systems and comparing the accuracy of existing systems. The objective of this study was to create reference syndrome definitions from a consensus of investigators who currently have or are building syndromic surveillance systems. Design Clinical condition–syndrome pairs were catalogued for 10 surveillance systems across the United States and the representatives of these systems were brought together for a workshop to discuss consensus syndrome definitions. Results Consensus syndrome definitions were generated for the four syndromes monitored by the majority of the 10 participating surveillance systems: Respiratory, gastrointestinal, constitutional, and influenza-like illness (ILI). An important element in coming to consensus quickly was the development of a sensitive and specific definition for respiratory and gastrointestinal syndromes. After the workshop, the definitions were refined and supplemented with keywords and regular expressions, the keywords were mapped to standard vocabularies, and a web ontology language (OWL) ontology was created. Limitations The consensus definitions have not yet been validated through implementation. Conclusion The consensus definitions provide an explicit description of the current state-of-the-art syndromes used in automated surveillance, which can subsequently be systematically evaluated against real data to improve the definitions. The method for creating consensus definitions could be applied to other domains that have diverse existing definitions. PMID:20819870

Developing syndrome definitions based on consensus and current use.

PubMed

Chapman, Wendy W; Dowling, John N; Baer, Atar; Buckeridge, David L; Cochrane, Dennis; Conway, Michael A; Elkin, Peter; Espino, Jeremy; Gunn, Julia E; Hales, Craig M; Hutwagner, Lori; Keller, Mikaela; Larson, Catherine; Noe, Rebecca; Okhmatovskaia, Anya; Olson, Karen; Paladini, Marc; Scholer, Matthew; Sniegoski, Carol; Thompson, David; Lober, Bill

2010-01-01

Standardized surveillance syndromes do not exist but would facilitate sharing data among surveillance systems and comparing the accuracy of existing systems. The objective of this study was to create reference syndrome definitions from a consensus of investigators who currently have or are building syndromic surveillance systems. Clinical condition-syndrome pairs were catalogued for 10 surveillance systems across the United States and the representatives of these systems were brought together for a workshop to discuss consensus syndrome definitions. Consensus syndrome definitions were generated for the four syndromes monitored by the majority of the 10 participating surveillance systems: Respiratory, gastrointestinal, constitutional, and influenza-like illness (ILI). An important element in coming to consensus quickly was the development of a sensitive and specific definition for respiratory and gastrointestinal syndromes. After the workshop, the definitions were refined and supplemented with keywords and regular expressions, the keywords were mapped to standard vocabularies, and a web ontology language (OWL) ontology was created. The consensus definitions have not yet been validated through implementation. The consensus definitions provide an explicit description of the current state-of-the-art syndromes used in automated surveillance, which can subsequently be systematically evaluated against real data to improve the definitions. The method for creating consensus definitions could be applied to other domains that have diverse existing definitions.

[Monitoring oxygen consumption in energy metabolism in pediatric anesthesia: clinical utility].

PubMed

Calvo Vecino, J M; Abad Gurumeta, A; Navarro Pérez, R; Stolle Dueñas, D; Nieto Moreno, E; De Juan García, S

2010-01-01

To determine changes in oxygen consumption as a marker of energy metabolism during general inhaled anesthesia in pediatric patients and to identify factors that might influence consumption. Prospective, observational, double-blind study in children under inhaled anesthesia in spontaneous ventilation. We monitored heart rate electrocardiogram, noninvasive blood pressure, respiratory frequency, carbon dioxide (CO2) end-expiratory pressure, oxygen saturation by pulse oximetry, state entropy, response entropy, esophageal temperature, and (by indirect calorimetry) oxygen consumption and the respiratory quotient. Capillary blood was extracted every 5 minutes to determine lactate concentration. Thirty-six patients (ASA 1-2) between 5 and 11 years old were included. Mean (SD) oxygen consumption was 0.6 (0.12) mL x kg(-1)min(-1) at baseline, 5.3 (03) mL x kg(-1) min(-1) during maintenance of anesthesia, and 8.1 (1.1) mL x kg(-1) min(-1) on awakening. A progressive increase was detected in lactic acid concentration, from a baseline mean of 0.8 (0.1) mmol/L to 2.2 (0.9) mmol/L half an hour later; the change was unrelated to oxygen consumption. After correcting the flow of normal saline solution to 0.9%, a significant increase in oxygen consumption (P < .05) was detected. Factors that were significantly correlated (P < 0.1 and r of +/- 0.95) were temperature (oxygen consumption decreased > 10% for each degree centigrade decrease), inspired oxygen fraction > 0.8; sharp changes in the expired CO2 fraction exceeding 2 standard deviations (+/- 6), use of nitrous oxide in the gas mix (inspired nitrous oxide fraction > 20%), the length of the sampling line, and increased respiratory frequency. A model with 3 factors was constructed to explain the kinetics of oxygen consumption during anesthesia. Oxygen consumption monitoring may provide an indirect indicator of homeostatic changes during surgery. The ideal system for carrying out such monitoring during anesthesia remains to be found, and the values to guide the anesthesiologist in deciding whether or not to intervene immediately still need to be determined.

A Prospective Cohort Study of Gated Stereotactic Liver Radiation Therapy Using Continuous Internal Electromagnetic Motion Monitoring.

PubMed

Worm, Esben S; Høyer, Morten; Hansen, Rune; Larsen, Lars P; Weber, Britta; Grau, Cai; Poulsen, Per R

2018-06-01

Intrafraction motion can compromise the treatment accuracy in liver stereotactic body radiation therapy (SBRT). Respiratory gating can improve treatment delivery; however, gating based on external motion surrogates is inaccurate. The present study reports the use of Calypso-based internal electromagnetic motion monitoring for gated liver SBRT. Fifteen patients were included in a study of 3-fraction respiratory gated liver SBRT guided by 3 implanted electromagnetic transponders. The planning target volume was created by a 5-mm axial and 7-mm (n = 12) or 10-mm (n = 3) craniocaudal expansion of the clinical target volume (CTV) and covered with 67% of the prescribed CTV mean dose. Treatment was gated to the end-exhale phase of the respiratory cycle with beam-on when the target deviated <3 mm (left-right/anteroposterior) and 4 mm (craniocaudal) from the planned position, according to the monitored (25-Hz) transponder centroid position. The couch was adjusted remotely if baseline drifts >1 to 2 mm occurred. Log files of transponder motion were used to determine the geometric error and reconstruct the delivered CTV dose in the actual gated treatments and in simulated nongated treatments. No severe side effects were observed in relation to transponder implantation. All 45 treatment fractions were successfully guided using the Calypso system. The mean number of couch corrections during each gated fraction was 2.8 (range 0-7). The mean duty cycle during gated treatment was 62.5% (range 29.1%-84.9%). Without gating, the mean 3-dimensional geometric error during a fraction would have been 5.4 mm (range 2.7-12.1). Gating reduced this error to 2.0 mm (range 1.2-3.0). The patient mean reduction in minimum dose to 95% of the CTV relative to the planned dose was 6.0 percentage points (range 0.7-22.0) without gating and 0.8 percentage point (range 0.2-2.0) with gating. Gating using internal motion monitoring was successfully applied for liver SBRT. It markedly improved the geometric and dosimetric accuracy compared with nongated standard treatment. Copyright © 2018 Elsevier Inc. All rights reserved.

PP-16 WEAK ACID REFLUX A TRIGGER FOR RECURRENT RESPIRATORY DISEASES IN CHILDREN.

PubMed

Kostovski, Aco; Zdraveska, Nikolina

2015-10-01

The main advantage of multichannel intraluminar impedance (MII) compared with pH monitoring is its ability to detect both acid and non-acid gastroesophageal reflux (GER) and to determine the characteristics of reflux (liquid or gas). To compare the value of pH monitoring and MII for diagnosis of GER in children who present with refractory respiratory symptoms. A prospective study that included 37 patients, aged 4.25 ± 3.15 years, using combined MII-pH monitoring was performed. Patients were referred for investigation because of suspected GER as the etiology of recurrent respiratory diseases, including recurrent obstructive bronchitis, recurrent pneumonia, laryngitis, and chronic cough. We analyzed the percentage of time during which the pH was less than 4, the numeric and percentile values of acid, weak acid, and non-acid reflux episodes, and the values of liquid and mixed reflux. Diagnostic values were determined separately for pH monitoring and MII using Fisher's exact test. Reflux was detected in 31 patients. pH monitoring was positive in 20 patients (% time during which pH <4 was 17.72 ± 12.06) and negative in 17 patients (2.93% ± 1.67). Both pH and MII were positive in 19 patients: in 11 patients, MII was positive and pH was negative, and in 6 patients, both were negative. Fisher's exact test showed significant statistical difference and superiority of MII in diagnosing GER (p = 0.033). Out of 30 patients with MII-positive results, 15 had both acid and weak acid reflux episodes, 3 had only acid reflux, 8 had weak acid reflux, and 3 had non-acid reflux. Sixteen patients had mixed (liquid and gas) reflux, and 14 had both liquid and mixed reflux. This study suggests that significant numbers of GER include weak acid reflux that cannot be detected by pH probes alone. The weak acid reflux could be a trigger for recurrent respiratory symptoms. Combining pH with MII monitoring is a valuable diagnostic method for diagnosing GER in children.

Novel Seals and Specialty Component Attachment Mechanisms for Respiratory Protection System (RESPO 21)

DTIC Science & Technology

1992-10-01

diagnosing heart diies.. empli,%% a pluralaiN of detector etements for de- tectimg hoth the comrnents and the time inersal betw~en components of the portions...ignil to produce signals indicative of dif. lion. With or without the membrane the device mnay COO fcrent forms of heart disease sltute a supporting...adapted to face the face of the wearer. means for moving the mask shell toward and away 1. The combination with a fetal monitoring device. hr,- from a

Practical Recommendations for Diagnosis and Management of Respiratory Muscle Weakness in Late-Onset Pompe Disease

PubMed Central

Boentert, Matthias; Prigent, Hélène; Várdi, Katalin; Jones, Harrison N.; Mellies, Uwe; Simonds, Anita K.; Wenninger, Stephan; Barrot Cortés, Emilia; Confalonieri, Marco

2016-01-01

Pompe disease is an autosomal-recessive lysosomal storage disorder characterized by progressive myopathy with proximal muscle weakness, respiratory muscle dysfunction, and cardiomyopathy (in infants only). In patients with juvenile or adult disease onset, respiratory muscle weakness may decline more rapidly than overall neurological disability. Sleep-disordered breathing, daytime hypercapnia, and the need for nocturnal ventilation eventually evolve in most patients. Additionally, respiratory muscle weakness leads to decreased cough and impaired airway clearance, increasing the risk of acute respiratory illness. Progressive respiratory muscle weakness is a major cause of morbidity and mortality in late-onset Pompe disease even if enzyme replacement therapy has been established. Practical knowledge of how to detect, monitor and manage respiratory muscle involvement is crucial for optimal patient care. A multidisciplinary approach combining the expertise of neurologists, pulmonologists, and intensive care specialists is needed. Based on the authors’ own experience in over 200 patients, this article conveys expert recommendations for the diagnosis and management of respiratory muscle weakness and its sequelae in late-onset Pompe disease. PMID:27763517

Breathing and Vocal Control: The Respiratory System as both a Driver and Target of Telencephalic Vocal Motor Circuits in Songbirds

PubMed Central

Schmidt, Marc F.; McLean, Judith; Goller, Franz

2011-01-01

The production of vocalizations is intimately linked to the respiratory system. Despite our understanding of neural circuits that generate normal respiratory patterns, very little is understood regarding how these ponto-medullary circuits become engaged during vocal production. Songbirds offer a potentially powerful model system for addressing this relationship. Songs dramatically alter the respiratory pattern in ways that are often highly predictable and songbirds have a specialized telencephalic vocal motor circuit that provides massive innervation to a brainstem respiratory network that shares many similarities with its mammalian counterpart. In this review, we highlight interactions between the song motor circuit and the respiratory system, describing how both systems likely interact to produce the complex respiratory patterns that are observed during vocalization. We also discuss how the respiratory system, through its bilateral bottom-up projections to thalamus, might play a key role in sending precisely timed signals that synchronize premotor activity in both hemispheres. PMID:21984733

An innovative design for cardiopulmonary resuscitation manikins based on a human-like thorax and embedded flow sensors.

PubMed

Thielen, Mark; Joshi, Rohan; Delbressine, Frank; Bambang Oetomo, Sidarto; Feijs, Loe

2017-03-01

Cardiopulmonary resuscitation manikins are used for training personnel in performing cardiopulmonary resuscitation. State-of-the-art cardiopulmonary resuscitation manikins are still anatomically and physiologically low-fidelity designs. The aim of this research was to design a manikin that offers high anatomical and physiological fidelity and has a cardiac and respiratory system along with integrated flow sensors to monitor cardiac output and air displacement in response to cardiopulmonary resuscitation. This manikin was designed in accordance with anatomical dimensions using a polyoxymethylene rib cage connected to a vertebral column from an anatomical female model. The respiratory system was composed of silicon-coated memory foam mimicking lungs, a polyvinylchloride bronchus and a latex trachea. The cardiovascular system was composed of two sets of latex tubing representing the pulmonary and aortic arteries which were connected to latex balloons mimicking the ventricles and lumped abdominal volumes, respectively. These balloons were filled with Life/form simulation blood and placed inside polyether foam. The respiratory and cardiovascular systems were equipped with flow sensors to gather data in response to chest compressions. Three non-medical professionals performed chest compressions on this manikin yielding data corresponding to force-displacement while the flow sensors provided feedback. The force-displacement tests on this manikin show a desirable nonlinear behaviour mimicking chest compressions during cardiopulmonary resuscitation in humans. In addition, the flow sensors provide valuable data on the internal effects of cardiopulmonary resuscitation. In conclusion, scientifically designed and anatomically high-fidelity designs of cardiopulmonary resuscitation manikins that embed flow sensors can improve physiological fidelity and provide useful feedback data.

Medical applications of shortwave FM radar: remote monitoring of cardiac and respiratory motion.

PubMed

Mostov, K; Liptsen, E; Boutchko, R

2010-03-01

This article introduces the use of low power continuous wave frequency modulated radar for medical applications, specifically for remote monitoring of vital signs in patients. Gigahertz frequency radar measures the electromagnetic wave signal reflected from the surface of a human body and from tissue boundaries. Time series analysis of the measured signal provides simultaneous information on range, size, and reflective properties of multiple targets in the field of view of the radar. This information is used to extract the respiratory and cardiac rates of the patient in real time. The results from several preliminary human subject experiments are provided. The heart and respiration rate frequencies extracted from the radar signal match those measured independently for all the experiments, including a case when additional targets are simultaneously resolved in the field of view and a case when only the patient's extremity is visible to the radar antennas. Micropower continuous wave FM radar is a reliable, robust, inexpensive, and harmless tool for real-time monitoring of the cardiac and respiratory rates. Additionally, it opens a range of new and exciting opportunities in diagnostic and critical care medicine. Differences between the presented approach and other types of radars used for biomedical applications are discussed.

The NAPRESSIM trial: the use of low-dose, prophylactic naloxone infusion to prevent respiratory depression with intrathecally administered morphine in elective hepatobiliary surgery: a study protocol and statistical analysis plan for a randomised controlled trial.

PubMed

Cosgrave, David; Galligan, Marie; Soukhin, Era; McMullan, Victoria; McGuinness, Siobhan; Puttappa, Anand; Conlon, Niamh; Boylan, John; Hussain, Rabia; Doran, Peter; Nichol, Alistair

2017-12-29

Intrathecally administered morphine is effective as part of a postoperative analgesia regimen following major hepatopancreaticobiliary surgery. However, the potential for postoperative respiratory depression at the doses required for effective analgesia currently limits its clinical use. The use of a low-dose, prophylactic naloxone infusion following intrathecally administered morphine may significantly reduce postoperative respiratory depression. The NAPRESSIM trial aims to answer this question. 'The use of low-dose, prophylactic naloxone infusion to prevent respiratory depression with intrathecally administered morphine' trial is an investigator-led, single-centre, randomised, double-blind, placebo-controlled, double-arm comparator study. The trial will recruit 96 patients aged > 18 years, undergoing major open hepatopancreaticobiliary resections, who are receiving intrathecally administered morphine as part of a standard anaesthetic regimen. It aims to investigate whether the prophylactic administration of naloxone via intravenous infusion compared to placebo will reduce the proportion of episodes of respiratory depression in this cohort of patients. Trial patients will receive an infusion of naloxone or placebo, commenced within 1 h of postoperative extubation continued until the first postoperative morning. The primary outcome is the rate of respiratory depression in the intervention group as compared to the placebo group. Secondary outcomes include pain scores, rates of nausea and vomiting, pruritus, sedation scores and adverse outcomes. We will also employ a novel, non-invasive, respiratory minute volume monitor (ExSpiron 1Xi, Respiratory Motion, Inc., 411 Waverley Oaks Road, Building 1, Suite 150, Waltham, MA, USA) to assess the monitor's accuracy for detecting respiratory depression. The trial aims to provide a clear management plan to prevent respiratory depression after the intrathecal administration of morphine, and thereby improve patient safety. ClinicalTrials.gov, ID: NCT02885948 . Registered retrospectively on 4 July 2016. Protocol Version 2.0, 3 April 2017. Protocol identification (code or reference number): UCDCRC/15/006 EudraCT registration number: 2015-003504-22. Registered on 5 August 2015.

Distinct respiratory responses of soils to complex organic substrate are governed predominantly by soil architecture and its microbial community.

PubMed

Fraser, F C; Todman, L C; Corstanje, R; Deeks, L K; Harris, J A; Pawlett, M; Whitmore, A P; Ritz, K

2016-12-01

Factors governing the turnover of organic matter (OM) added to soils, including substrate quality, climate, environment and biology, are well known, but their relative importance has been difficult to ascertain due to the interconnected nature of the soil system. This has made their inclusion in mechanistic models of OM turnover or nutrient cycling difficult despite the potential power of these models to unravel complex interactions. Using high temporal-resolution respirometery (6 min measurement intervals), we monitored the respiratory response of 67 soils sampled from across England and Wales over a 5 day period following the addition of a complex organic substrate (green barley powder). Four respiratory response archetypes were observed, characterised by different rates of respiration as well as different time-dependent patterns. We also found that it was possible to predict, with 95% accuracy, which type of respiratory behaviour a soil would exhibit based on certain physical and chemical soil properties combined with the size and phenotypic structure of the microbial community. Bulk density, microbial biomass carbon, water holding capacity and microbial community phenotype were identified as the four most important factors in predicting the soils' respiratory responses using a Bayesian belief network. These results show that the size and constitution of the microbial community are as important as physico-chemical properties of a soil in governing the respiratory response to OM addition. Such a combination suggests that the 'architecture' of the soil, i.e. the integration of the spatial organisation of the environment and the interactions between the communities living and functioning within the pore networks, is fundamentally important in regulating such processes.

An ECG electrode-mounted heart rate, respiratory rhythm, posture and behavior recording system.

PubMed

Yoshimura, Takahiro; Yonezawa, Yoshiharu; Maki, Hiromichi; Ogawa, Hidekuni; Ninomiya, Ishio; Morton Caldwell, W

2004-01-01

R-R interval, respiration rhythm, posture and behavior recording system has been developed for monitoring a patient's cardiovascular regulatory system in daily life. The recording system consists of three ECG chest electrodes, a variable gain instrumentation amplifier, a dual axis accelerometer, a low power 8-bit single-chip microcomputer and a 1024 KB EEPROM. The complete system is mounted on the chest electrodes. R-R interval and respiration rhythm are calculated by the R waves detected from the ECG. Posture and behavior such as walking and running are detected from the body movements recorded by the accelerometer. The detected data are stored by the EEPROM and, after recording, are downloaded to a desktop computer for analysis.

Design of a Novel Flexible Capacitive Sensing Mattress for Monitoring Sleeping Respiratory

PubMed Central

Chang, Wen-Ying; Huang, Chien-Chun; Chen, Chi-Chun; Chang, Chih-Cheng; Yang, Chin-Lung

2014-01-01

In this paper, an algorithm to extract respiration signals using a flexible projected capacitive sensing mattress (FPCSM) designed for personal health assessment is proposed. Unlike the interfaces of conventional measurement systems for poly-somnography (PSG) and other alternative contemporary systems, the proposed FPCSM uses projected capacitive sensing capability that is not worn or attached to the body. The FPCSM is composed of a multi-electrode sensor array that can not only observe gestures and motion behaviors, but also enables the FPCSM to function as a respiration monitor during sleep using the proposed approach. To improve long-term monitoring when body movement is possible, the FPCSM enables the selection of data from the sensing array, and the FPCSM methodology selects the electrodes with the optimal signals after the application of a channel reduction algorithm that counts the reversals in the capacitive sensing signals as a quality indicator. The simple algorithm is implemented in the time domain. The FPCSM system is used in experimental tests and is simultaneously compared with a commercial PSG system for verification. Multiple synchronous measurements are performed from different locations of body contact, and parallel data sets are collected. The experimental comparison yields a correlation coefficient of 0.88 between FPCSM and PSG, demonstrating the feasibility of the system design. PMID:25420152

[Clinical experiences with a new reusable pressure transducer].

PubMed

Brandt, L; Dick, W

1987-08-01

Invasive blood pressure monitoring is increasing in anesthesia and intensive care. Compared to noninvasive methods, it has some decisive advantages: (1) blood pressure trends can be assessed beat by beat, which is important especially in situations of cardiac arrhythmia; (2) respiratory changes in blood pressure as one sign of hypovolemia can be detected easily; and (3) pressure changes induced by the autonomic nervous system become apparent. We studied a new, reusable pressure transducer system, the Medex Novatrans-MX800 in routine intra- and postoperative monitoring of patients undergoing cardiac surgery using the following criteria: (1) handling; (2) accuracy of measurement; (3) durability; and (4) costs. The system is easy to use and has a low susceptability to breakdown. In 29 of 31 transducers tested, the error of measurement over a range of 0-150 mmHg was less than 2% as reported by the manufacturer. Two transducers showed errors of measurement over 5% after 60 times of reuse. The mean reusability rate until the transducer became defective was 75.8 +/- 17.3 in the operating room (19 transducers tested) and 59.7 +/- 29 in the intensive care unit (12 transducers tested, 11 still in use). A comparison of costs shows that the Novatrans-MX800 system is the cheapest system for invasive pressure monitoring available at this time.

Visualization of tumor vascular reactivity in response to respiratory challenges by optical coherence tomography (Conference Presentation)

NASA Astrophysics Data System (ADS)

Kim, Hoon Sup; Lee, Songhyun; Lee, Kiri; Eom, Tae Joong; Kim, Jae G.

2016-02-01

We previously reported the potential of using vascular reactivity during respiratory challenges as a marker to predict the response of breast tumor to chemotherapy in a rat model by using a continuous wave near-infrared spectroscopy. However, it cannot visualize how the vascular reactivity from tumor vessel can predict the tumor response to its treatment. In this study, we utilized a spectral domain optical coherence tomography (SD-OCT) system to visualize vascular reactivity of both tumor and normal vasculature during respiratory challenges in a mouse model. We adapted intensity based Doppler variance algorithm to draw angiogram from the ear of mouse (8-week-old Balb/c nu/nu). Animals were anesthetized using 1.5% isoflurane, and the body temperature was maintained by a heating pad. Inhalational gas was switched from air (10min) to 100% oxygen (10min), and a pulse oximeter was used to monitor arterial oxygen saturation and heart rate. OCT angiograms were acquired 5 min after the onset of each gas. The vasoconstriction effect of hyperoxic gas on vasculature was shown by subtracting an en-face image acquired during 100% oxygen from the image acquired during air inhalation. The quantitative change in the vessel diameter was measured from the en-face OCT images of the individual blood vessels. The percentage of blood vessel diameter reduction varied from 1% to 12% depending on arterial, capillary, or venous blood vessel. The vascular reactivity change during breast tumor progression and post chemotherapy will be monitored by OCT angiography.

A CAM (continuous air monitor) sampler for collecting and assessing alpha-emitting aerosol particles

DOE Office of Scientific and Technical Information (OSTI.GOV)

McFarland, A.R.; Bethel, E.L.; Ortiz, C.A.

1991-07-01

A new continuous air monitor (CAM) sampler for assessing alpha-emitting transuranic aerosol particles has been developed. The system has been designed to permit collection of particles that can potentially penetrate into the thoracic region of the human respiratory system. Wind tunnel testing of the sampler has been used to characterize the penetration of aerosol to the collection filter. Results show that greater than or equal to 50% of 10-micrograms aerodynamic equivalent diameter (AED) particles are collected by the filter at wind speeds of 0.3 to 2 m s-1 and at sampling flow rates of 28 to 113 L min-1 (1more » to 4 cfm). The deposition of 10-microns AED particles takes place primarily in the center of the filter, where the counting efficiency of the detector is highest.« less

Effects of Aging on the Respiratory System.

ERIC Educational Resources Information Center

Levitzky, Michael G.

1984-01-01

Relates alterations in respiratory system functions occurring with aging to changes in respiratory system structure during the course of life. Main alterations noted include loss of alveolar elastic recoil, alteration in chest wall structure and decreased respiratory muscle strength, and loss of surface area and changes in pulmonary circulation.…

Monitorization of the effects of spinal anaesthesia on cerebral oxygen saturation in elder patients using near-infrared spectroscopy.

PubMed

Kusku, Aysegul; Demir, Guray; Cukurova, Zafer; Eren, Gulay; Hergunsel, Oya

2014-01-01

Central blockage provided by spinal anaesthesia enables realization of many surgical procedures, whereas hemodynamic and respiratory changes influence systemic oxygen delivery leading to the potential development of series of problems such as cerebral ischemia, myocardial infarction and acute renal failure. This study was intended to detect potentially adverse effects of hemodynamic and respiratory changes on systemic oxygen delivery using cerebral oxymetric methods in patients who underwent spinal anaesthesia. Twenty-five ASA I-II Group patients aged 65-80 years scheduled for unilateral inguinal hernia repair under spinal anaesthesia were included in the study. Following standard monitorization baseline cerebral oxygen levels were measured using cerebral oximetric methods. Standardized Mini Mental Test (SMMT) was applied before and after the operation so as to determine the level of cognitive functioning of the cases. Using a standard technique and equal amounts of a local anaesthetic drug (15mg bupivacaine 5%) intratechal blockade was performed. Mean blood pressure (MBP), maximum heart rate (MHR), peripheral oxygen saturation (SpO2) and cerebral oxygen levels (rSO2) were preoperatively monitored for 60min. Pre- and postoperative haemoglobin levels were measured. The variations in data obtained and their correlations with the cerebral oxygen levels were investigated. Significant changes in pre- and postoperative measurements of haemoglobin levels and SMMT scores and intraoperative SpO2 levels were not observed. However, significant variations were observed in intraoperative MBP, MHR and rSO2 levels. Besides, a correlation between variations in rSO2, MBP and MHR was determined. Evaluation of the data obtained in the study demonstrated that post-spinal decline in blood pressure and also heart rate decreases systemic oxygen delivery and adversely effects cerebral oxygen levels. However, this downward change did not result in deterioration of cognitive functioning. Copyright © 2013 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

[Monitorization of the effects of spinal anaesthesia on cerebral oxygen saturation in elder patients using near-infrared spectroscopy].

PubMed

Kusku, Aysegul; Demir, Guray; Cukurova, Zafer; Eren, Gulay; Hergunsel, Oya

2014-01-01

Central blockage provided by spinal anaesthesia enables realization of many surgical procedures, whereas hemodynamic and respiratory changes influence systemic oxygen delivery leading to the potential development of series of problems such as cerebral ischemia, myocardial infarction and acute renal failure. This study was intended to detect potentially adverse effects of hemodynamic and respiratory changes on systemic oxygen delivery using cerebral oxymetric methods in patients who underwent spinal anaesthesia. Twenty-five ASA I-II Group patients aged 65-80 years scheduled for unilateral inguinal hernia repair under spinal anaesthesia were included in the study. Following standard monitorization baseline cerebral oxygen levels were measured using cerebral oximetric methods. Standardized Mini Mental Test (SMMT) was applied before and after the operation so as to determine the level of cognitive functioning of the cases. Using a standard technique and equal amounts of a local anaesthetic drug (15mg bupivacaine 5%) intratechal blockade was performed. Mean blood pressure (MBP), maximum heart rate (MHR), peripheral oxygen saturation (SpO2) and cerebral oxygen levels (rSO2) were preoperatively monitored for 60min. Pre- and postoperative haemoglobin levels were measured. The variations in data obtained and their correlations with the cerebral oxygen levels were investigated. Significant changes in pre- and postoperative measurements of haemoglobin levels and SMMT scores and intraoperative SpO2 levels were not observed. However, significant variations were observed in intraoperative MBP, MHR and rSO2 levels. Besides, a correlation between variations in rSO2, MBP and MHR was determined. Evaluation of the data obtained in the study demonstrated that post-spinal decline in blood pressure and also heart rate decreases systemic oxygen delivery and adversely effects cerebral oxygen levels. However, this downward change did not result in deterioration of cognitive functioning. Copyright © 2013 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

Management of Respiratory Motion in Extracorporeal High-Intensity Focused Ultrasound Treatment in Upper Abdominal Organs: Current Status and Perspectives

DOE Office of Scientific and Technical Information (OSTI.GOV)

Muller, A., E-mail: arnaud.muller@chu-lyon.fr; Petrusca, L.; Auboiroux, V.

2013-12-15

Extracorporeal high-intensity focused ultrasound (HIFU) is a minimally invasive therapy considered with increased interest for the ablation of small tumors in deeply located organs while sparing surrounding critical tissues. A multitude of preclinical and clinical studies have showed the feasibility of the method; however, concurrently they showed several obstacles, among which the management of respiratory motion of abdominal organs is at the forefront. The aim of this review is to describe the different methods that have been proposed for managing respiratory motion and to identify their advantages and weaknesses. First, we specify the characteristics of respiratory motion for the liver,more » kidneys, and pancreas and the problems it causes during HIFU planning, treatment, and monitoring. Second, we make an inventory of the preclinical and clinical approaches used to overcome the problem of organ motion. Third, we analyze their respective benefits and drawbacks to identify the remaining physical, technological, and clinical challenges. We thereby consider the outlook of motion compensation techniques and those that would be the most suitable for clinical use, particularly under magnetic resonance thermometry monitoring.« less

NIV-Helmet in Severe Hypoxemic Acute Respiratory Failure.

PubMed

Martins, Joana; Nunes, P; Silvestre, C; Abadesso, C; Loureiro, H; Almeida, H

2015-01-01

Noninvasive ventilation (NIV) is a method to be applied in acute respiratory failure, given the possibility of avoiding tracheal intubation and conventional ventilation. A previous healthy 5-month-old boy developed low-grade intermittent fever, flu-like symptoms, and dry cough for 3 days. On admission, he showed severe respiratory distress with SpO2/FiO2 ratio of 94. Subsequent evaluation identified an RSV infection complicated with an increase of inflammatory parameters (reactive C protein 15 mg/dL). Within the first hour after NIV-helmet CPAP SpO2/FiO2 ratio increased to 157. This sustained improvement allowed the continuing of this strategy. After 102 h, he was disconnected from the helmet CPAP device. The NIV use in severe hypoxemic acute respiratory failure should be carefully monitored as the absence of clinical improvement has a predictive value in the need to resume to intubation and mechanical ventilation. We emphasize that SpO2/FiO2 ratio is a valuable monitoring instrument. Helmet interface use represents a more comfortable alternative for providing ventilatory support, particularly to small infants, which constitute a sensitive group within pediatric patients.

RESPIRATORY DYSFUNCTION IN UNSEDATED DOGS WITH GOLDEN RETRIEVER MUSCULAR DYSTROPHY

PubMed Central

DeVanna, Justin C.; Kornegay, Joe N.; Bogan, Daniel J.; Bogan, Janet R.; Dow, Jennifer L.; Hawkins, Eleanor C.

2013-01-01

Golden retriever muscular dystrophy (GRMD) is a well-established model of Duchenne muscular dystrophy. The value of this model would be greatly enhanced with practical tools to monitor progression of respiratory dysfunction during treatment trials. Arterial blood gas analysis, tidal breathing spirometry, and respiratory inductance plethysmography (RIP) were performed to determine if quantifiable abnormalities could be identified in unsedated, untrained, GRMD dogs. Results from 11 dogs with a mild phenotype of GRMD and 11 age-matched carriers were compared. Arterial blood gas analysis was successfully performed in all dogs, spirometry in 21 of 22 (95%) dogs, and RIP in 18 of 20 (90%) dogs. Partial pressure of carbon dioxide and bicarbonate concentration were higher in GRMD dogs. Tidal breathing peak expiratory flows were markedly higher in GRMD dogs. Abnormal abdominal motion was present in 7 of 10 (70%) GRMD dogs. Each technique provided objective, quantifiable measures that will be useful for monitoring respiratory function in GRMD dogs during clinical trials while avoiding the influence of sedation on results. Increased expiratory flows and the pattern of abdominal breathing are novel findings, not reported in people with Duchenne muscular dystrophy, and might be a consequence of hyperinflation. PMID:24295812

Noninvasive ventilation for patients with acute lung injury or acute respiratory distress syndrome.

PubMed

Nava, Stefano; Schreiber, Ania; Domenighetti, Guido

2011-10-01

Few studies have been performed on noninvasive ventilation (NIV) to treat hypoxic acute respiratory failure in patients with acute lung injury (ALI) or acute respiratory distress syndrome (ARDS). The outcomes of these patients, for whom endotracheal intubation is not mandatory, depend on the degree of hypoxia, the presence of comorbidities and complications, and their illness severity. The use of NIV as an alternative to invasive ventilation in severely hypoxemic patients with ARDS (ie, P(aO(2))/F(IO(2)) < 200) is not generally advisable and should be limited to hemodynamically stable patients who can be closely monitored in an intensive care unit by highly skilled staff. Early NIV application may be extremely helpful in immunocompromised patients with pulmonary infiltrates, in whom intubation dramatically increases the risk of infection, pneumonia, and death. The use of NIV in patients with severe acute respiratory syndrome and other airborne diseases has generated debate, despite encouraging clinical results, mainly because of safety issues. Overall, the high rate of NIV failure suggests a cautious approach to NIV use in patients with ALI/ARDS, including early initiation, intensive monitoring, and prompt intubation if signs of NIV failure emerge.

Vascular changes in the retina in patients with chronic respiratory insufficiency.

PubMed

Adžić-Zečević, Antoaneta; Milojko, Biljana; Janićijević-Petrović, Mirjana A

2014-12-01

Chronic respiratory insufficiency is a pathological state which occurs as a result of respiratory system inability to maintain normal gas exchange between the outside air and circulating blood. For the purposes of human organism's proper functioning, it is necessary that a certain amount of air in the lungs comes into contact with a certain amount of blood within a unit of time, so that an adequate hemoglobin oxygenation could be achieved. Then, hemoglobin from erythrocytes in the blood supply delivers oxygen to all the tissues and cells of the body including the eye. Direct impact of hypoxemia and hypercapnia on the wall of arterioles, venules and capillaries results in a severe vasodilatation along with the increased permeability of the walls causing clinically evident changes in the retina. The aim of this study was to determine the degree of ocular changes in retina with patients suffering from chronic respiratory insufficiency. A prospective study was conducted on 80 patients, 40 patients with respiratory failure and 40 patients with chronic obstructive pulmonary disease an and bronchial asthma (the control group). In all the patients direct and indirect ophthalmoscopy and fluoresceine angiography was performed. Clinically visible fundus and retina changes in patients suffering from chronic respiratory failure were categorized as mild (dilatation and retinal veins and arteries tortosion up to the mid-periphery), moderate (retinal hemorrhage) and severe (optic nerve edema, macular edema, superficial and deep retinal hemorrhages and venous occlusion). In the patients suffering from respiratory insufficiency the changes in retinal blood vessels were found [in 18 (45%) mild, in 13 (32.5%) moderate, and in 9 (22%) severe], while in the patients with chronic obstructive pulmonary disease and bronchial asthma (without respiratory insufficiency) no changes were recognized. The results of this study indicate the need for ophthalmologic examination in patients with chronic respiratory insufficiency. It is important to recognize, identify and quantify the changes on retinal blood vessels which are clinically significant. It is necessary to provide their monitoring and to prescribe proper therapeutic treatment in order to preserve visual functions.

Creating Clinical Fuzzy Automata with Fuzzy Arden Syntax.

PubMed

de Bruin, Jeroen S; Steltzer, Heinz; Rappelsberger, Andrea; Adlassnig, Klaus-Peter

2017-01-01

Formal constructs for fuzzy sets and fuzzy logic are incorporated into Arden Syntax version 2.9 (Fuzzy Arden Syntax). With fuzzy sets, the relationships between measured or observed data and linguistic terms are expressed as degrees of compatibility that model the unsharpness of the boundaries of linguistic terms. Propositional uncertainty due to incomplete knowledge of relationships between clinical linguistic concepts is modeled with fuzzy logic. Fuzzy Arden Syntax also supports the construction of fuzzy state monitors. The latter are defined as monitors that employ fuzzy automata to observe gradual transitions between different stages of disease. As a use case, we re-implemented FuzzyARDS, a previously published clinical monitoring system for patients suffering from acute respiratory distress syndrome (ARDS). Using the re-implementation as an example, we show how key concepts of fuzzy automata, i.e., fuzzy states and parallel fuzzy state transitions, can be implemented in Fuzzy Arden Syntax. The results showed that fuzzy state monitors can be implemented in a straightforward manner.

STS-107 Crew Interviews: Laurel Clark, Mission Specialist

NASA Technical Reports Server (NTRS)

2002-01-01

STS-107 Mission Specialist 4 Laurel Clark is seen during this preflight interview, where she gives a quick overview of the mission before answering questions about her inspiration to become an astronaut and her career path. Clark outlines her role in the mission in general, and specifically in conducting onboard science experiments. She discusses the following suite of experiments and instruments in detail: ARMS (Advanced Respiratory Monitoring System) and the European Space Agency's Biopack. Clark also mentions on-board activities and responsibilities during launch and reentry, mission training, and microgravity research. In addition, she touches on the use of crew members as research subjects including pre and postflight monitoring activities, the emphasis on crew safety and the value of international cooperation.

Anesthetic Management in Pediatric Patient for Percutaneous Endoscopic Gastrostomy with Mitochondrial Myopathy: Leigh Syndrome

PubMed Central

Kiliç, Ebru Tarikçi; Gerenli, Nelgin; Akdemir, Mehmet Salim; Tastan, Necmi Onur; Atag, Egemen

2018-01-01

Leigh syndrome (LS) is a rare disease mainly affecting the central nervous system due to the abnormalities of mitochondrial energy generation and seen in early childhood with progressive loss of movement, mental abilities, seizures, nystagmus, ophthalmoparesis, optic atrophy, ataxia, dystonia, or respiratory failure. Anesthesia and surgery exacerbate the risks of aspiration, wheezing, and breathing difficulties. Tracheal irritability can be stimulated with the efforts of intubation. We report the anesthetic management of a rare case of an 11-year-old boy with a severe form of LS for percutaneous endoscopic gastrostomy insertion. The patient was closely monitored during the procedure and the postoperative period. Carefully chosen anesthetic agents, good pain control, and close monitoring are essential. PMID:29628597

Establishment and evaluation of a theater influenza monitoring platform.

PubMed

Wang, Jian; Yang, Hui-Suo; Deng, Bing; Shi, Meng-Jing; Li, Xiang-Da; Nian, Qing-Gong; Song, Wen-Jing; Bing, Feng; Li, Qing-Feng

2017-11-20

Influenza is an acute respiratory infectious disease with a high incidence rate in the Chinese army, which directly disturbs military training and affects soldiers' health. Influenza surveillance systems are widely used around the world and play an important role in influenza epidemic prevention and control. As a theater centers for disease prevention and control, we established an influenza monitoring platform (IMP) in 2014 to strengthen the monitoring of influenza-like illness and influenza virus infection. In this study, we introduced the constitution, influenza virus detection, and quality control for an IMP. The monitoring effect was also evaluated by comparing the monitoring data with data from national influenza surveillance systems. The experiences and problems associated with the platform also were summarized. A theater IMP was established based on 3 levels of medical units, including monitoring sites, testing laboratories and a checking laboratory. A series of measures were taken to guarantee the quality of monitoring, such as technical training, a unified process, sufficient supervision and timely communication. The platform has run smoothly for 3 monitoring years to date. In the 2014-2015 and 2016-2017 monitoring years, sample amount coincided with that obtained from the National Influenza Surveillance program. In the 2015-2016 monitoring year, due to the strict prevention and control measures, an influenza epidemic peak was avoided in monitoring units, and the monitoring data did not coincide with that of the National Influenza Surveillance program. Several problems, including insufficient attention, unreasonable administrative intervention or subordination relationships, and the necessity of detection in monitoring sites were still observed. A theater IMP was established rationally and played a deserved role in the prevention and control of influenza. However, several problems remain to be solved.

Estimating actigraphy from motion artifacts in ECG and respiratory effort signals.

PubMed

Fonseca, Pedro; Aarts, Ronald M; Long, Xi; Rolink, Jérôme; Leonhardt, Steffen

2016-01-01

Recent work in unobtrusive sleep/wake classification has shown that cardiac and respiratory features can help improve classification performance. Nevertheless, actigraphy remains the single most discriminative modality for this task. Unfortunately, it requires the use of dedicated devices in addition to the sensors used to measure electrocardiogram (ECG) or respiratory effort. This paper proposes a method to estimate actigraphy from the body movement artifacts present in the ECG and respiratory inductance plethysmography (RIP) based on the time-frequency analysis of those signals. Using a continuous wavelet transform to analyze RIP, and ECG and RIP combined, it provides a surrogate measure of actigraphy with moderate correlation (for ECG+RIP, ρ = 0.74, p  <  0.001) and agreement (mean bias ratio of 0.94 and 95% agreement ratios of 0.11 and 8.45) with reference actigraphy. More important, it can be used as a replacement of actigraphy in sleep/wake classification: after cross-validation with a data set comprising polysomnographic (PSG) recordings of 15 healthy subjects and 25 insomniacs annotated by an external sleep technician, it achieves a statistically non-inferior classification performance when used together with respiratory features (average κ of 0.64 for 15 healthy subjects, and 0.50 for a dataset with 40 healthy and insomniac subjects), and when used together with respiratory and cardiac features (average κ of 0.66 for 15 healthy subjects, and 0.56 for 40 healthy and insomniac subjects). Since this method eliminates the need for a dedicated actigraphy device, it reduces the number of sensors needed for sleep/wake classification to a single sensor when using respiratory features, and to two sensors when using respiratory and cardiac features without any loss in performance. It offers a major benefit in terms of comfort for long-term home monitoring and is immediately applicable for legacy ECG and RIP monitoring devices already used in clinical practice and which do not have an accelerometer built-in.

Evaluation of sliding baseline methods for spatial estimation for cluster detection in the biosurveillance system

PubMed Central

Xing, Jian; Burkom, Howard; Moniz, Linda; Edgerton, James; Leuze, Michael; Tokars, Jerome

2009-01-01

Background The Centers for Disease Control and Prevention's (CDC's) BioSense system provides near-real time situational awareness for public health monitoring through analysis of electronic health data. Determination of anomalous spatial and temporal disease clusters is a crucial part of the daily disease monitoring task. Our study focused on finding useful anomalies at manageable alert rates according to available BioSense data history. Methods The study dataset included more than 3 years of daily counts of military outpatient clinic visits for respiratory and rash syndrome groupings. We applied four spatial estimation methods in implementations of space-time scan statistics cross-checked in Matlab and C. We compared the utility of these methods according to the resultant background cluster rate (a false alarm surrogate) and sensitivity to injected cluster signals. The comparison runs used a spatial resolution based on the facility zip code in the patient record and a finer resolution based on the residence zip code. Results Simple estimation methods that account for day-of-week (DOW) data patterns yielded a clear advantage both in background cluster rate and in signal sensitivity. A 28-day baseline gave the most robust results for this estimation; the preferred baseline is long enough to remove daily fluctuations but short enough to reflect recent disease trends and data representation. Background cluster rates were lower for the rash syndrome counts than for the respiratory counts, likely because of seasonality and the large scale of the respiratory counts. Conclusion The spatial estimation method should be chosen according to characteristics of the selected data streams. In this dataset with strong day-of-week effects, the overall best detection performance was achieved using subregion averages over a 28-day baseline stratified by weekday or weekend/holiday behavior. Changing the estimation method for particular scenarios involving different spatial resolution or other syndromes can yield further improvement. PMID:19615075

Contact tracing the first Middle East respiratory syndrome case in the Philippines, February 2015.

PubMed

Racelis, Sheryl; de los Reyes, Vikki Carr; Sucaldito, Ma Nemia; Deveraturda, Imelda; Roca, John Bobbie; Tayag, Enrique

2015-01-01

Middle East respiratory syndrome (MERS) is an illness caused by a coronavirus in which infected persons develop severe acute respiratory illness. A person can be infected through close contacts. This is an outbreak investigation report of the first confirmed MERS case in the Philippines and the subsequent contact tracing activities. Review of patient records and interviews with health-care personnel were done. Patient and close contacts were tested for MERS-coronavirus (CoV) by real time-polymerase chain reaction. Close contacts were identified and categorized. All traced contacts were monitored daily for appearance of illness for 14 days starting from the date of last known exposure to the confirmed case. A standard log sheet was used for symptom monitoring. The case was a 31-year-old female who was a health-care worker in Saudi Arabia. She had mild acute respiratory illness five days before travelling to the Philippines. On 1 February, she travelled with her husband to the Philippines while she had a fever. On 2 February, she attended a health facility in the Philippines. On 8 February, respiratory samples were tested for MERS-CoV and yielded positive results. A total of 449 close contacts were identified, and 297 (66%) were traced. Of those traced, 15 developed respiratory symptoms. All of them tested negative for MERS. In this outbreak investigation, the participation of health-care personnel in conducting vigorous contact tracing may have reduced the risk of transmission. However, being overly cautious to include more contacts for the outbreak response should be further reconsidered.

Change of tumor vascular reactivity during tumor growth and postchemotherapy observed by near-infrared spectroscopy

NASA Astrophysics Data System (ADS)

Lee, Songhyun; Jeong, Hyeryun; Seong, Myeongsu; Kim, Jae Gwan

2017-12-01

Breast cancer is one of the most common cancers in females. To monitor chemotherapeutic efficacy for breast cancer, medical imaging systems such as x-ray mammography, computed tomography, magnetic resonance imaging, and ultrasound imaging have been used. Currently, it can take up to 3 to 6 weeks to see the tumor response from chemotherapy by monitoring tumor volume changes. We used near-infrared spectroscopy (NIRS) to predict breast cancer treatment efficacy earlier than tumor volume changes by monitoring tumor vascular reactivity during inhalational gas interventions. The results show that the amplitude of oxy-hemoglobin changes (vascular reactivity) during hyperoxic gas inhalation is well correlated with tumor growth and responded one day earlier than tumor volume changes after chemotherapy. These results may imply that NIRS with respiratory challenges can be useful in early detection of tumor and in the prediction of tumor response to chemotherapy.

Cost-efficient speckle interferometry with plastic optical fiber for unobtrusive monitoring of human vital signs.

PubMed

Podbreznik, Peter; Đonlagić, Denis; Lešnik, Dejan; Cigale, Boris; Zazula, Damjan

2013-10-01

A cost-efficient plastic optical fiber (POF) system for unobtrusive monitoring of human vital signs is presented. The system is based on speckle interferometry. A laser diode is butt-coupled to the POF whose exit face projects speckle patterns onto a linear optical sensor array. Sequences of acquired speckle images are transformed into one-dimensional signals by using the phase-shifting method. The signals are analyzed by band-pass filtering and a Morlet-wavelet-based multiresolutional approach for the detection of cardiac and respiratory activities, respectively. The system is tested with 10 healthy nonhospitalized persons, lying supine on a mattress with the embedded POF. Experimental results are assessed statistically: precisions of 98.8% ± 1.5% and 97.9% ± 2.3%, sensitivities of 99.4% ± 0.6% and 95.3% ± 3%, and mean delays between interferometric detections and corresponding referential signals of 116.6 ± 55.5 and 1299.2 ± 437.3 ms for the heartbeat and respiration are obtained, respectively.

Adaptive support ventilation: State of the art review

PubMed Central

Fernández, Jaime; Miguelena, Dayra; Mulett, Hernando; Godoy, Javier; Martinón-Torres, Federico

2013-01-01

Mechanical ventilation is one of the most commonly applied interventions in intensive care units. Despite its life-saving role, it can be a risky procedure for the patient if not applied appropriately. To decrease risks, new ventilator modes continue to be developed in an attempt to improve patient outcomes. Advances in ventilator modes include closed-loop systems that facilitate ventilator manipulation of variables based on measured respiratory parameters. Adaptive support ventilation (ASV) is a positive pressure mode of mechanical ventilation that is closed-loop controlled, and automatically adjust based on the patient's requirements. In order to deliver safe and appropriate patient care, clinicians need to achieve a thorough understanding of this mode, including its effects on underlying respiratory mechanics. This article will discuss ASV while emphasizing appropriate ventilator settings, their advantages and disadvantages, their particular effects on oxygenation and ventilation, and the monitoring priorities for clinicians. PMID:23833471

Multiple-dose safety study of ibuprofen/codeine and aspirin/codeine combinations.

PubMed

Friedman, H; Seckman, C; Stubbs, C; Oster, H; Royer, G

1990-01-01

This multiple-dose, double-blind, placebo-controlled, randomized, normal volunteer study compared formulations of ibuprofen/codeine and aspirin/codeine for systemic safety. Vital signs, hematologic, biochemical and urinary parameters, side effects, mood and mental alertness, were monitored. The placebo group had less gastrointestinal side effects and more frequent stools than the active treatment groups. There was statistical evidence for greater adverse effects of aspirin/codeine on mood and mental alertness in comparison to ibuprofen/codeine and placebo. Ibuprofen/codeine had a more favorable adverse effect profile than aspirin/codeine. A mild respiratory and cardiac depressant effect attributable to codeine was evident in all active treatment groups after 7 days of frequent therapy. More work needs to be done to elucidate the factors regulating the development of tolerance to the respiratory and cardiovascular depressant effects of opiates in general, and for codeine in particular.

A Molecular atlas of Xenopus respiratory system development.

PubMed

Rankin, Scott A; Thi Tran, Hong; Wlizla, Marcin; Mancini, Pamela; Shifley, Emily T; Bloor, Sean D; Han, Lu; Vleminckx, Kris; Wert, Susan E; Zorn, Aaron M

2015-01-01

Respiratory system development is regulated by a complex series of endoderm-mesoderm interactions that are not fully understood. Recently Xenopus has emerged as an alternative model to investigate early respiratory system development, but the extent to which the morphogenesis and molecular pathways involved are conserved between Xenopus and mammals has not been systematically documented. In this study, we provide a histological and molecular atlas of Xenopus respiratory system development, focusing on Nkx2.1+ respiratory cell fate specification in the developing foregut. We document the expression patterns of Wnt/β-catenin, fibroblast growth factor (FGF), and bone morphogenetic protein (BMP) signaling components in the foregut and show that the molecular mechanisms of respiratory lineage induction are remarkably conserved between Xenopus and mice. Finally, using several functional experiments we refine the epistatic relationships among FGF, Wnt, and BMP signaling in early Xenopus respiratory system development. We demonstrate that Xenopus trachea and lung development, before metamorphosis, is comparable at the cellular and molecular levels to embryonic stages of mouse respiratory system development between embryonic days 8.5 and 10.5. This molecular atlas provides a fundamental starting point for further studies using Xenopus as a model to define the conserved genetic programs controlling early respiratory system development. © 2014 Wiley Periodicals, Inc.

Respiratory Frequency during Exercise: The Neglected Physiological Measure.

PubMed

Nicolò, Andrea; Massaroni, Carlo; Passfield, Louis

2017-01-01

The use of wearable sensor technology for athlete training monitoring is growing exponentially, but some important measures and related wearable devices have received little attention so far. Respiratory frequency ( f R ), for example, is emerging as a valuable measurement for training monitoring. Despite the availability of unobtrusive wearable devices measuring f R with relatively good accuracy, f R is not commonly monitored during training. Yet f R is currently measured as a vital sign by multiparameter wearable devices in the military field, clinical settings, and occupational activities. When these devices have been used during exercise, f R was used for limited applications like the estimation of the ventilatory threshold. However, more information can be gained from f R . Unlike heart rate, [Formula: see text]O 2 , and blood lactate, f R is strongly associated with perceived exertion during a variety of exercise paradigms, and under several experimental interventions affecting performance like muscle fatigue, glycogen depletion, heat exposure and hypoxia. This suggests that f R is a strong marker of physical effort. Furthermore, unlike other physiological variables, f R responds rapidly to variations in workload during high-intensity interval training (HIIT), with potential important implications for many sporting activities. This Perspective article aims to (i) present scientific evidence supporting the relevance of f R for training monitoring; (ii) critically revise possible methodologies to measure f R and the accuracy of currently available respiratory wearables; (iii) provide preliminary indication on how to analyze f R data. This viewpoint is expected to advance the field of training monitoring and stimulate directions for future development of sports wearables.

[Development of Audio Indicator System for Respiratory Dynamic CT Imaging].

PubMed

Muramatsu, Shun; Moriya, Hiroshi; Tsukagoshi, Shinsuke; Yamada, Norikazu

We created the device, which can conduct a radiological technologist's voice to a subject during CT scanning. For 149 lung cancer, dynamic respiratory CT were performed. 92 cases were performed using this device, the others were without this device. The respiratory cycle and respiratory amplitude were analyzed from the lung density. A stable respirating cycle was obtained by using the audio indicator system. The audio indicator system is useful for respiratory dynamic CT.

A study of adherence to antibiotic treatment in ambulatory respiratory infections.

PubMed

Llor, Carl; Hernández, Silvia; Bayona, Carolina; Moragas, Ana; Sierra, Nuria; Hernández, Marta; Miravitlles, Marc

2013-03-01

To assess the different types of antibiotic-taking behavior and to compare self-reported with objectively measured adherence to antibiotic regimens in respiratory infections. This was a prospective study of patients with suspected bacterial pharyngitis and lower respiratory tract infections recruited from five primary care clinics in Catalonia. Adherence to various antibiotic regimens was assessed by the Medication Event Monitoring System (MEMS), which recorded every opening of the patient's bottle of tablets, and a self-reported adherence question. The outcome variables were antibiotic-taking adherence, correct dosing, and timing adherence. A total of 428 patients were included in the analysis. Five types of antibiotic use behavior were observed: excellent adherence (130 patients, 30.4%), acceptable adherence over time (53; 12.4%), declining adherence over time (123; 28.7%), non-adherence to correct dosing (108; 25.2%), and unacceptable adherence (14; 3.3%). Excellent adherence was significantly associated with the number of daily doses of antibiotic and antibiotic duration. A total of 254 patients reported never forgetting to take the antibiotic (59.3%), achieving a negative predictive value of 100% and a positive predictive value of 51.2%. Outpatients with respiratory infections treated with antibiotics showed poor adherence outcomes. Self-reported adherence was remarkably higher than that observed with the use of MEMS and failed to predict true patient adherence. Copyright © 2012 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Design and Evaluation of an Intelligent Remote Tidal Volume Variability Monitoring System in E-Health Applications.

PubMed

Fekr, Atena Roshan; Radecka, Katarzyna; Zilic, Zeljko

2015-09-01

A reliable long-term monitoring and diagnosis of breath disorders at an early stage provides an improvement of medical act, life expectancy, and quality of life while decreasing the costs of treatment and medical services. Therefore, a real-time unobtrusive monitoring of respiration patterns, as well as breath parameters, is a critical need in medical applications. In this paper, we propose an intelligent system for patient home care, capable of measuring respiration rate and tidal volume variability via a wearable sensing technology. The proposed system is designed particularly for the goal of diagnosis and treatment in patients with pathological breathing, e.g., respiratory complications after surgery or sleep disorders. The complete system was comprised of wearable calibrated accelerometer sensor, Bluetooth low energy, and cloud database. The experiments are conducted with eight subjects and the overall error in respiration rate calculation is obtained 0.29%±0.33% considering SPR-BTA spirometer as the reference. We also introduce a method for tidal volume variability estimation while validated using Pearson correlation. Furthermore, since it is essential to detect the critical events resulted from sudden rise or fall in per breath tidal volume of the patients, we provide a technique to automatically find the accurate threshold values based on each individual breath characteristics. Therefore, the system is able to detect the major changes, precisely by more than 98%, and provide immediate feedback such as sound alarm for round-the-clock respiration monitoring.

Adaptive responses of the cardiovascular system to prolonged spaceflight conditions: assessment with Holter monitoring

NASA Technical Reports Server (NTRS)

Baevsky, R. M.; Bennett, B. S.; Bungo, M. W.; Charles, J. B.; Goldberger, A. L.; Nikulina, G. A.

1997-01-01

This article presents selected findings obtained with Holter monitoring from two crew members of the expedition, performed during a 175-day space mission on board orbital space station "MIR." Using mathematical processing of daily cardiointervals files, 5-minute sections of records were analyzed consecutively. Then, the average daily values of indices, the average-per-every-eight-hours values (morning, evening, night) and mean values per hour were computed. The results of analysis showed that prolonged exposure of man to microgravity conditions leads to important functional alteration in human neuroautonomic regulatory mechanisms. Both crew members had significant increase of heart rate, the rise of stress index, the decrease in power of the spectrum in the range of respiratory sinus arrhythmia. These marked signs of activation of the sympathetic section of the vegetative nervous system showed individual variations. The analysis of the daily collection of cardiointervals with Holter monitoring allows us to understand and forecast the functional feasibilities of the human organism under a variety of stress conditions associated with acute and chronic microgravity exposure.

A respiratory compensating system: design and performance evaluation.

PubMed

Chuang, Ho-Chiao; Huang, Ding-Yang; Tien, Der-Chi; Wu, Ren-Hong; Hsu, Chung-Hsien

2014-05-08

This study proposes a respiratory compensating system which is mounted on the top of the treatment couch for reverse motion, opposite from the direction of the targets (diaphragm and hemostatic clip), in order to offset organ displacement generated by respiratory motion. Traditionally, in the treatment of cancer patients, doctors must increase the field size for radiation therapy of tumors because organs move with respiratory motion, which causes radiation-induced inflammation on the normal tissues (organ at risk (OAR)) while killing cancer cells, and thereby reducing the patient's quality of life. This study uses a strain gauge as a respiratory signal capture device to obtain abdomen respiratory signals, a proposed respiratory simulation system (RSS) and respiratory compensating system to experiment how to offset the organ displacement caused by respiratory movement and compensation effect. This study verifies the effect of the respiratory compensating system in offsetting the target displacement using two methods. The first method uses linac (medical linear accelerator) to irradiate a 300 cGy dose on the EBT film (GAFCHROMIC EBT film). The second method uses a strain gauge to capture the patients' respiratory signals, while using fluoroscopy to observe in vivo targets, such as a diaphragm, to enable the respiratory compensating system to offset the displacements of targets in superior-inferior (SI) direction. Testing results show that the RSS position error is approximately 0.45 ~ 1.42 mm, while the respiratory compensating system position error is approximately 0.48 ~ 1.42 mm. From the EBT film profiles based on different input to the RSS, the results suggest that when the input respiratory signals of RSS are sine wave signals, the average dose (%) in the target area is improved by 1.4% ~ 24.4%, and improved in the 95% isodose area by 15.3% ~ 76.9% after compensation. If the respiratory signals input into the RSS respiratory signals are actual human respiratory signals, the average dose (%) in the target area is improved by 31.8% ~ 67.7%, and improved in the 95% isodose area by 15.3% ~ 86.4% (the above rates of improvements will increase with increasing respiratory motion displacement) after compensation. The experimental results from the second method suggested that about 67.3% ~ 82.5% displacement can be offset. In addition, gamma passing rate after compensation can be improved to 100% only when the displacement of the respiratory motion is within 10 ~ 30 mm. This study proves that the proposed system can contribute to the compensation of organ displacement caused by respiratory motion, enabling physicians to use lower doses and smaller field sizes in the treatment of tumors of cancer patients.

A respiratory compensating system: design and performance evaluation

PubMed Central

Huang, Ding‐Yang; Tien, Der‐Chi; Wu, Ren‐Hong; Hsu, Chung‐Hsien

2014-01-01

This study proposes a respiratory compensating system which is mounted on the top of the treatment couch for reverse motion, opposite from the direction of the targets (diaphragm and hemostatic clip), in order to offset organ displacement generated by respiratory motion. Traditionally, in the treatment of cancer patients, doctors must increase the field size for radiation therapy of tumors because organs move with respiratory motion, which causes radiation‐induced inflammation on the normal tissues (organ at risk (OAR)) while killing cancer cells, and thereby reducing the patient's quality of life. This study uses a strain gauge as a respiratory signal capture device to obtain abdomen respiratory signals, a proposed respiratory simulation system (RSS) and respiratory compensating system to experiment how to offset the organ displacement caused by respiratory movement and compensation effect. This study verifies the effect of the respiratory compensating system in offsetting the target displacement using two methods. The first method uses linac (medical linear accelerator) to irradiate a 300 cGy dose on the EBT film (GAFCHROMIC EBT film). The second method uses a strain gauge to capture the patients' respiratory signals, while using fluoroscopy to observe in vivo targets, such as a diaphragm, to enable the respiratory compensating system to offset the displacements of targets in superior‐inferior (SI) direction. Testing results show that the RSS position error is approximately 0.45 ~ 1.42 mm, while the respiratory compensating system position error is approximately 0.48 ~ 1.42 mm. From the EBT film profiles based on different input to the RSS, the results suggest that when the input respiratory signals of RSS are sine wave signals, the average dose (%) in the target area is improved by 1.4% ~ 24.4%, and improved in the 95% isodose area by 15.3% ~ 76.9% after compensation. If the respiratory signals input into the RSS respiratory signals are actual human respiratory signals, the average dose (%) in the target area is improved by 31.8% ~ 67.7%, and improved in the 95% isodose area by 15.3% ~ 86.4% (the above rates of improvements will increase with increasing respiratory motion displacement) after compensation. The experimental results from the second method suggested that about 67.3% ~ 82.5% displacement can be offset. In addition, gamma passing rate after compensation can be improved to 100% only when the displacement of the respiratory motion is within 10 ~ 30 mm. This study proves that the proposed system can contribute to the compensation of organ displacement caused by respiratory motion, enabling physicians to use lower doses and smaller field sizes in the treatment of tumors of cancer patients. PACS number: 87.19. Wx; 87.55. Km PMID:24892345

Avian respiratory system disorders

USGS Publications Warehouse

Olsen, Glenn H.

1989-01-01

Diagnosing and treating respiratory diseases in avian species requires a basic knowledge about the anatomy and physiology of this system in birds. Differences between mammalian and avian respiratory system function, diagnosis, and treatment are highlighted.

Southern Hemisphere Influenza and Vaccine Effectiveness Research and Surveillance

PubMed Central

Huang, Qiu Sue; Turner, Nikki; Baker, Michael G; Williamson, Deborah A; Wong, Conroy; Webby, Richard; Widdowson, Marc-Alain

2015-01-01

The 2009 influenza A(H1N1)pdm09 pandemic highlighted the need for improved scientific knowledge to support better pandemic preparedness and seasonal influenza control. The Southern Hemisphere Influenza and Vaccine Effectiveness Research and Surveillance (SHIVERS) project, a 5-year (2012–2016) multiagency and multidisciplinary collaboration, aimed to measure disease burden, epidemiology, aetiology, risk factors, immunology, effectiveness of vaccination and other prevention strategies for influenza and other respiratory infectious diseases of public health importance. Two active, prospective, population-based surveillance systems were established for monitoring influenza and other respiratory pathogens among those hospitalized patients with acute respiratory illness and those enrolled patients seeking consultations at sentinel general practices. In 2015, a sero-epidemiological study will use a sample of patients from the same practices. These data will provide a full picture of the disease burden and risk factors from asymptomatic infections to severe hospitalized disease and deaths and related economic burden. The results during the first 2 years (2012–2013) provided scientific evidence to (a) support a change to NZ's vaccination policy for young children due to high influenza hospitalizations in these children; (b) contribute to the revision of the World Health Organization's case definition for severe acute respiratory illness for global influenza surveillance; and (c) contribute in part to vaccine strain selection using vaccine effectiveness assessment in the prevention of influenza-related consultations and hospitalizations. In summary, SHIVERS provides valuable international platforms for supporting seasonal influenza control and pandemic preparedness, and responding to other emerging/endemic respiratory-related infections. PMID:25912617

Extrapulmonary manifestations of severe respiratory syncytial virus infection – a systematic review

PubMed Central

Eisenhut, Michael

2006-01-01

Introduction Respiratory syncytial virus (RSV) bronchiolitis is the most important cause for admission to the paediatric intensive care unit in infants with lower respiratory tract infection. In recent years the importance of extrapulmonary manifestations of RSV infection has become evident. This systematic review aimed at summarizing the available evidence on manifestations of RSV infection outside the respiratory tract, their causes and the changes in clinical management required. Methods Databases searched were Medline (1950 to present), EMBASE (1974 to present), PubMed and reference lists of relevant articles. Summarized were the findings of articles reporting on manifestations of RSV infection outside the respiratory tract in patients of all age groups. Results Extrapulmonary manifestations reported in previous observational studies included cardiovascular failure with hypotension and inotrope requirements associated with myocardial damage as evident from elevated cardiac troponin levels (35–54% of ventilated infants), cardiac arrhythmias like supraventricular tachycardias and ventricular tachycardias, central apnoeas (16–21% of admissions), focal and generalized seizures, focal neurological abnormalities, hyponatraemia (33%) associated with increased antidiuretic hormone secretion, and hepatitis (46–49% of ventilated infants). RSV or its genetic material have been isolated from cerebrospinal fluid, myocardium, liver and peripheral blood. Conclusion The data summarized indicate a systemic dissemination of RSV during severe disease. Cerebral and myocardial involvement may explain the association of RSV with some cases of sudden infant death. In infants with severe RSV infection cardiac rhythm, blood pressure and serum sodium need to be monitored and supportive treatment including fluid management adjusted accordingly. PMID:16859512

77 FR 35264 - Extension of Expiration Dates for Several Body System Listings

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-13

... of Impairments (listings) in our regulations: Growth Impairment, Musculoskeletal System, Respiratory....00..... July 1, 2014. Musculoskeletal System 1.00 July 1, 2014. and 101.00. Respiratory System 3.00..., 2014. 2. Musculoskeletal System (1.00 and 101.00): July 1, 2014. * * * * * 4. Respiratory System (3.00...

Inside Your Body

MedlinePlus

... body through the anus as a bowel movement. Respiratory system The respiratory (say: RES-puh-ruh-TOR-ee) system delivers ... body when a person exhales (breathes out). The respiratory system has another job: protecting your body from ...

Rapid and stable measurement of respiratory rate from Doppler radar signals using time domain autocorrelation model.

PubMed

Sun, Guanghao; Matsui, Takemi

2015-01-01

Noncontact measurement of respiratory rate using Doppler radar will play a vital role in future clinical practice. Doppler radar remotely monitors the tiny chest wall movements induced by respiration activity. The most competitive advantage of this technique is to allow users fully unconstrained with no biological electrode attachments. However, the Doppler radar, unlike other contact-type sensors, is easily affected by the random body movements. In this paper, we proposed a time domain autocorrelation model to process the radar signals for rapid and stable estimation of the respiratory rate. We tested the autocorrelation model on 8 subjects in laboratory, and compared the respiratory rates detected by noncontact radar with reference contact-type respiratory effort belt. Autocorrelation model showed the effects of reducing the random body movement noise added to Doppler radar's respiration signals. Moreover, the respiratory rate can be rapidly calculated from the first main peak in the autocorrelation waveform within 10 s.

Effect of Influenza Vaccination on Acute Respiratory Symptoms in Malaysian Hajj Pilgrims.

PubMed

Hasan, Habsah; Deris, Zakuan Zainy; Sulaiman, Siti Amrah; Abdul Wahab, Mohd Suhaimi; Naing, Nyi Nyi; Ab Rahman, Zulkefle; Othman, Nor Hayati

2015-08-01

Respiratory illness were a major problem and caused high hospital admission during hajj seasons. One of the contributing cause to this illness is infection. Various measures had been implemented to reduce respiratory infections. The aim on the study is to determine the effect of influenza vaccination against acute respiratory illness among Malaysian Hajj pilgrims. This is an observational cohort study. Influenza vaccination was given to pilgrims at least 2 weeks prior to departure. The occurrence of symptoms for respiratory illness such as cough, fever, sore throat and runny nose was monitored daily for 6 weeks during pilgrimage using a health diary. A total of 65 vaccinated hajj pilgrims and 41 controls were analyzed. There was no significant difference in pattern of occurrence of symptoms of respiratory illness by duration of pilgrimage as well as the number of symptoms between both groups. Hajj pilgrims have frequent respiratory symptoms. We were unable to document benefit from influenza vaccination, but our study was limited by a small sample size and lack of laboratory testing for influenza.

Influence of sulfur dioxide on the respiratory system of Miyakejima adult residents 6 years after returning to the island.

PubMed

Kochi, Takeshi; Iwasawa, Satoko; Nakano, Makiko; Tsuboi, Tazuru; Tanaka, Shigeru; Kitamura, Hiroko; Wilson, Donald John; Takebayashi, Toru; Omae, Kazuyuki

2017-07-27

Mount Oyama, on the Japanese island of Miyakejima, began erupting in June 2000, necessitating the evacuation of 3,000 island residents. Volcanic gas emissions, primarily consisting of sulfur dioxide (SO 2 ), gradually decreased and residents returned to the island after the evacuation order was lifted in February 2005. To assess the exposure-effect and exposure-response relationships between SO 2 exposure and effects on respiratory system in adult Miyakejima residents. Health checkups focusing on pulmonary function and respiratory/irritative symptoms were conducted six times every November from 2006 to 2011. The study population comprised 168 subjects who underwent all health checkups. SO 2 concentrations were measured at six fixed monitoring stations in inhabitable areas. Based on the annual mean SO 2 concentration, inhabitable areas were classified into three categories; namely, lower (L), higher (H-1), and highest (H-2) areas. Average SO 2 concentrations (ppb) during 3 months prior to each health checkup dropped from 11.3 to 3.29, 32.2 to 13.4 and 75.1 to 12.6 from 2006 to 2010/2011 in L, H-1, and H-2. No significant declines in pulmonary function were observed in all areas. However, prevalence of subjective symptoms such as "Cough," "Irritation and/or pain in throat," "Irritation, runny nose, and/or nasal sniffles," and "Irritation and/or pain in the eyes," dependently increased on SO 2 concentration. Odds ratios were statistically significant at approximately 70 ppb of SO 2 or above. Adult residents of Miyakejima island showed no deterioration in pulmonary function at SO 2 levels, but complained of respiratory/irritative symptoms in an SO 2 concentration-dependent manner.

[The respiratory system--its self-cleaning system. General mechanisms of clearance].

PubMed

Mustajbegović, J; Zuskin, E

1998-01-01

The behaviour of particles and deposition in different parts of respiratory system are described. Listed are factors which contribute to the deposition of particles in the lungs and upper areas of the respiratory system. The general mechanisms of lung clearance and their action such as cough, mucociliary transport, alveolar clearance and immunological system are reported. Particularly is stressed the necessity of coordination of all defense mechanisms in order to maintain normal respiratory function.

Robust tracking of respiratory rate in high-dynamic range scenes using mobile thermal imaging

PubMed Central

Cho, Youngjun; Julier, Simon J.; Marquardt, Nicolai; Bianchi-Berthouze, Nadia

2017-01-01

The ability to monitor the respiratory rate, one of the vital signs, is extremely important for the medical treatment, healthcare and fitness sectors. In many situations, mobile methods, which allow users to undertake everyday activities, are required. However, current monitoring systems can be obtrusive, requiring users to wear respiration belts or nasal probes. Alternatively, contactless digital image sensor based remote-photoplethysmography (PPG) can be used. However, remote PPG requires an ambient source of light, and does not work properly in dark places or under varying lighting conditions. Recent advances in thermographic systems have shrunk their size, weight and cost, to the point where it is possible to create smart-phone based respiration rate monitoring devices that are not affected by lighting conditions. However, mobile thermal imaging is challenged in scenes with high thermal dynamic ranges (e.g. due to the different environmental temperature distributions indoors and outdoors). This challenge is further amplified by general problems such as motion artifacts and low spatial resolution, leading to unreliable breathing signals. In this paper, we propose a novel and robust approach for respiration tracking which compensates for the negative effects of variations in the ambient temperature and motion artifacts and can accurately extract breathing rates in highly dynamic thermal scenes. The approach is based on tracking the nostril of the user and using local temperature variations to infer inhalation and exhalation cycles. It has three main contributions. The first is a novel Optimal Quantization technique which adaptively constructs a color mapping of absolute temperature to improve segmentation, classification and tracking. The second is the Thermal Gradient Flow method that computes thermal gradient magnitude maps to enhance the accuracy of the nostril region tracking. Finally, we introduce the Thermal Voxel method to increase the reliability of the captured respiration signals compared to the traditional averaging method. We demonstrate the extreme robustness of our system to track the nostril-region and measure the respiratory rate by evaluating it during controlled respiration exercises in high thermal dynamic scenes (e.g. strong correlation (r = 0.9987) with the ground truth from the respiration-belt sensor). We also demonstrate how our algorithm outperformed standard algorithms in settings with different amounts of environmental thermal changes and human motion. We open the tracked ROI sequences of the datasets collected for these studies (i.e. under both controlled and unconstrained real-world settings) to the community to foster work in this area. PMID:29082079

Robust tracking of respiratory rate in high-dynamic range scenes using mobile thermal imaging.

PubMed

Cho, Youngjun; Julier, Simon J; Marquardt, Nicolai; Bianchi-Berthouze, Nadia

2017-10-01

The ability to monitor the respiratory rate, one of the vital signs, is extremely important for the medical treatment, healthcare and fitness sectors. In many situations, mobile methods, which allow users to undertake everyday activities, are required. However, current monitoring systems can be obtrusive, requiring users to wear respiration belts or nasal probes. Alternatively, contactless digital image sensor based remote-photoplethysmography (PPG) can be used. However, remote PPG requires an ambient source of light, and does not work properly in dark places or under varying lighting conditions. Recent advances in thermographic systems have shrunk their size, weight and cost, to the point where it is possible to create smart-phone based respiration rate monitoring devices that are not affected by lighting conditions. However, mobile thermal imaging is challenged in scenes with high thermal dynamic ranges (e.g. due to the different environmental temperature distributions indoors and outdoors). This challenge is further amplified by general problems such as motion artifacts and low spatial resolution, leading to unreliable breathing signals. In this paper, we propose a novel and robust approach for respiration tracking which compensates for the negative effects of variations in the ambient temperature and motion artifacts and can accurately extract breathing rates in highly dynamic thermal scenes. The approach is based on tracking the nostril of the user and using local temperature variations to infer inhalation and exhalation cycles. It has three main contributions. The first is a novel Optimal Quantization technique which adaptively constructs a color mapping of absolute temperature to improve segmentation, classification and tracking. The second is the Thermal Gradient Flow method that computes thermal gradient magnitude maps to enhance the accuracy of the nostril region tracking. Finally, we introduce the Thermal Voxel method to increase the reliability of the captured respiration signals compared to the traditional averaging method. We demonstrate the extreme robustness of our system to track the nostril-region and measure the respiratory rate by evaluating it during controlled respiration exercises in high thermal dynamic scenes (e.g. strong correlation (r = 0.9987) with the ground truth from the respiration-belt sensor). We also demonstrate how our algorithm outperformed standard algorithms in settings with different amounts of environmental thermal changes and human motion. We open the tracked ROI sequences of the datasets collected for these studies (i.e. under both controlled and unconstrained real-world settings) to the community to foster work in this area.

Improvement of a respiratory ozone analyzer.

PubMed

Ultman, J S; Ben-Jebria, A; Mac Dougall, C S; Rigas, M L

1997-10-01

The breath-to-breath measurement of total respiratory ozone (O3) uptake requires monitoring O3 concentration at the airway opening with an instrument that responds rapidly relative to the breathing frequency. Our original chemiluminescent analyzer, using 2-methyl-2-butene as the reactant gas, had a 10% to 90% step-response time of 110 msec and a minimal detectable concentration of 0.018 parts per million (ppm) O3 (Ben-Jebria et al. 1990). This instrument was suitable for respiratory O3 monitoring during quiet breathing and light exercise. For this study, we constructed a more self-contained analyzer with a faster response time using ethylene as the reactant gas. When the analyzer was operated at a reaction chamber pressure of 350 torr, an ethylene-to-sample flow ratio of 4:1, and a sampling flow of 0.6 liters per minute (Lpm), it had a 10% to 90% step-response time of 70 msec and a minimal detectable concentration of 0.006 ppm. These specifications make respiratory O3 monitoring possible during moderate-to-heavy exercise. In addition, the nonlinear calibration and the carbon dioxide (CO2) interference exhibited by the original analyzer were eliminated. In breath-to-breath measurements in two healthy men, the fractional uptake of O3 during one minute of quiet breathing was comparable to the results obtained by using a slowly responding commercial analyzer with a quasi-steady material balance method (Wiester et al. 1996). In fact, fractional uptake was about 0.8 regardless of O3 exposure concentration (0.11 to 0.43 ppm) or ventilation rate (4 to 41 Lpm/m2).

PLMA vs. I-gel: A Comparative Evaluation of Respiratory Mechanics in Laparoscopic Cholecystectomy

PubMed Central

Sharma, Bimla; Sehgal, Raminder; Sahai, Chand; Sood, Jayashree

2010-01-01

Background: Supraglottic airway devices (SADs), such as ProSealTM laryngeal mask airway (PLMA), which produce high oropharyngeal seal pressure (OSP) and have the facility for gastric decompression have been used in laparoscopic procedures. i-gel is a new SAD which shares these features with the PLMA. This study was designed to compare the respiratory mechanics of these two devices during positive pressure ventilation in anaesthetised adult patients undergoing laparoscopic cholecystectomy. Patients & Methods: The study included 60 ASA I-II adult patients scheduled for laparoscopic cholecystectomy. The patients were randomized to two groups of 30 each, with either PLMA or i-gel as their airway device. Anaesthesia and premedication were standardized for both the groups. In addition to routine monitoring, neuromuscular monitoring with TOF ratio, OSP and respiratory mechanics monitoring (dynamic compliance, resistance, work of breathing, measured minute ventilation and peak airway pressures) were employed. Fibreoptic evaluation of positioning of the devices and adverse events related to them were also compared. Results: The OSP (cm H2O) were higher for PLMA (38.9 vs. 35.6, P=0.007). The respiratory mechanics parameters using the two devices were comparable apart from the dynamic compliance, which was significantly higher with i-gel (P < 0.05). Malrotation was higher with i-gel than with PLMA (15 vs. 5, P = 0.006). Conclusion: The PLMA formed a better seal while the dynamic compliance was higher with the i-gel. Both devices provided optimal ventilation and oxygenation and the adverse events were also comparable. PMID:21547168

Use of plant extracts as an efficient alternative therapy of respiratory tract infections.

PubMed

Šmejkal, Karel; Rjašková, Veronika

Medicinal plants are advantageously used in the treatment of respiratory tract diseases. Upper respiratory tract catarrh is one of the diseases associated with seasonal weakening of immunity, and therefore, plant drugs with a non-specific immunomodulation effect are often used. Such plants include, but are not limited to, Echinacea (Echinacea purpurea) and American ginseng (Panax quinquefolius). In combination with medicinal plants having antibacterial and antiseptic effects, such as thyme (Thymus vulgaris) and pelargonium (Pelargonium sidoides), they can constitute efficient help in the treatment of respiratory tract diseases, shorten the duration of the disease and reduce the need of antibiotic therapy. The text presented summarizes the basic information about these plants, their ingredients, mechanisms of action and clinical tests confirming their effect and monitoring eventual adverse effects.Key words: Echinacea purpurea Panax quinquefolius Pelargonium sidoides Thymus vulgaris upper respiratory tract catarrh immunity.

Longitudinal analysis of respiratory outcomes among bauxite exposed workers in Western Australia.

PubMed

Dennekamp, Martine; de Klerk, Nicholas Hubert; Reid, Alison; Abramson, Michael John; Cui, Jisheng; Del Monaco, Anthony; Fritschi, Lin; Benke, Geza Paul; Sim, Malcolm Ross; Musk, Arthur William

2015-08-01

Occupational exposure to bauxite is common in the aluminium industry but little is known about the associated health effects. This study investigates respiratory health in relation to respirable bauxite dust exposure longitudinally over a 13 year period. An inception cohort study recruited 91 male bauxite miners and 363 male alumina refinery workers. Annual measurements of respiratory symptoms and lung function were made. Cumulative exposure to bauxite was derived from job histories and air monitoring data. Mixed-effects modeling was used. No associations were found between cumulative bauxite exposure and respiratory symptoms or lung function. However, when analysis was restricted to the first three rounds, FEV1 was significantly lower in all exposure groups than in those unexposed but with no significant trend. Increasing exposure to bauxite dust in the aluminum industry was not associated with respiratory symptoms or consistent decrements in lung function. © 2015 Wiley Periodicals, Inc.

Monitoring of intratidal lung mechanics: a Graphical User Interface for a model-based decision support system for PEEP-titration in mechanical ventilation.

PubMed

Buehler, S; Lozano-Zahonero, S; Schumann, S; Guttmann, J

2014-12-01

In mechanical ventilation, a careful setting of the ventilation parameters in accordance with the current individual state of the lung is crucial to minimize ventilator induced lung injury. Positive end-expiratory pressure (PEEP) has to be set to prevent collapse of the alveoli, however at the same time overdistension should be avoided. Classic approaches of analyzing static respiratory system mechanics fail in particular if lung injury already prevails. A new approach of analyzing dynamic respiratory system mechanics to set PEEP uses the intratidal, volume-dependent compliance which is believed to stay relatively constant during one breath only if neither atelectasis nor overdistension occurs. To test the success of this dynamic approach systematically at bedside or in an animal study, automation of the computing steps is necessary. A decision support system for optimizing PEEP in form of a Graphical User Interface (GUI) was targeted. Respiratory system mechanics were analyzed using the gliding SLICE method. The resulting shapes of the intratidal compliance-volume curve were classified into one of six categories, each associated with a PEEP-suggestion. The GUI should include a graphical representation of the results as well as a quality check to judge the reliability of the suggestion. The implementation of a user-friendly GUI was successfully realized. The agreement between modelled and measured pressure data [expressed as root-mean-square (RMS)] tested during the implementation phase with real respiratory data from two patient studies was below 0.2 mbar for data taken in volume controlled mode and below 0.4 mbar for data taken in pressure controlled mode except for two cases with RMS < 0.6 mbar. Visual inspections showed, that good and medium quality data could be reliably identified. The new GUI allows visualization of intratidal compliance-volume curves on a breath-by-breath basis. The automatic categorisation of curve shape into one of six shape-categories provides the rational decision-making model for PEEP-titration.

Multileaf collimator tracking integrated with a novel x-ray imaging system and external surrogate monitoring

NASA Astrophysics Data System (ADS)

Krauss, Andreas; Fast, Martin F.; Nill, Simeon; Oelfke, Uwe

2012-04-01

We have previously developed a tumour tracking system, which adapts the aperture of a Siemens 160 MLC to electromagnetically monitored target motion. In this study, we exploit the use of a novel linac-mounted kilovoltage x-ray imaging system for MLC tracking. The unique in-line geometry of the imaging system allows the detection of target motion perpendicular to the treatment beam (i.e. the directions usually featuring steep dose gradients). We utilized the imaging system either alone or in combination with an external surrogate monitoring system. We equipped a Siemens ARTISTE linac with two flat panel detectors, one directly underneath the linac head for motion monitoring and the other underneath the patient couch for geometric tracking accuracy assessments. A programmable phantom with an embedded metal marker reproduced three patient breathing traces. For MLC tracking based on x-ray imaging alone, marker position was detected at a frame rate of 7.1 Hz. For the combined external and internal motion monitoring system, a total of only 85 x-ray images were acquired prior to or in between the delivery of ten segments of an IMRT beam. External motion was monitored with a potentiometer. A correlation model between external and internal motion was established. The real-time component of the MLC tracking procedure then relied solely on the correlation model estimations of internal motion based on the external signal. Geometric tracking accuracies were 0.6 mm (1.1 mm) and 1.8 mm (1.6 mm) in directions perpendicular and parallel to the leaf travel direction for the x-ray-only (the combined external and internal) motion monitoring system in spite of a total system latency of ˜0.62 s (˜0.51 s). Dosimetric accuracy for a highly modulated IMRT beam-assessed through radiographic film dosimetry-improved substantially when tracking was applied, but depended strongly on the respective geometric tracking accuracy. In conclusion, we have for the first time integrated MLC tracking with x-ray imaging in the in-line geometry and demonstrated highly accurate respiratory motion tracking.

Instructional Methods for Neuroscience in Nurse Anesthesia Graduate Programs: A Survey of Educational Programs

DTIC Science & Technology

1999-10-01

Sciences A. Anatomy, physiology and pathophysiology 1. Cardiovascular a. Arrhythmias b. Ischemic heart disease/angina c. Myocardial infarction d...Hypertension e. Congestive Heart Failure f. Shock Instructional Methods 66 g. Valvular Heart disease h. Cardiomyopathy i. Peripheral vascular disease j...Pulmonary artery pressure monitoring Instructional Methods 71 3. Precordial/esophageal stethoscope /Doppler 4. Respiratory monitoring a. Apnea monitor b

Photoacoustic monitoring of life cycles of Leishmania Mexicana

NASA Astrophysics Data System (ADS)

Arguello, C.; Acosta-Avalos, D.; Alvarado-Gil, J. J.; Vargas, H.

1999-03-01

Photoacoustic spectroscopy is used to monitor in situ, the difference between the two forms of the protozoan Leishmania Mexicana. Differences are the result of changes in the respiratory chain and could be attributed, according to our results, to the presence of cytochrome b in promastigotes and cytochrome c in amastigotes.

Lung injury and respiratory mechanics in rugby union.

PubMed

Lindsay, Angus; Bernard, Angelique; Davidson, Shaun M; Redmond, Daniel P; Chiew, Yeong S; Pretty, Christopher; Chase, J Geoffrey; Shaw, Geoffrey M; Gieseg, Steven P; Draper, Nick

2016-04-01

Rugby is a highly popular team contact sport associated with high injury rates. Specifically, there is a chance of inducing internal lung injuries as a result of the physical nature of the game. Such injuries are only identified with the use of specific invasive protocols or equipment. This study presents a model-based method to assess respiratory mechanics of N=11 rugby players that underwent a low intensity experimental Mechanical Ventilation (MV) Test before and after a rugby game. Participants were connected to a ventilator via a facemask and their respiratory mechanics estimated using a time-varying elastance model. All participants had a respiratory elastance <10 cmH2O/L with no significant difference observed between pre and postgame respiratory mechanics (P>0.05). Model-based respiratory mechanics estimation has been used widely in the treatment of the critically ill in intensive care. However, the application of a ventilator to assess the respiratory mechanics of healthy human beings is limited. This method adapted from ICU mechanical ventilation can be used to provide insight to respiratory mechanics of healthy participants that can be used as a more precise measure of lung inflammation/injury that avoids invasive procedures. This is the first study to conceptualize the assessment of respiratory mechanics in healthy athletes as a means to monitor postexercise stress and therefore manage recovery.

EPR spectroscopy of complex biological iron-sulfur systems.

PubMed

Hagen, Wilfred R

2018-02-21

From the very first discovery of biological iron-sulfur clusters with EPR, the spectroscopy has been used to study not only purified proteins but also complex systems such as respiratory complexes, membrane particles and, later, whole cells. In recent times, the emphasis of iron-sulfur biochemistry has moved from characterization of individual proteins to the systems biology of iron-sulfur biosynthesis, regulation, degradation, and implications for human health. Although this move would suggest a blossoming of System-EPR as a specific, non-invasive monitor of Fe/S (dys)homeostasis in whole cells, a review of the literature reveals limited success possibly due to technical difficulties in adherence to EPR spectroscopic and biochemical standards. In an attempt to boost application of System-EPR the required boundary conditions and their practical applications are explicitly and comprehensively formulated.

Respiratory gating based on internal electromagnetic motion monitoring during stereotactic liver radiation therapy: First results.

PubMed

Poulsen, Per Rugaard; Worm, Esben Schjødt; Hansen, Rune; Larsen, Lars Peter; Grau, Cai; Høyer, Morten

2015-01-01

Intrafraction motion may compromise the target dose in stereotactic body radiation therapy (SBRT) of tumors in the liver. Respiratory gating can improve the treatment delivery, but gating based on an external surrogate signal may be inaccurate. This is the first paper reporting on respiratory gating based on internal electromagnetic monitoring during liver SBRT. Two patients with solitary liver metastases were treated with respiratory-gated SBRT guided by three implanted electromagnetic transponders. The treatment was delivered in end-exhale with beam-on when the centroid of the three transponders deviated less than 3 mm [left-right (LR) and anterior-posterior (AP) directions] and 4mm [cranio-caudal (CC)] from the planned position. For each treatment fraction, log files were used to determine the transponder motion during beam-on in the actual gated treatments and in simulated treatments without gating. The motion was used to reconstruct the dose to the clinical target volume (CTV) with and without gating. The reduction in D95 (minimum dose to 95% of the CTV) relative to the plan was calculated for both treatment courses. With gating the maximum course mean (standard deviation) geometrical error in any direction was 1.2 mm (1.8 mm). Without gating the course mean error would mainly increase for Patient 1 [to -2.8 mm (1.6 mm) (LR), 7.1 mm (5.8 mm) (CC), -2.6 mm (2.8mm) (AP)] due to a large systematic cranial baseline drift at each fraction. The errors without gating increased only slightly for Patient 2. The reduction in CTV D95 was 0.5% (gating) and 12.1% (non-gating) for Patient 1 and 0.3% (gating) and 1.7% (non-gating) for Patient 2. The mean duty cycle was 55%. Respiratory gating based on internal electromagnetic motion monitoring was performed for two liver SBRT patients. The gating added robustness to the dose delivery and ensured a high CTV dose even in the presence of large intrafraction motion.

Technical challenges related to implementation of a formula one real time data acquisition and analysis system in a paediatric intensive care unit.

PubMed

Matam, B Rajeswari; Duncan, Heather

2018-06-01

Most existing, expert monitoring systems do not provide the real time continuous analysis of the monitored physiological data that is necessary to detect transient or combined vital sign indicators nor do they provide long term storage of the data for retrospective analyses. In this paper we examine the feasibility of implementing a long term data storage system which has the ability to incorporate real-time data analytics, the system design, report the main technical issues encountered, the solutions implemented and the statistics of the data recorded. McLaren Electronic Systems expertise used to continually monitor and analyse the data from F1 racing cars in real time was utilised to implement a similar real-time data recording platform system adapted with real time analytics to suit the requirements of the intensive care environment. We encountered many technical (hardware and software) implementation challenges. However there were many advantages of the system once it was operational. They include: (1) The ability to store the data for long periods of time enabling access to historical physiological data. (2) The ability to alter the time axis to contract or expand periods of interest. (3) The ability to store and review ECG morphology retrospectively. (4) Detailed post event (cardiac/respiratory arrest or other clinically significant deteriorations in patients) data can be reviewed clinically as opposed to trend data providing valuable clinical insight. Informed mortality and morbidity reviews can be conducted. (5) Storage of waveform data capture to use for algorithm development for adaptive early warning systems. Recording data from bed-side monitors in intensive care/wards is feasible. It is possible to set up real time data recording and long term storage systems. These systems in future can be improved with additional patient specific metrics which predict the status of a patient thus paving the way for real time predictive monitoring.

[SOME CLINICAL AND CYTOKINE FEATURES OF THE CLINICAL COURSE OF RECURRENT RESPIRATORY SYSTEM DISEASES IN CHILDREN WITH THE TOXOCARIASIS INVASION].

PubMed

Dralova, A; Usachova, E

2015-12-01

The aim of the present study was to analyze clinical and cytokine features of recurrent respiratory system diseases in children with toxocariasis. 50 children aged 1 to 17 years (mean age - 10±5 years) with recurrent current of respiratory system disorders were studied. During the survey such clinical manifestations of the respiratory system disorders as obstructive bronchitis (50%), bronchial asthma (30%), pneumonia (10%) and laryngotracheitis (10%) have been revealed. Statistical analysis of the results was performed using the software package STATISTICA 6.1 (SNANSOFT). We have shown that the disorders of respiratory system in case of toxocariasis invasion often occur with severe intoxication and bronchial obstruction syndromes, temperature reaction, respiratory insufficiency and hepatomegaly. A prolonged course of the disease has been noted. "Inflammatory" indicators of general blood analysis, such as leukocytosis and increased of ESR have been recorded in patients with respiratory system disorders in children with T.canis infection significantly more often, significant "allergic" laboratory changes were in the form of eosinophilia. High average levels of pro-inflammatory IL-6, as well as low levels of IL 5 have been determined in children suffering from the respiratory system disorders and with toxocariasis invasion in the anamnesis. The obtained findings require further study.

Mortality and pulmonary mechanics in relation to respiratory system and transpulmonary driving pressures in ARDS.

PubMed

Baedorf Kassis, Elias; Loring, Stephen H; Talmor, Daniel

2016-08-01

The driving pressure of the respiratory system has been shown to strongly correlate with mortality in a recent large retrospective ARDSnet study. Respiratory system driving pressure [plateau pressure-positive end-expiratory pressure (PEEP)] does not account for variable chest wall compliance. Esophageal manometry can be utilized to determine transpulmonary driving pressure. We have examined the relationships between respiratory system and transpulmonary driving pressure, pulmonary mechanics and 28-day mortality. Fifty-six patients from a previous study were analyzed to compare PEEP titration to maintain positive transpulmonary end-expiratory pressure to a control protocol. Respiratory system and transpulmonary driving pressures and pulmonary mechanics were examined at baseline, 5 min and 24 h. Analysis of variance and linear regression were used to compare 28 day survivors versus non-survivors and the intervention group versus the control group, respectively. At baseline and 5 min there was no difference in respiratory system or transpulmonary driving pressure. By 24 h, survivors had lower respiratory system and transpulmonary driving pressures. Similarly, by 24 h the intervention group had lower transpulmonary driving pressure. This decrease was explained by improved elastance and increased PEEP. The results suggest that utilizing PEEP titration to target positive transpulmonary pressure via esophageal manometry causes both improved elastance and driving pressures. Treatment strategies leading to decreased respiratory system and transpulmonary driving pressure at 24 h may be associated with improved 28 day mortality. Studies to clarify the role of respiratory system and transpulmonary driving pressures as a prognosticator and bedside ventilator target are warranted.

Evaluation of the clinical efficacy of the PeTrack motion tracking system for respiratory gating in cardiac PET imaging

NASA Astrophysics Data System (ADS)

Manwell, Spencer; Chamberland, Marc J. P.; Klein, Ran; Xu, Tong; deKemp, Robert

2017-03-01

Respiratory gating is a common technique used to compensate for patient breathing motion and decrease the prevalence of image artifacts that can impact diagnoses. In this study a new data-driven respiratory gating method (PeTrack) was compared with a conventional optical tracking system. The performance of respiratory gating of the two systems was evaluated by comparing the number of respiratory triggers, patient breathing intervals and gross heart motion as measured in the respiratory-gated image reconstructions of rubidium-82 cardiac PET scans in test and control groups consisting of 15 and 8 scans, respectively. We found evidence suggesting that PeTrack is a robust patient motion tracking system that can be used to retrospectively assess patient motion in the event of failure of the conventional optical tracking system.

Automated respiratory cycles selection is highly specific and improves respiratory mechanics analysis.

PubMed

Rigo, Vincent; Graas, Estelle; Rigo, Jacques

2012-07-01

Selected optimal respiratory cycles should allow calculation of respiratory mechanic parameters focusing on patient-ventilator interaction. New computer software automatically selecting optimal breaths and respiratory mechanics derived from those cycles are evaluated. Retrospective study. University level III neonatal intensive care unit. Ten mins synchronized intermittent mandatory ventilation and assist/control ventilation recordings from ten newborns. The ventilator provided respiratory mechanic data (ventilator respiratory cycles) every 10 secs. Pressure, flow, and volume waves and pressure-volume, pressure-flow, and volume-flow loops were reconstructed from continuous pressure-volume recordings. Visual assessment determined assisted leak-free optimal respiratory cycles (selected respiratory cycles). New software graded the quality of cycles (automated respiratory cycles). Respiratory mechanic values were derived from both sets of optimal cycles. We evaluated quality selection and compared mean values and their variability according to ventilatory mode and respiratory mechanic provenance. To assess discriminating power, all 45 "t" values obtained from interpatient comparisons were compared for each respiratory mechanic parameter. A total of 11,724 breaths are evaluated. Automated respiratory cycle/selected respiratory cycle selections agreement is high: 88% of maximal κ with linear weighting. Specificity and positive predictive values are 0.98 and 0.96, respectively. Averaged values are similar between automated respiratory cycle and ventilator respiratory cycle. C20/C alone is markedly decreased in automated respiratory cycle (1.27 ± 0.37 vs. 1.81 ± 0.67). Tidal volume apparent similarity disappears in assist/control: automated respiratory cycle tidal volume (4.8 ± 1.0 mL/kg) is significantly lower than for ventilator respiratory cycle (5.6 ± 1.8 mL/kg). Coefficients of variation decrease for all automated respiratory cycle parameters in all infants. "t" values from ventilator respiratory cycle data are two to three times higher than ventilator respiratory cycles. Automated selection is highly specific. Automated respiratory cycle reflects most the interaction of both ventilator and patient. Improving discriminating power of ventilator monitoring will likely help in assessing disease status and following trends. Averaged parameters derived from automated respiratory cycles are more precise and could be displayed by ventilators to improve real-time fine tuning of ventilator settings.

Air pollution and acute respiratory response in a panel of asthmatic children along the U.S.-Mexico border.

PubMed

Sarnat, Stefanie Ebelt; Raysoni, Amit U; Li, Wen-Whai; Holguin, Fernando; Johnson, Brent A; Flores Luevano, Silvia; Garcia, Jose Humberto; Sarnat, Jeremy A

2012-03-01

Concerns regarding the health impact of urban air pollution on asthmatic children are pronounced along the U.S.-Mexico border because of rapid population growth near busy border highways and roads. We conducted the first binational study of the impacts of air pollution on asthmatic children in Ciudad Juarez, Mexico, and El Paso, Texas, USA, and compared different exposure metrics to assess acute respiratory response. We recruited 58 asthmatic children from two schools in Ciudad Juarez and two schools in El Paso. A marker of airway inflammation [exhaled nitric oxide (eNO)], respiratory symptom surveys, and pollutant measurements (indoor and outdoor 48-hr size-fractionated particulate matter, 48-hr black carbon, and 96-hr nitrogen dioxide) were collected at each school for 16 weeks. We examined associations between the pollutants and respiratory response using generalized linear mixed models. We observed small but consistent associations between eNO and numerous pollutant metrics, with estimated increases in eNO ranging from 1% to 3% per interquartile range increase in pollutant concentrations. Effect estimates from models using school-based concentrations were generally stronger than corresponding estimates based on concentrations from ambient air monitors. Both traffic-related and non-traffic-related particles were typically more robust predictors of eNO than was nitrogen dioxide, for which associations were highly sensitive to model specification. Associations differed significantly across the four school-based cohorts, consistent with heterogeneity in pollutant concentrations and cohort characteristics. Models examining respiratory symptoms were consistent with the null. The results indicate adverse effects of air pollution on the subclinical respiratory health of asthmatic children in this region and provide preliminary support for the use of air pollution monitors close to schools to track exposure and potential health risk in this population.

Noninvasive determination of anaerobic threshold by monitoring the %SpO2 changes and respiratory gas exchange.

PubMed

Nikooie, Roohollah; Gharakhanlo, Reza; Rajabi, Hamid; Bahraminegad, Morteza; Ghafari, Ali

2009-10-01

The purpose of this study was to determine the validity of noninvasive anaerobic threshold (AT) estimation using %SpO2 (arterial oxyhemoglobin saturation) changes and respiratory gas exchanges. Fifteen active, healthy males performed 2 graded exercise tests on a motor-driven treadmill in 2 separated sessions. Respiratory gas exchanges and heart rate (HR), lactate concentration, and %SpO2 were measured continuously throughout the test. Anaerobic threshold was determined based on blood lactate concentration (lactate-AT), %SpO2 changes (%SpO2-AT), respiratory exchange ratio (RER-AT), V-slope method (V-slope-AT), and ventilatory equivalent for O2 (EqO2-AT). Blood lactate measuring was considered as gold standard assessment of AT and was applied to confirm the validity of other noninvasive methods. The mean O2 corresponding to lactate-AT, %SpO2-AT, RER-AT, V-slope -AT, and EqO2-AT were 2176.6 +/- 206.4, 1909.5 +/- 221.4, 2141.2 +/- 245.6, 1933.7 +/- 216.4, and 1975 +/- 232.4, respectively. Intraclass correlation coefficient (ICC) analysis indicates a significant correlation between 4 noninvasive methods and the criterion method. Blond-Altman plots showed the good agreement between O2 corresponding to AT in each method and lactate-AT (95% confidence interval (CI). Our results indicate that a noninvasive and easy procedure of monitoring the %SpO2 is a valid method for estimation of AT. Also, in the present study, the respiratory exchange ratio (RER) method seemed to be the best respiratory index for noninvasive estimation of anaerobic threshold, and the heart rate corresponding to AT predicted by this method can be used by coaches and athletes to define training zones.

Extracting respiratory information from seismocardiogram signals acquired on the chest using a miniature accelerometer.

PubMed

Pandia, Keya; Inan, Omer T; Kovacs, Gregory T A; Giovangrandi, Laurent

2012-10-01

Seismocardiography (SCG) is a non-invasive measurement of the vibrations of the chest caused by the heartbeat. SCG signals can be measured using a miniature accelerometer attached to the chest, and are thus well-suited for unobtrusive and long-term patient monitoring. Additionally, SCG contains information relating to both cardiovascular and respiratory systems. In this work, algorithms were developed for extracting three respiration-dependent features of the SCG signal: intensity modulation, timing interval changes within each heartbeat, and timing interval changes between successive heartbeats. Simultaneously with a reference respiration belt, SCG signals were measured from 20 healthy subjects and a respiration rate was estimated using each of the three SCG features and the reference signal. The agreement between each of the three accelerometer-derived respiration rate measurements was computed with respect to the respiration rate derived from the reference respiration belt. The respiration rate obtained from the intensity modulation in the SCG signal was found to be in closest agreement with the respiration rate obtained from the reference respiration belt: the bias was found to be 0.06 breaths per minute with a 95% confidence interval of -0.99 to 1.11 breaths per minute. The limits of agreement between the respiration rates estimated using SCG (intensity modulation) and the reference were within the clinically relevant ranges given in existing literature, demonstrating that SCG could be used for both cardiovascular and respiratory monitoring. Furthermore, phases of each of the three SCG parameters were investigated at four instances of a respiration cycle-start inspiration, peak inspiration, start expiration, and peak expiration-and during breath hold (apnea). The phases of the three SCG parameters observed during the respiration cycle were congruent with existing literature and physiologically expected trends.

Four-dimensional computed tomography based respiratory-gated radiotherapy with respiratory guidance system: analysis of respiratory signals and dosimetric comparison.

PubMed

Lee, Jung Ae; Kim, Chul Yong; Yang, Dae Sik; Yoon, Won Sup; Park, Young Je; Lee, Suk; Kim, Young Bum

2014-01-01

To investigate the effectiveness of respiratory guidance system in 4-dimensional computed tomography (4 DCT) based respiratory-gated radiation therapy (RGRT) by comparing respiratory signals and dosimetric analysis of treatment plans. The respiratory amplitude and period of the free, the audio device-guided, and the complex system-guided breathing were evaluated in eleven patients with lung or liver cancers. The dosimetric parameters were assessed by comparing free breathing CT plan and 4 DCT-based 30-70% maximal intensity projection (MIP) plan. The use of complex system-guided breathing showed significantly less variation in respiratory amplitude and period compared to the free or audio-guided breathing regarding the root mean square errors (RMSE) of full inspiration (P = 0.031), full expiration (P = 0.007), and period (P = 0.007). The dosimetric parameters including V(5 Gy), V(10 Gy), V(20 Gy), V(30 Gy), V(40 Gy), and V(50 Gy) of normal liver or lung in 4 DCT MIP plan were superior over free breathing CT plan. The reproducibility and regularity of respiratory amplitude and period were significantly improved with the complex system-guided breathing compared to the free or the audio-guided breathing. In addition, the treatment plan based on the 4D CT-based MIP images acquired with the complex system guided breathing showed better normal tissue sparing than that on the free breathing CT.

Attitudes towards vital signs monitoring in the detection of clinical deterioration: scale development and survey of ward nurses.

PubMed

Mok, Wenqi; Wang, Wenru; Cooper, Simon; Ang, Emily Neo Kim; Liaw, Sok Ying

2015-06-01

To develop and determine the psychometrics properties of an instrument (V-scale) and to explore nurses' attitudes towards vital signs monitoring in the detection of clinical deterioration in general wards. Scale development with psychometric testing and a descriptive quantitative survey. Tertiary acute care hospital. A total of 614 general ward nurses. Principal component analysis revealed a 16-item instrument in a five-factor solution (key indicators, knowledge, communication, workload and technology) that explained 56.27% of the variance. The internal consistency was sufficient with Cronbach's alpha of 0.71 and strong item subscale correlations (0.56-0.89). The test-retest reliability was adequate with an Intraclass Correlation Coefficient (ICC) of 0.85. Many nurses (56.9%) erroneously perceived blood pressure changes as the first indicator of deterioration, and 46% agreed that an altered respiratory rate was the least important indicator. Most nurses (59.8%) also reported relying on oxygen saturation to evaluate respiratory dysfunction, and 27.4% indicated that they make quick estimates of the respiratory rate. Current practices for vital signs monitoring were considered to be time consuming (21.0%) and overwhelming (35.3%). Nurses' attitudes were most significantly influenced by whether they had a degree qualification followed by whether they worked in a general ward with a specialty and had >5 years of experience. This exploratory study provides evidence for the psychometric properties of the V-scale. It reveals a need for continuous professional development to improve ward nurses' attitudes towards vital signs monitoring. Vital signs monitoring needs to be prioritized in workload planning. © The Author 2015. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

Comparison of remote sensing and fixed-site monitoring approaches for examining air pollution and health in a national study population

NASA Astrophysics Data System (ADS)

Prud'homme, Genevieve; Dobbin, Nina A.; Sun, Liu; Burnett, Richard T.; Martin, Randall V.; Davidson, Andrew; Cakmak, Sabit; Villeneuve, Paul J.; Lamsal, Lok N.; van Donkelaar, Aaron; Peters, Paul A.; Johnson, Markey

2013-12-01

Satellite remote sensing (RS) has emerged as a cutting edge approach for estimating ground level ambient air pollution. Previous studies have reported a high correlation between ground level PM2.5 and NO2 estimated by RS and measurements collected at regulatory monitoring sites. The current study examined associations between air pollution and adverse respiratory and allergic health outcomes using multi-year averages of NO2 and PM2.5 from RS and from regulatory monitoring. RS estimates were derived using satellite measurements from OMI, MODIS, and MISR instruments. Regulatory monitoring data were obtained from Canada's National Air Pollution Surveillance Network. Self-reported prevalence of doctor-diagnosed asthma, current asthma, allergies, and chronic bronchitis were obtained from the Canadian Community Health Survey (a national sample of individuals 12 years of age and older). Multi-year ambient pollutant averages were assigned to each study participant based on their six digit postal code at the time of health survey, and were used as a marker for long-term exposure to air pollution. RS derived estimates of NO2 and PM2.5 were associated with 6-10% increases in respiratory and allergic health outcomes per interquartile range (3.97 μg m-3 for PM2.5 and 1.03 ppb for NO2) among adults (aged 20-64) in the national study population. Risk estimates for air pollution and respiratory/allergic health outcomes based on RS were similar to risk estimates based on regulatory monitoring for areas where regulatory monitoring data were available (within 40 km of a regulatory monitoring station). RS derived estimates of air pollution were also associated with adverse health outcomes among participants residing outside the catchment area of the regulatory monitoring network (p < 0.05). The consistency between risk estimates based on RS and regulatory monitoring as well as the associations between air pollution and health among participants living outside the catchment area for regulatory monitoring suggest that RS can provide useful estimates of long-term ambient air pollution in epidemiologic studies. This is particularly important in rural communities and other areas where monitoring and modeled air pollution data are limited or unavailable.

40 CFR 721.72 - Hazard communication program.

Code of Federal Regulations, 2011 CFR

2011-07-01

... irritation. (ii) Respiratory complications. (iii) Central nervous system effects. (iv) Internal organ effects... irritation (B) Respiratory complications (C) Central nervous system effects (D) Internal organ effects (E... irritation (B) Respiratory complications (C) Central nervous system effects (D) Internal organ effects (E...

40 CFR 721.72 - Hazard communication program.

Code of Federal Regulations, 2010 CFR

2010-07-01

... irritation. (ii) Respiratory complications. (iii) Central nervous system effects. (iv) Internal organ effects... irritation (B) Respiratory complications (C) Central nervous system effects (D) Internal organ effects (E... irritation (B) Respiratory complications (C) Central nervous system effects (D) Internal organ effects (E...

40 CFR 721.72 - Hazard communication program.

Code of Federal Regulations, 2012 CFR

2012-07-01

... irritation. (ii) Respiratory complications. (iii) Central nervous system effects. (iv) Internal organ effects... irritation (B) Respiratory complications (C) Central nervous system effects (D) Internal organ effects (E... irritation (B) Respiratory complications (C) Central nervous system effects (D) Internal organ effects (E...

40 CFR 721.72 - Hazard communication program.

Code of Federal Regulations, 2014 CFR

2014-07-01

... irritation. (ii) Respiratory complications. (iii) Central nervous system effects. (iv) Internal organ effects... irritation (B) Respiratory complications (C) Central nervous system effects (D) Internal organ effects (E... irritation (B) Respiratory complications (C) Central nervous system effects (D) Internal organ effects (E...

40 CFR 721.72 - Hazard communication program.

Code of Federal Regulations, 2013 CFR

2013-07-01

... irritation. (ii) Respiratory complications. (iii) Central nervous system effects. (iv) Internal organ effects... irritation (B) Respiratory complications (C) Central nervous system effects (D) Internal organ effects (E... irritation (B) Respiratory complications (C) Central nervous system effects (D) Internal organ effects (E...

Respiratory system

NASA Technical Reports Server (NTRS)

Bartlett, R. G., Jr.

1973-01-01

The general anatomy and function of the human respiratory system is summarized. Breathing movements, control of breathing, lung volumes and capacities, mechanical relations, and factors relevant to respiratory support and equipment design are discussed.

The respiratory-vocal system of songbirds: anatomy, physiology, and neural control.

PubMed

Schmidt, Marc F; Martin Wild, J

2014-01-01

This wide-ranging review presents an overview of the respiratory-vocal system in songbirds, which are the only other vertebrate group known to display a degree of respiratory control during song rivalling that of humans during speech; this despite the fact that the peripheral components of both the respiratory and vocal systems differ substantially in the two groups. We first provide a brief description of these peripheral components in songbirds (lungs, air sacs and respiratory muscles, vocal organ (syrinx), upper vocal tract) and then proceed to a review of the organization of central respiratory-related neurons in the spinal cord and brainstem, the latter having an organization fundamentally similar to that of the ventral respiratory group of mammals. The second half of the review describes the nature of the motor commands generated in a specialized "cortical" song control circuit and how these might engage brainstem respiratory networks to shape the temporal structure of song. We also discuss a bilaterally projecting "respiratory-thalamic" pathway that links the respiratory system to "cortical" song control nuclei. This necessary pathway for song originates in the brainstem's primary inspiratory center and is hypothesized to play a vital role in synchronizing song motor commands both within and across hemispheres. © 2014 Elsevier B.V. All rights reserved.

The respiratory-vocal system of songbirds: Anatomy, physiology, and neural control

PubMed Central

Schmidt, Marc F.; Wild, J. Martin

2015-01-01

This wide-ranging review presents an overview of the respiratory-vocal system in songbirds, which are the only other vertebrate group known to display a degree of respiratory control during song rivalling that of humans during speech; this despite the fact that the peripheral components of both the respiratory and vocal systems differ substantially in the two groups. We first provide a brief description of these peripheral components in songbirds (lungs, air sacs and respiratory muscles, vocal organ (syrinx), upper vocal tract) and then proceed to a review of the organization of central respiratory-related neurons in the spinal cord and brainstem, the latter having an organization fundamentally similar to that of the ventral respiratory group of mammals. The second half of the review describes the nature of the motor commands generated in a specialized “cortical” song control circuit and how these might engage brainstem respiratory networks to shape the temporal structure of song. We also discuss a bilaterally projecting “respiratory-thalamic” pathway that links the respiratory system to “cortical” song control nuclei. This necessary pathway for song originates in the brainstem’s primary inspiratory center and is hypothesized to play a vital role in synchronizing song motor commands both within and across hemispheres. PMID:25194204

Interleukin-6 and lung inflammation: evidence for a causative role in inducing respiratory system resistance increments.

PubMed

Rubini, Alessandro

2013-10-01

Interleukin-6 is a multifunctional cytokine that has been shown to be increased in some pathological conditions involving the respiratory system such as those experimentally induced in animals or spontaneously occurring in humans. Experimental data demonstrating that interleukin-6 plays a significant role in commonly occurring respiratory system inflammatory diseases are reviewed here. Those diseases, i.e. asthma and chronic obstructive pulmonary disease, are characterised by mechanical derangements of the respiratory system, for the most part due to increased elastance and airway resistance. Recent findings showing that interleukin-6 has a causative role in determining an increase in airway resistance are reviewed. The end-inflation occlusion method was used to study the mechanical properties of the respiratory system before and after interleukin-6 administration. The cytokine was shown to induce significant, dose-dependent increments in both the resistive pressure dissipation due to frictional forces opposing the airflow in the airway (ohmic resistance) and the additional resistive pressure dissipation due to the visco-elastic properties of the system, i.e. stress relaxation (visco-elastic resistance). There were no alterations in respiratory system elastance. Even when administered to healthy mammals, interleukin-6 determines a significant effect on respiratory system resistance causing an increase in the mechanical work of breathing during inspiration. IL-6 hypothetically plays an active role in the pathogenesis of respiratory system diseases and the mechanisms that may be involved are discussed here.

75 FR 33166 - Extension of Expiration Dates for Several Body System Listings

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-11

... Impairment, Hematological Disorders, Musculoskeletal System, Mental Disorders, Neurological, and Respiratory... be effective: Growth Impairment (100.00); Respiratory System (3.00 and 103.00); Hematological... listings (70 FR 53323 (2005)), the respiratory listings (70 FR 19358 (2005)), the cardiovascular listings...

The effects of low tidal ventilation on lung strain correlate with respiratory system compliance.

PubMed

Xie, Jianfeng; Jin, Fang; Pan, Chun; Liu, Songqiao; Liu, Ling; Xu, Jingyuan; Yang, Yi; Qiu, Haibo

2017-02-03

The effect of alterations in tidal volume on mortality of acute respiratory distress syndrome (ARDS) is determined by respiratory system compliance. We aimed to investigate the effects of different tidal volumes on lung strain in ARDS patients who had various levels of respiratory system compliance. Nineteen patients were divided into high (C high group) and low (C low group) respiratory system compliance groups based on their respiratory system compliance values. We defined compliance ≥0.6 ml/(cmH 2 O/kg) as C high and compliance <0.6 ml/(cmH 2 O/kg) as C low . End-expiratory lung volumes (EELV) at various tidal volumes were measured by nitrogen wash-in/washout. Lung strain was calculated as the ratio between tidal volume and EELV. The primary outcome was that lung strain is a function of tidal volume in patients with various levels of respiratory system compliance. The mean baseline EELV, strain and respiratory system compliance values were 1873 ml, 0.31 and 0.65 ml/(cmH 2 O/kg), respectively; differences in all of these parameters were statistically significant between the two groups. For all participants, a positive correlation was found between the respiratory system compliance and EELV (R = 0.488, p = 0.034). Driving pressure and strain increased together as the tidal volume increased from 6 ml/kg predicted body weight (PBW) to 12 ml/kg PBW. Compared to the C high ARDS patients, the driving pressure was significantly higher in the C low patients at each tidal volume. Similar effects of lung strain were found for tidal volumes of 6 and 8 ml/kg PBW. The "lung injury" limits for driving pressure and lung strain were much easier to exceed with increases in the tidal volume in C low patients. Respiratory system compliance affected the relationships between tidal volume and driving pressure and lung strain in ARDS patients. These results showed that increasing tidal volume induced lung injury more easily in patients with low respiratory system compliance. Clinicaltrials.gov identifier NCT01864668 , Registered 21 May 2013.

SU-E-J-48: Development of An Abdominal Compression Device for Respiratory Correlated Radiation Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kim, T; Kang, S; Kim, D

Purpose: The aim of this study is to develop the abdominal compression device which could control pressure level according to the abdominal respiratory motion and evaluate its feasibility. Methods: In this study, we focused on developing the abdominal compression device which could control pressure level at any point of time so the developed device is possible to use a variety of purpose (gating technique or respiratory training system) while maintaining the merit of the existing commercial device. The compression device (air pad form) was designed to be able to compress the front and side of abdomen and the pressure levelmore » of the abdomen is controlled by air flow. Pressure level of abdomen (air flow) was determined using correlation data between external abdominal motion and respiratory volume signal measured by spirometer. In order to verify the feasibility of the device, it was necessary to confirm the correlation between the abdominal respiratory motion and respiratory volume signal and cooperation with respiratory training system also checked. Results: In the previous study, we could find that the correlation coefficient ratio between diaphragm and respiratory volume signal measured by spirometer was 0.95. In this study, we confirmed the correlation between the respiratory volume signal and the external abdominal motion measured by belt-transducer (correlation coefficient ratio was 0.92) and used the correlated respiratory volume data as an abdominal pressure level. It was possible to control the pressure level with negligible time delay and respiratory volume data based guiding waveforms could be properly inserted into the respiratory training system. Conclusion: Through this feasibility study, we confirmed the correlation between the respiratory volume signal and the external abdominal motion. Also initial assessment of the device and its compatibility with the respiratory training system were verified. Further study on application in respiratory gated therapy and respiratory training system will be investigated. This work was supported by Radiation Technology R and D program (No. 2013M2A2A7043498)and Basic Atomic Energy Research Institute (BAERI)(No. NRF-2009-0078390) through the National Research Foundation of Korea funded by the Ministry of Science, ICT and Future Planning.« less

Synthetic cannabis and respiratory depression.

PubMed

Jinwala, Felecia N; Gupta, Mayank

2012-12-01

In recent years, synthetic cannabis use has been increasing in appeal among adolescents, and its use is now at a 30 year peak among high school seniors. The constituents of synthetic cannabis are difficult to monitor, given the drug's easy accessibility. Currently, 40 U.S. states have banned the distribution and use of some known synthetic cannabinoids, and have included these drugs in the Schedule I category. The depressive respiratory effect in humans caused by synthetic cannabis inhalation has not been thoroughly investigated in the medical literature. We are the first to report, to our knowledge, two cases of self-reported synthetic cannabis use leading to respiratory depression and necessary intubation.

Wearable technology: role in respiratory health and disease.

PubMed

Aliverti, Andrea

2017-06-01

In the future, diagnostic devices will be able to monitor a patient's physiological or biochemical parameters continuously, under natural physiological conditions and in any environment through wearable biomedical sensors. Together with apps that capture and interpret data, and integrated enterprise and cloud data repositories, the networks of wearable devices and body area networks will constitute the healthcare's Internet of Things. In this review, four main areas of interest for respiratory healthcare are described: pulse oximetry, pulmonary ventilation, activity tracking and air quality assessment. Although several issues still need to be solved, smart wearable technologies will provide unique opportunities for the future or personalised respiratory medicine.

[Functional respiratory and blood gas analytical studies of the effects of fenspiride, in oral and intramuscular administration, in chronic bronchopneumopathic subjects].

PubMed

Cascella, D; Raffi, G B; Caudarella, R; Gennari, P; Caprara, C; Cipolla, C

1979-12-01

A group of 20 chronic bronchopneumopathics was treated for 15 days with fenspiride orally and i.m. The behaviour of a set of functional respiratory and haemogasanalytic parameters was monitored at various times (basic, 5th, 10th and 15th days). Progressive, significant improvements in VC, FEV1, RV and in related parameters were observed. These were attributed to the drug's anti-inflammatory effect in the respiratory ways as well as to its direct antibronchospastic action. Stress is laid on the excellent clinical tolerance of fenspiride following its oral and i.m. administration.

Tetany During Intravenous Conscious Sedation in Dentistry Resulting From Hyperventilation-Induced Hypocapnia.

PubMed

McCarthy, Caroline; Brady, Paul; O'Halloran, Ken D; McCreary, Christine

2016-01-01

Hyperventilation can be a manifestation of anxiety that involves abnormally fast breathing (tachypnea) and an elevated minute ventilation that exceeds metabolic demand. This report describes a case of hyperventilation-induced hypocapnia resulting in tetany in a 16-year-old girl undergoing orthodontic extractions under intravenous conscious sedation. Pulse oximetry is the gold standard respiratory-related index in conscious sedation. Although the parameter has great utility in determining oxygen desaturation, it provides no additional information on respiratory function, including, for example, respiratory rate. In this case, we found capnography to be a very useful aid to monitor respiration in this patient and also to treat the hypocapnia.

Wearable technology: role in respiratory health and disease

PubMed Central

2017-01-01

In the future, diagnostic devices will be able to monitor a patient’s physiological or biochemical parameters continuously, under natural physiological conditions and in any environment through wearable biomedical sensors. Together with apps that capture and interpret data, and integrated enterprise and cloud data repositories, the networks of wearable devices and body area networks will constitute the healthcare’s Internet of Things. In this review, four main areas of interest for respiratory healthcare are described: pulse oximetry, pulmonary ventilation, activity tracking and air quality assessment. Although several issues still need to be solved, smart wearable technologies will provide unique opportunities for the future or personalised respiratory medicine. PMID:28966692

An approach to monitoring cyanobacteria blooms at surface drinking water intakes using satellite imagery (10th National Monitoring Conference)

EPA Science Inventory

Cyanobacterial blooms occur worldwide and are associated with human respiratory irritation, undesirable taste and odor of potable water, increased drinking water treatment costs, loss of revenue from recreational use, and human illness as a result of ingestion or skin exposure du...

Correlation Between Hierarchical Bayesian and Aerosol Optical Depth PM2.5 Data and Respiratory-Cardiovascular Chronic Diseases

EPA Science Inventory

Tools to estimate PM2.5 mass have expanded in recent years, and now include: 1) stationary monitor readings, 2) Community Multi-Scale Air Quality (CMAQ) model estimates, 3) Hierarchical Bayesian (HB) estimates from combined stationary monitor readings and CMAQ model output; and, ...

Design of a new artificial breathing system for simulating the human respiratory activities.

PubMed

Essoukaki, Elmaati; Rattal, Mourad; Ben Taleb, Lhoucine; Harmouchi, Mohammed; Assir, Abdelhadi; Mouhsen, Azeddine; Lyazidi, Aissam

2018-01-01

The purpose of this work is the conception and implementation of an artificial active respiratory system that allows the simulation of human respiratory activities. The system consists of two modules, mechanical and electronical. The first one represents a cylindrical lung adjustable in resistance and compliance. This lung is located inside a transparent thoracic box, connected to a piston that generates variable respiratory efforts. The parameters of the system, which are pressure, flow and volume, are measured by the second module. A computer application was developed to control the whole system, and enables the display of the parameters. A series of tests were made to evaluate the respiratory efforts, resistances and compliances. The results were compared to the bibliographical studies, allowing the validation of the proposed system.

Respiratory monitoring system based on the nasal pressure technique for the analysis of sleep breathing disorders: Reduction of static and dynamic errors, and comparisons with thermistors and pneumotachographs

NASA Astrophysics Data System (ADS)

Alves de Mesquita, Jayme; Lopes de Melo, Pedro

2004-03-01

Thermally sensitive devices—thermistors—have usually been used to monitor sleep-breathing disorders. However, because of their long time constant, these devices are not able to provide a good characterization of fast events, like hypopneas. Nasal pressure recording technique (NPR) has recently been suggested to quantify airflow during sleep. It is claimed that the short time constants of the devices used to implement this technique would allow an accurate analysis of fast abnormal respiratory events. However, these devices present errors associated with nonlinearities and acoustic resonance that could reduce the diagnostic value of the NPR. Moreover, in spite of the high scientific and clinical potential, there is no detailed description of a complete instrumentation system to implement this promising technique in sleep studies. In this context, the purpose of this work was twofold: (1) describe the development of a flexible NPR device and (2) evaluate the performance of this device when compared to pneumotachographs (PNTs) and thermistors. After the design details are described, the system static accuracy is evaluated by a comparative analysis with a PNT. This analysis revealed a significant reduction (p<0.001) of the static error when system nonlinearities were reduced. The dynamic performance of the NPR system was investigated by frequency response analysis and time constant evaluations and the results showed that the developed device response was as good as PNT and around 100 times faster (τ=5,3 ms) than thermistors (τ=512 ms). Experimental results obtained in simulated clinical conditions and in a patient are presented as examples, and confirmed the good features achieved in engineering tests. These results are in close agreement with physiological fundamentals, supplying substantial evidence that the improved dynamic and static characteristics of this device can contribute to a more accurate implementation of medical research projects and to improve the diagnoses of sleep-breathing disorders.

Respiratory infections in children up to two years of age on prophylaxis with palivizumab

PubMed Central

Monteiro, Ana Isabel M. P.; Bellei, Nancy Cristina J.; Sousa, Alessandra Ramos; dos Santos, Amélia Miyashiro N.; Weckx, Lily Yin

2014-01-01

OBJECTIVE: To identify the viruses involved in acute respiratory tract infections and to analyze the rates of hospitalization and death in children on palivizumab prophylaxis. METHODS: Prospective cohort of 198 infants up to one year old who were born before 29 weeks of gestational age and infants under two years old with hemodynamically unstable cardiopathy or chronic pulmonary disease who received prophylactic palivizumab against severe respiratory syncytial virus infections in 2008. During the study period, in each episode of acute respiratory tract infection, nasopharyngeal aspirate was collected to identify respiratory syncytial virus, adenovirus, parainfluenza 1, 2 and 3, influenza A and B by direct immunofluorescence, rhinovirus and metapneumovirus by polymerase chain reaction preceded by reverse transcription. Data regarding hospitalization and deaths were monitored. RESULTS: Among the 198 studied infants, 117 (59.1%) presented acute respiratory tract infections, with a total of 175 episodes. Of the 76 nasopharyngeal aspirates collected during respiratory tract infections, 37 were positive, as follow: rhinovirus (75.7%), respiratory syncytial virus (18.9%), parainfluenza (8.1%), adenovirus 2 (2.7%), metapneumovirus (2.7%) and three samples presented multiple agents. Of the 198 children, 48 (24.4%) were hospitalized: 30 (15.2%) for non-infectious etiology and 18 (9.1%) for respiratory causes. Among these 18 children, one case of respiratory syncytial virus was identified. Two deaths were reported, but respiratory syncytial virus was not identified. CONCLUSIONS: During the prophylaxis period, low frequency of respiratory syncytial virus infections and low rates of hospitalization were observed, suggesting the benefit of palivizumab prophylaxis. PMID:25119744

Risk factors for impaired respiratory function during nurse-administered procedural sedation and analgesia in the cardiac catheterisation laboratory: a matched case-control study.

PubMed

Conway, Aaron; Page, Karen; Rolley, John; Fulbrook, Paul

2013-08-01

Side effects of the medications used for procedural sedation and analgesia in the cardiac catheterisation laboratory are known to cause impaired respiratory function. Impaired respiratory function poses considerable risk to patient safety as it can lead to inadequate oxygenation. Having knowledge about the conditions that predict impaired respiratory function prior to the procedure would enable nurses to identify at-risk patients and selectively implement intensive respiratory monitoring. This would reduce the possibility of inadequate oxygenation occurring. To identify pre-procedure risk factors for impaired respiratory function during nurse-administered procedural sedation and analgesia in the cardiac catheterisation laboratory. Retrospective matched case-control. 21 cases of impaired respiratory function were identified and matched to 113 controls from a consecutive cohort of patients over 18 years of age. Conditional logistic regression was used to identify risk factors for impaired respiratory function. With each additional indicator of acute illness, case patients were nearly two times more likely than their controls to experience impaired respiratory function (OR 1.78; 95% CI 1.19-2.67; p = 0.005). Indicators of acute illness included emergency admission, being transferred from a critical care unit for the procedure or requiring respiratory or haemodynamic support in the lead up to the procedure. Several factors that predict the likelihood of impaired respiratory function were identified. The results from this study could be used to inform prospective studies investigating the effectiveness of interventions for impaired respiratory function during nurse-administered procedural sedation and analgesia in the cardiac catheterisation laboratory.

Extraction of respiratory signals from the electrocardiogram and photoplethysmogram: technical and physiological determinants.

PubMed

Charlton, Peter H; Bonnici, Timothy; Tarassenko, Lionel; Alastruey, Jordi; Clifton, David A; Beale, Richard; Watkinson, Peter J

2017-05-01

Breathing rate (BR) can be estimated by extracting respiratory signals from the electrocardiogram (ECG) or photoplethysmogram (PPG). The extracted respiratory signals may be influenced by several technical and physiological factors. In this study, our aim was to determine how technical and physiological factors influence the quality of respiratory signals. Using a variety of techniques 15 respiratory signals were extracted from the ECG, and 11 from PPG signals collected from 57 healthy subjects. The quality of each respiratory signal was assessed by calculating its correlation with a reference oral-nasal pressure respiratory signal using Pearson's correlation coefficient. Relevant results informing device design and clinical application were obtained. The results informing device design were: (i) seven out of 11 respiratory signals were of higher quality when extracted from finger PPG compared to ear PPG; (ii) laboratory equipment did not provide higher quality of respiratory signals than a clinical monitor; (iii) the ECG provided higher quality respiratory signals than the PPG; (iv) during downsampling of the ECG and PPG significant reductions in quality were first observed at sampling frequencies of  <250 Hz and  <16 Hz respectively. The results informing clinical application were: (i) frequency modulation-based respiratory signals were generally of lower quality in elderly subjects compared to young subjects; (ii) the qualities of 23 out of 26 respiratory signals were reduced at elevated BRs; (iii) there were no differences associated with gender. Recommendations based on the results are provided regarding device designs for BR estimation, and clinical applications. The dataset and code used in this study are publicly available.

Reductions in the variations of respiration signals for respiratory-gated radiotherapy when using the video-coaching respiration guiding system

NASA Astrophysics Data System (ADS)

Lee, Hyun Jeong; Yea, Ji Woon; Oh, Se An

2015-07-01

Respiratory-gated radiation therapy (RGRT) has been used to minimize the dose to normal tissue in lung-cancer radiotherapy. The present research aims to improve the regularity of respiration in RGRT by using a video-coached respiration guiding system. In the study, 16 patients with lung cancer were evaluated. The respiration signals of the patients were measured by using a realtime position management (RPM) respiratory gating system (Varian, USA), and the patients were trained using the video-coaching respiration guiding system. The patients performed free breathing and guided breathing, and the respiratory cycles were acquired for ~5 min. Then, Microsoft Excel 2010 software was used to calculate the mean and the standard deviation for each phase. The standard deviation was computed in order to analyze the improvement in the respiratory regularity with respect to the period and the displacement. The standard deviation of the guided breathing decreased to 48.8% in the inhale peak and 24.2% in the exhale peak compared with the values for the free breathing of patient 6. The standard deviation of the respiratory cycle was found to be decreased when using the respiratory guiding system. The respiratory regularity was significantly improved when using the video-coaching respiration guiding system. Therefore, the system is useful for improving the accuracy and the efficiency of RGRT.

The Circadian System Contributes to Apnea Lengthening across the Night in Obstructive Sleep Apnea.

PubMed

Butler, Matthew P; Smales, Carolina; Wu, Huijuan; Hussain, Mohammad V; Mohamed, Yusef A; Morimoto, Miki; Shea, Steven A

2015-11-01

To test the hypothesis that respiratory event duration exhibits an endogenous circadian rhythm. Within-subject and between-subjects. Inpatient intensive physiologic monitoring unit at the Brigham and Women's Hospital. Seven subjects with moderate/severe sleep apnea and four controls, age 48 (SD = 12) years, 7 males. Subjects completed a 5-day inpatient protocol in dim light. Polysomnography was recorded during an initial control 8-h night scheduled at the usual sleep time, then through 10 recurrent cycles of 2 h 40 min sleep and 2 h 40 min wake evenly distributed across all circadian phases, and finally during another 8-h control sleep period. Event durations, desaturations, and apnea-hypopnea index for each sleep opportunity were assessed according to circadian phase (derived from salivary melatonin), time into sleep, and sleep stage. Average respiratory event durations in NREM sleep significantly lengthened across both control nights (21.9 to 28.2 sec and 23.7 to 30.2 sec, respectively). During the circadian protocol, event duration in NREM increased across the circadian phases that corresponded to the usual sleep period, accounting for > 50% of the increase across normal 8-h control nights. AHI and desaturations were also rhythmic: AHI was highest in the biological day while desaturations were greatest in the biological night. The endogenous circadian system plays an important role in the prolongation of respiratory events across the night, and might provide a novel therapeutic target for modulating sleep apnea. © 2015 Associated Professional Sleep Societies, LLC.

Digital technology in respiratory diseases: Promises, (no) panacea and time for a new paradigm.

PubMed

Pinnock, Hilary; McKinstry, Brian

2016-05-01

In a world where digital technology has revolutionized the way we work, shop and manage our finances it is unsurprising that digital systems are suggested as potential solutions to delivering clinically and cost-effective care for an aging population with one or more long-term conditions. However, recent evidence suggesting that telehealth may not be quite the panacea that was promised, has led to discussions on the mechanisms and role of digital technology in respiratory care. Implementation in rural and remote settings offers significant benefits in terms of convenient access to care, but is contingent on technical and organizational infrastructure. Telemonitoring systems rely on algorithms to detect deterioration and trigger alerts; machine learning may enable telemonitoring of the future to develop personalized systems that are sensitive to clinical status whilst reducing false alerts. By providing access to information, offering convenient and flexible modes of communication and enabling the transfer of monitoring data to support professional assessment, telehealth can support self-management. At present, all too often, expensive 'off the shelf' systems are purchased and given to clinicians to use. It is time for the paradigm to shift. As clinicians we should identify the specific challenges we face in delivering care, and expect flexible systems that can be customized to individual patients' requirements and adapted to our diverse healthcare contexts. © The Author(s) 2016.

A Review on the Respiratory System Toxicity of Carbon Nanoparticles.

PubMed

Pacurari, Maricica; Lowe, Kristine; Tchounwou, Paul B; Kafoury, Ramzi

2016-03-15

The respiratory system represents the main gateway for nanoparticles' entry into the human body. Although there is a myriad of engineered nanoparticles, carbon nanoparticles/nanotubes (CNPs/CNTs) have received much attention mainly due to their light weight, very high surface area, durability, and their diverse applications. Since their discovery and manufacture over two decades ago, much has been learned about nanoparticles' interactions with diverse biological system models. In particular, the respiratory system has been of great interest because various natural and man-made fibrous particles are known to be responsible for chronic and debilitating lung diseases. In this review, we present up-to-date the literature regarding the effects of CNTs or carbon nanofibers (CNFs) on the human respiratory system with respect to respiratory toxicity pathways and associated pathologies. This article is intended to emphasize the potentially dangerous effects to the human respiratory system if inadequate measures are used in the manufacture, handling, and preparation and applications of CNP or CNP-based products.

Risk Factors for Postoperative Respiratory Mortality and Morbidity in Patients Undergoing Coronary Artery Bypass Grafting

PubMed Central

Rajaei, Samira; Dabbagh, Ali

2012-01-01

ABSTRACT Nowadays, coronary artery bypass grafting (CABG) is considered to be one of the most common surgical procedures. This procedure has been the main topic in many clinical research studies, which have assessed the effect of the procedure on patients’ outcomes. Like other surgical procedures, this procedure is also accompanied by a number of unwanted complications, including those of the respiratory system. Since the respiratory system plays an integral role in defining the clinical outcome of patients, improvements in studies that can assess and predict clinical outcomes of the respiratory system, assume greater importance. There are a number of predictive models which can assess patients in the preoperative period and introduce a number of risk factors, which could be considered as prognostic factors for patients undergoing CABG. The respiratory system is among the clinical systems that are assessed in many prediction scoring systems. This review assesses the main studies which have evaluated the possible risk factors for postoperative respiratory mortality and morbidity, in patients undergoing CABG. PMID:24223339

A Review on the Respiratory System Toxicity of Carbon Nanoparticles

PubMed Central

Pacurari, Maricica; Lowe, Kristine; Tchounwou, Paul B.; Kafoury, Ramzi

2016-01-01

The respiratory system represents the main gateway for nanoparticles’ entry into the human body. Although there is a myriad of engineered nanoparticles, carbon nanoparticles/nanotubes (CNPs/CNTs) have received much attention mainly due to their light weight, very high surface area, durability, and their diverse applications. Since their discovery and manufacture over two decades ago, much has been learned about nanoparticles’ interactions with diverse biological system models. In particular, the respiratory system has been of great interest because various natural and man-made fibrous particles are known to be responsible for chronic and debilitating lung diseases. In this review, we present up-to-date the literature regarding the effects of CNTs or carbon nanofibers (CNFs) on the human respiratory system with respect to respiratory toxicity pathways and associated pathologies. This article is intended to emphasize the potentially dangerous effects to the human respiratory system if inadequate measures are used in the manufacture, handling, and preparation and applications of CNP or CNP-based products. PMID:26999172

Respiratory health outcomes and air pollution in the Eastern Mediterranean Region: a systematic review.

PubMed

Abdo, Nour; Khader, Yousef S; Abdelrahman, Mostafa; Graboski-Bauer, Ashley; Malkawi, Mazen; Al-Sharif, Munjed; Elbetieha, Ahmad M

2016-06-01

Exposure to air pollution can cause detrimental health and be an economic burden. With newly developed equipment, monitoring of different air pollutants, identifying the sources, types of air pollutants and their corresponding concentrations, and applying mitigation intervention techniques became a crucial step in public health protection. Countries in the Eastern Mediterranean Region (EMR) are highly exposed to dust storms, have high levels of particulate matter (PM) concentrations, and have a unique climatic as well as topographic and socio-economic structure. This is the first study conducted to systemically and qualitatively assess the health impacts of air pollution in the EMR, identify susceptible populations, and ascertain research and knowledge gaps in the literature to better inform decisions by policy makers. We screened relevant papers and reports published between 2000 and 2014 in research databases. A total of 36 published studies met the inclusion criteria. A variety of indoor and outdoor exposures associated with various acute and chronic respiratory health outcomes were included. Respiratory health outcomes ranged in severity, from allergies and general respiratory complaints to lung cancer and mortality. Several adverse health outcomes were positively associated with various indoor/outdoor air pollutants throughout the EMR. However, epidemiological literature concerning the EMR is limited to a few studies in a few countries. More research is needed to elucidate the health outcomes of air pollution. Standardized reliable assessments on the national level for various air pollutants in different regions should be implemented and made publically available for researchers to utilize in their research. Moreover, advancing and utilizing more sound epidemiological designs and studies on the effect of air pollution on the respiratory health outcomes is needed to portray the actual situation in the region.

Breathing and temperature control disrupted by morphine and stabilized by clonidine in neonatal rats.

PubMed

Kesavan, Kalpashri; Ezell, Tarrah; Bierman, Alexis; Nunes, Ana Rita; Northington, Frances J; Tankersley, Clarke G; Gauda, Estelle B

2014-09-15

Sedative-analgesics are often given to newborn infants and are known to affect many components of the autonomic nervous system. While morphine is most frequently used, α-2 adrenergic receptor agonists are being increasingly used in this population. Alpha-2 adrenergic receptors agonists also have anti-shivering properties which may make it a desirable drug to give to infants undergoing therapeutic hypothermia. The aim of this study was to systematically compare two different classes of sedative-analgesics, morphine, a μ-opioid receptor agonist, and clonidine an α-2 adrenergic receptor agonist on breathing, metabolism and core body temperature (CBT) in neonatal rodents. Breathing parameters, oxygen consumption (VO2) and carbon dioxide production (VCO2), were measured prior to, 10 and 90 min after intraperitoneal (IP) administration of morphine (2, 10 or 20 mg/kg), clonidine (40, 200 or 400 μg/kg), or saline in Sprague-Dawley rat pups at postnatal day 7 (p7) while continuously monitoring CBT. Morphine reduced the respiratory rate, VO2 and VCO2 greater than clonidine at all dosages used (p<0.05, morphine vs. clonidine, for all metabolic and respiratory parameters). Furthermore, morphine induced prolonged respiratory pauses, which were not observed in animals treated with clonidine or saline. Morphine caused hypothermia which was dose dependent, while clonidine stabilized CBT in comparison to saline treated animals (p<0.0001). In the newborn rat, morphine causes profound respiratory depression and hypothermia while clonidine causes minimal respiratory depression and stabilizes CBT. All together, we suggest that clonidine promotes autonomic stability and may be a desirable agent to use in infants being treated with therapeutic hypothermia. Copyright © 2014 Elsevier B.V. All rights reserved.

BREATHING AND TEMPERATURE CONTROL DISRUPTED BY MORPHINE AND STABILIZED BY CLONIDINE IN NEONATAL RATS

PubMed Central

Kesavan, Kalpashri; Ezell, Tarrah; Bierman, Alexis; Nunes, Ana Rita; Northington, Frances J.; Tankersley, Clarke G.; Gauda, Estelle B.

2014-01-01

Background Sedative-analgesics are often given to newborn infants and are known to affect many components of the autonomic nervous system. While morphine is most frequently used, α-2 adrenergic receptor agonists are being increasingly used in this population. Alpha-2 adrenergic receptors agonists also have anti-shivering properties which may make it a desirable drug to give to infants undergoing therapeutic hypothermia. The aim of this study was to systematically compare two different classes of sedative-analgesics, morphine, a μ-opioid receptor agonist, and clonidine an α-2 adrenergic receptor agonist on breathing, metabolism and core body temperature (CBT) in neonatal rodents. Methods Breathing parameters, oxygen consumption (VO2) and carbon dioxide production (VCO2), were measured prior to, 10 and 90 minutes after intraperitoneal (IP) administration of morphine (2, 10 or 20mg/kg), clonidine (40, 200 or 400 μg/kg), or saline in Sprague-Dawley rat pups at postnatal day 7 (p7) while continuously monitoring CBT. Results Morphine reduced the respiratory rate, VO2 and VCO2 greater than clonidine at all dosages used (p<0.05, morphine vs. clonidine, for all metabolic and respiratory parameters). Furthermore, morphine induced prolonged respiratory pauses, which were not observed in animals treated with clonidine or saline. Morphine caused hypothermia which was dose dependent, while clonidine stabilized CBT in comparison to saline treated animals (p<0.0001). Conclusion In the newborn rat, morphine causes profound respiratory depression and hypothermia while clonidine causes minimal respiratory depression and stabilizes CBT. All together, we suggest that clonidine promotes autonomic stability and may be a desirable agent to use in infants being treated with therapeutic hypothermia. PMID:25008573

Respiratory tract immune response to microbial pathogens.

PubMed

Wilkie, B N

1982-11-15

Effective resistance to respiratory tract infection depends principally on specific immunity on mucosal surfaces of the upper or lower respiratory tract. Respiratory tract immune response comprises antibody and cell-mediated systems and may be induced most readily by surface presentation of replicating agents but can result from parenteral or local presentation of highly immunogenic antigens. Upper and lower respiratory tract systems differ in immunologic competence, with the lungs having a greater inventory of protective mechanisms than the trachea or nose. Several effective vaccines have been developed for prevention or modification of respiratory tract diseases.

Effects of viral respiratory disease education and surveillance on antibiotic prescribing.

PubMed

Temte, J L; Shult, P A; Kirk, C J; Amspaugh, J

1999-02-01

We describe a partnership between family practice residency clinics and a state public health virology laboratory that has produced comprehensive viral respiratory disease education and surveillance. Family practice residents have been provided with education on respiratory viruses and the results of ongoing viral surveillance. The preliminary effects of this program on antibiotic prescribing by senior residents are evaluated in this paper. We used a questionnaire to assess the acceptance by family practice residents of the educational component and the utility of ongoing viral surveillance. We used chart review to evaluate rates of antibiotic prescribing and the number of patients diagnosed per year with acute upper respiratory infection and acute bronchitis by senior residents in 1992 (preexposure) and 1996 (postexposure). By the third year of training, most residents (79%) reported receiving adequate training regarding common viral respiratory diseases. Moreover, residents reported that they were less likely to prescribe antibiotics to patients presenting with respiratory infections when provided with specific information on circulating viral pathogens. Antibiotic prescribing in the postexposure group was 68% lower for upper respiratory infection (URI) and 45% lower for a composite of URI and bronchitis. Education and monitoring of circulating respiratory viruses can result in familiarity with common disorders in primary care and reduce unnecessary antibiotic use.

A human-like H1N2 influenza virus detected during an outbreak of acute respiratory disease in swine in Brazil.

PubMed

Schaefer, Rejane; Rech, Raquel Rubia; Gava, Danielle; Cantão, Mauricio Egídio; da Silva, Marcia Cristina; Silveira, Simone; Zanella, Janice Reis Ciacci

2015-01-01

Passive monitoring for detection of influenza A viruses (IAVs) in pigs has been carried out in Brazil since 2009, detecting mostly the A(H1N1)pdm09 influenza virus. Since then, outbreaks of acute respiratory disease suggestive of influenza A virus infection have been observed frequently in Brazilian pig herds. During a 2010-2011 influenza monitoring, a novel H1N2 influenza virus was detected in nursery pigs showing respiratory signs. The pathologic changes were cranioventral acute necrotizing bronchiolitis to subacute proliferative and purulent bronchointerstitial pneumonia. Lung tissue samples were positive for both influenza A virus and A(H1N1)pdm09 influenza virus based on RT-qPCR of the matrix gene. Two IAVs were isolated in SPF chicken eggs. HI analysis of both swine H1N2 influenza viruses showed reactivity to the H1δ cluster. DNA sequencing was performed for all eight viral gene segments of two virus isolates. According to the phylogenetic analysis, the HA and NA genes clustered with influenza viruses of the human lineage (H1-δ cluster, N2), whereas the six internal gene segments clustered with the A(H1N1)pdm09 group. This is the first report of a reassortant human-like H1N2 influenza virus derived from pandemic H1N1 virus causing an outbreak of respiratory disease in pigs in Brazil. The emergence of a reassortant IAV demands the close monitoring of pigs through the full-genome sequencing of virus isolates in order to enhance genetic information about IAVs circulating in pigs.

Safety and clinical effect of i.v. infusion of cyclopropyl-methoxycarbonyl etomidate (ABP-700), a soft analogue of etomidate, in healthy subjects.

PubMed

Valk, B I; Absalom, A R; Meyer, P; Meier, S; den Daas, I; van Amsterdam, K; Campagna, J A; Sweeney, S P; Struys, M M R F

2018-06-01

Cyclopropyl-methoxycarbonyl metomidate, or ABP-700, is a second generation analogue of etomidate, developed to retain etomidate's beneficial haemodynamic and respiratory profile but diminishing its suppression of the adrenocortical axis. The objective of this study was to characterise the safety and efficacy of 30-min continuous infusions of ABP-700, and to assess its effect on haemodynamics and the adrenocortical response in healthy human volunteers. Five cohorts involving 40 subjects received increasing infusion doses of ABP-700, propofol 60 μg kg -1  min -1 or placebo. Safety was evaluated through adverse event (AE) monitoring, safety laboratory tests, and arterial blood gasses. Haemodynamic and respiratory stability were assessed by continuous monitoring. Adrenocortical function was analysed by adrenocorticotropic hormone (ACTH) stimulation tests. Clinical effect was measured using the modified observer's assessment of alertness/sedation (MOAA/S) and continuous bispectral index monitoring. No serious AEs were reported. Haemodynamic and respiratory effects included mild dose-dependent tachycardia, slightly elevated blood pressure, and no centrally mediated apnoea. Upon stimulation with ACTH, no adrenocortical depression was observed in any subject. Involuntary muscle movements (IMM) were reported, which were more extensive with higher dosing regimens. Higher dosages of ABP-700 were associated with deeper sedation and increased likelihood of sedation. Time to onset of clinical effect was variable throughout the cohorts and recovery was swift. Infusions of ABP-700 showed a dose-dependent hypnotic effect, and did not cause severe hypotension, severe respiratory depression, or adrenocortical suppression. The presentation and nature of IMM is a matter of concern. NTR4735. Copyright © 2018 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.

Effect of Panpal pretreatment and antidotal treatment (HI-6 plus benactyzine) on respiratory and circulatory function in soman-poisoned rats.

PubMed

Kassa, J; Fusek, J

1997-10-01

1 The effect of pharmacological pretreatment (pyridostigmine, benactyzine and trihexyphenidyle), designated Panpal, and antidotal treatment (the oxime HI-6 plus benactyzine) in soman poisoning was investigated in a rat model with on-line monitoring of respiratory and circulatory parameters. 2 Soman poisoning caused a high decrease in respiratory rate as well as minute respiratory volume and an increase in mean arterial pressure from 30-120 min following soman challenge. Soman at sublethal dose also significantly inhibited acetylcholinesterase activity in diaphragm and various brain parts. 3 Panpal pretreatment as well as antidotal treatment were effective in improving the respiratory and circulatory function disturbed by soman without the ability to increase significantly soman-inhibited acetylcholinesterase activity in all brain parts studied. 4 The efficacy of combined Panpal pretreatment and antidotal treatment against sublethal soman poisoning was not different from the efficacy of Panpal pretreatment or antidotal treatment alone. 5 The results of this investigation suggest that Panpal pretreatment as well as antidotal treatment are able to restore respiratory and circulatory function in soman-poisoned rats without significant reactivation of brain acetylcholinesterase.

Automated measurement of respiratory gas exchange by an inert gas dilution technique

NASA Technical Reports Server (NTRS)

Sawin, C. F.; Rummel, J. A.; Michel, E. L.

1974-01-01

A respiratory gas analyzer (RGA) has been developed wherein a mass spectrometer is the sole transducer required for measurement of respiratory gas exchange. The mass spectrometer maintains all signals in absolute phase relationships, precluding the need to synchronize flow and gas composition as required in other systems. The RGA system was evaluated by comparison with the Douglas bag technique. The RGA system established the feasibility of the inert gas dilution method for measuring breath-by-breath respiratory gas exchange. This breath-by-breath analytical capability permits detailed study of transient respiratory responses to exercise.

Extensive Core Microbiome in Drone-Captured Whale Blow Supports a Framework for Health Monitoring

PubMed Central

Miller, Carolyn A.; Moore, Michael J.; Durban, John W.; Fearnbach, Holly; Barrett-Lennard, Lance G.

2017-01-01

ABSTRACT The pulmonary system is a common site for bacterial infections in cetaceans, but very little is known about their respiratory microbiome. We used a small, unmanned hexacopter to collect exhaled breath condensate (blow) from two geographically distinct populations of apparently healthy humpback whales (Megaptera novaeangliae), sampled in the Massachusetts coastal waters off Cape Cod (n = 17) and coastal waters around Vancouver Island (n = 9). Bacterial and archaeal small-subunit rRNA genes were amplified and sequenced from blow samples, including many of sparse volume, as well as seawater and other controls, to characterize the associated microbial community. The blow microbiomes were distinct from the seawater microbiomes and included 25 phylogenetically diverse bacteria common to all sampled whales. This core assemblage comprised on average 36% of the microbiome, making it one of the more consistent animal microbiomes studied to date. The closest phylogenetic relatives of 20 of these core microbes were previously detected in marine mammals, suggesting that this core microbiome assemblage is specialized for marine mammals and may indicate a healthy, noninfected pulmonary system. Pathogen screening was conducted on the microbiomes at the genus level, which showed that all blow and few seawater microbiomes contained relatives of bacterial pathogens; no known cetacean respiratory pathogens were detected in the blow. Overall, the discovery of a shared large core microbiome in humpback whales is an important advancement for health and disease monitoring of this species and of other large whales. IMPORTANCE The conservation and management of large whales rely in part upon health monitoring of individuals and populations, and methods generally necessitate invasive sampling. Here, we used a small, unmanned hexacopter drone to noninvasively fly above humpback whales from two populations, capture their exhaled breath (blow), and examine the associated microbiome. In the first extensive examination of the large-whale blow microbiome, we present surprising results about the discovery of a large core microbiome that was shared across individual whales from geographically separated populations in two ocean basins. We suggest that this core microbiome, in addition to other microbiome characteristics, could be a useful feature for health monitoring of large whales worldwide. PMID:29034331

Extensive Core Microbiome in Drone-Captured Whale Blow Supports a Framework for Health Monitoring.

PubMed

Apprill, Amy; Miller, Carolyn A; Moore, Michael J; Durban, John W; Fearnbach, Holly; Barrett-Lennard, Lance G

2017-01-01

The pulmonary system is a common site for bacterial infections in cetaceans, but very little is known about their respiratory microbiome. We used a small, unmanned hexacopter to collect exhaled breath condensate (blow) from two geographically distinct populations of apparently healthy humpback whales ( Megaptera novaeangliae ), sampled in the Massachusetts coastal waters off Cape Cod ( n = 17) and coastal waters around Vancouver Island ( n = 9). Bacterial and archaeal small-subunit rRNA genes were amplified and sequenced from blow samples, including many of sparse volume, as well as seawater and other controls, to characterize the associated microbial community. The blow microbiomes were distinct from the seawater microbiomes and included 25 phylogenetically diverse bacteria common to all sampled whales. This core assemblage comprised on average 36% of the microbiome, making it one of the more consistent animal microbiomes studied to date. The closest phylogenetic relatives of 20 of these core microbes were previously detected in marine mammals, suggesting that this core microbiome assemblage is specialized for marine mammals and may indicate a healthy, noninfected pulmonary system. Pathogen screening was conducted on the microbiomes at the genus level, which showed that all blow and few seawater microbiomes contained relatives of bacterial pathogens; no known cetacean respiratory pathogens were detected in the blow. Overall, the discovery of a shared large core microbiome in humpback whales is an important advancement for health and disease monitoring of this species and of other large whales. IMPORTANCE The conservation and management of large whales rely in part upon health monitoring of individuals and populations, and methods generally necessitate invasive sampling. Here, we used a small, unmanned hexacopter drone to noninvasively fly above humpback whales from two populations, capture their exhaled breath (blow), and examine the associated microbiome. In the first extensive examination of the large-whale blow microbiome, we present surprising results about the discovery of a large core microbiome that was shared across individual whales from geographically separated populations in two ocean basins. We suggest that this core microbiome, in addition to other microbiome characteristics, could be a useful feature for health monitoring of large whales worldwide.

Understanding the use of continuous oscillating positive airway pressure (bubble CPAP) to treat neonatal respiratory disease: an engineering approach.

PubMed

Manilal-Reddy, P I; Al-Jumaily, A M

2009-01-01

A continuous oscillatory positive airway pressure with pressure oscillations incidental to the mean airway pressure (bubble CPAP) is defined as a modified form of traditional continuous positive airway pressure (CPAP) delivery where pressure oscillations in addition to CPAP are administered to neonates with lung diseases. The mechanical effect of the pressure oscillations on lung performance is investigated by formulating mathematical models of a typical bubble CPAP device and a simple representation of a neonatal respiratory system. Preliminary results of the respiratory system's mechanical response suggest that bubble CPAP may improve lung performance by minimizing the respiratory system impedance and that the resonant frequency of the respiratory system may be a controlling factor. Additional steps in terms of clinical trials and a more complex respiratory system model are required to gain a deeper insight into the mechanical receptiveness of the respiratory system to pressure oscillations. However, the current results are promising in that they offer a deeper insight into the trends of variations that can be expected in future extended models as well as the model philosophies that need to be adopted to produce results that are compatible with experimental verification.

Hospital admissions for respiratory system diseases in adults with intellectual disabilities in Southeast London: a register-based cohort study.

PubMed

Chang, Chin-Kuo; Chen, Chih-Yin; Broadbent, Mathew; Stewart, Robert; O'Hara, Jean

2017-03-29

Intellectual disability (ID) carries a high impact on need for care, health status and premature mortality. Respiratory system diseases contribute a major part of mortality among people with ID, but remain underinvestigated as consequent morbidities. Anonymised electronic mental health records from the South London and Maudsley Trust (SLaM) were linked to national acute medical care data. Using retrospective cohort and matched case-control study designs, adults with ID receiving SLaM care between 1 January 2008 and 31 March 2013 were identified and compared with local catchment residents for respiratory system disease admissions. Standardised admission ratios (SARs) were first calculated, followed by a comparison of duration of hospitalisation with respiratory system disease between people with ID and age-matched and gender-matched random counterparts modelled using linear regression. Finally, the risk of readmission for respiratory system disease was analysed using the Cox models. For the 3138 adults with ID identified in SLaM, the SAR for respiratory system disease admissions was 4.02 (95% CI 3.79 to 4.26). Compared with adults without ID, duration of hospitalisation was significantly longer by 2.34 days (95% CI 0.03 to 4.64) and respiratory system disease readmission was significantly elevated (HR=1.35; 95% CI 1.17 to 1.56) after confounding adjustment. Respiratory system disease admissions in adults with ID are more frequent, of longer duration and have a higher likelihood of recurring. Development and evaluation of potential interventions to the preventable causes of respiratory diseases should be prioritised. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Respiratory syncytial virus--the unrecognised cause of health and economic burden among young children in Australia.

PubMed

Ranmuthugala, Geetha; Brown, Laurie; Lidbury, Brett A

2011-06-01

Respiratory syncytial virus (RSV) presents very similar to influenza and is the principle cause of bronchiolitis in infants and young children worldwide. Yet, there is no systematic monitoring of RSV activity in Australia. This study uses existing published data sources to estimate incidence, hospitalisation rates, and associated costs of RSV among young children in Australia. Published reports from the Laboratory Virology and Serology Reporting Scheme, a passive voluntary surveillance system, and the National Hospital Morbidity Dataset were used to estimate RSV-related age-specific hospitalisation rates in New South Wales and Australia. These estimates and national USA estimates of RSV-related hospitalisation rates were applied to Australian population data to estimate RSV incidence in Australia. Direct economic burden was estimated by applying cost estimates used to derive economic cost associated with the influenza virus. The estimated RSV-related hospitalisation rates ranged from 2.2-4.5 per 1,000 among children less than 5 years of age to 8.7-17.4 per 1,000 among infants. Incidence ranged from 110.0-226.5 per 1,000 among the under five age group to 435.0-869.0 per 1,000 among infants. The total annual direct healthcare cost was estimated to be between $24 million and $50 million. Comparison with the health burdens attributed to the influenza virus and rotavirus suggests that the disease burden caused by RSV is potentially much higher. The limitations associated with using a passive surveillance system to estimate disease burden, and the need to explore further assessments and to monitor RSV activity are discussed.

Respiratory monitoring by inductive plethysmography in unrestrained subjects using position sensor-adjusted calibration.

PubMed

Brüllmann, Gregor; Fritsch, Karsten; Thurnheer, Robert; Bloch, Konrad E

2010-01-01

Portable respiratory inductive plethysmography (RIP) is promising for noninvasive monitoring of breathing patterns in unrestrained subjects. However, its use has been hampered by requiring recalibration after changes in body position. To facilitate RIP application in unrestrained subjects, we developed a technique for adjustment of RIP calibration using position sensor feedback. Five healthy subjects and 12 patients with lung disease were monitored by portable RIP with sensors incorporated within a body garment. Unrestrained individuals were studied during 40-60 min while supine, sitting and upright/walking. Position was changed repeatedly every 5-10 min. Initial qualitative diagnostic calibration followed by volume scaling in absolute units during 20 breaths in different positions by flow meter provided position-specific volume-motion coefficients for RIP. These were applied during subsequent monitoring in corresponding positions according to feedback from 4 accelerometers placed at the chest and thigh. Accuracy of RIP was evaluated by face mask pneumotachography. Position sensor feedback allowed accurate adjustment of RIP calibration during repeated position changes in subjects and patients as reflected in a minor mean difference (bias) in breath-by-breath tidal volumes estimated by RIP and flow meter of 0.02 liters (not significant) and limits of agreement (+/-2 SD) of +/-19% (2,917 comparisons). An average of 10 breaths improved precision of RIP (limits of agreement +/-14%). RIP calibration incorporating position sensor feedback greatly enhances the application of RIP as a valuable, unobtrusive tool to investigate respiratory physiology and ventilatory limitation in unrestrained healthy subjects and patients with lung disease during everyday activities including position changes. Copyright 2009 S. Karger AG, Basel.

Mass spectrometry method to monitor the sevoflurane concentration in an apparatus for inhalational anesthesia

NASA Astrophysics Data System (ADS)

Elokhin, V. A.; Ershov, T. D.; Levshankov, A. I.; Nikolaev, V. I.; Saifullin, M. F.; Elizarov, A. Yu.

2010-08-01

The feasibility of real-time monitoring of the inhalational anesthetic (sevoflurane) concentration in the respiratory circuit of an apparatus for inhalational anesthesia using mass spectrometry is considered. It is shown that the absolute anesthetic concentration can be monitored in real time if low-flow ventilation is provided during general anesthesia. The time dependences of the anesthetic concentration are taken at different stages of anesthesia in the inspiration-expiration regime.

Design and Evaluation of Novel Textile Wearable Systems for the Surveillance of Vital Signals.

PubMed

Trindade, Isabel G; Machado da Silva, José; Miguel, Rui; Pereira, Madalena; Lucas, José; Oliveira, Luís; Valentim, Bruno; Barreto, Jorge; Santos Silva, Manuel

2016-09-24

This article addresses the design, development, and evaluation of T-shirt prototypes that embed novel textile sensors for the capture of cardio and respiratory signals. The sensors are connected through textile interconnects to either an embedded custom-designed data acquisition and transmission unit or to snap fastener terminals for connection to external monitoring devices. The performance of the T-shirt prototype is evaluated in terms of signal-to-noise ratio amplitude and signal interference caused by baseline wander and motion artefacts, through laboratory tests with subjects in standing and walking conditions. Performance tests were also conducted in a hospital environment using a T-shirt prototype connected to a commercial three-channel Holter monitoring device. The textile sensors and interconnects were realized with the assistance of an industrial six-needle digital embroidery tool and their resistance to wear addressed with normalized tests of laundering and abrasion. The performance of these wearable systems is discussed, and pathways and methods for their optimization are highlighted.

Design and Evaluation of Novel Textile Wearable Systems for the Surveillance of Vital Signals

PubMed Central

Trindade, Isabel G.; Machado da Silva, José; Miguel, Rui; Pereira, Madalena; Lucas, José; Oliveira, Luís; Valentim, Bruno; Barreto, Jorge; Santos Silva, Manuel

2016-01-01

This article addresses the design, development, and evaluation of T-shirt prototypes that embed novel textile sensors for the capture of cardio and respiratory signals. The sensors are connected through textile interconnects to either an embedded custom-designed data acquisition and transmission unit or to snap fastener terminals for connection to external monitoring devices. The performance of the T-shirt prototype is evaluated in terms of signal-to-noise ratio amplitude and signal interference caused by baseline wander and motion artefacts, through laboratory tests with subjects in standing and walking conditions. Performance tests were also conducted in a hospital environment using a T-shirt prototype connected to a commercial three-channel Holter monitoring device. The textile sensors and interconnects were realized with the assistance of an industrial six-needle digital embroidery tool and their resistance to wear addressed with normalized tests of laundering and abrasion. The performance of these wearable systems is discussed, and pathways and methods for their optimization are highlighted. PMID:27669263

[Automated RNA amplification for the rapid identification of Mycobacterium tuberculosis complex in respiratory specimens].

PubMed

Drouillon, V; Houriez, F; Buze, M; Lagrange, P; Herrmann, J-L

2006-01-01

Rapid and sensitive detection of Mycobacterium tuberculosis complex (MTB) directly on clinical respiratory specimens is essential for a correct management of patients suspected of tuberculosis. For this purpose PCR-based kits are available to detect MTB in respiratory specimen but most of them need at least 4 hours to be completed. New methods, based on TRC method (TRC: Transcription Reverse transcription Concerted--TRCRapid M. Tuberculosis--Tosoh Bioscience, Tokyo, Japon) and dedicated monitor have been developed. A new kit (TRC Rapid M. tuberculosis and Real-time monitor TRCRapid-160, Tosoh Corporation, Japan) enabling one step amplification and real-time detection of MTB 16S rRNA by a combination of intercalative dye oxazole yellow-linked DNA probe and isothermal RNA amplification directly on respiratory specimens has been tested in our laboratory. 319 respiratory specimens were tested in this preliminary study and results were compared to smear and culture. Fourteen had a positive culture for MTB. Among theses samples, smear was positive in 11 cases (78.6%) and TRC process was positive in 8 cases (57.1%). Overall sensitivity of TRC compared to smear positive samples is 73%. Theses first results demonstrated that a rapid identification of MTB was possible (less than 2 processing hours for 14 specimens and about 1 hour for 1 specimen) in most cases of smear positive samples using ready to use reagents for real time detection of MTB rRNA in clinical samples. New pretreatment and extraction reagents kits to increase the stability of the sputum RNA and the extraction efficiency are now tested in our laboratory.

Respiratory syncytial virus epidemiology in a birth cohort from Kilifi district, Kenya: infection during the first year of life.

PubMed

Nokes, D James; Okiro, Emelda A; Ngama, Mwanajuma; White, Lisa J; Ochola, Rachel; Scott, Paul D; Cane, Patricia A; Medley, Graham F

2004-11-15

We report estimates of incidence of respiratory syncytial virus (RSV) infection during the first year of life for a birth cohort from rural, coastal Kenya. A total of 338 recruits born between 21 January 2002 and 30 May 2002 were monitored for symptoms of respiratory infection by home visits and hospital referrals. Nasal washings were screened by use of immunofluorescence. From 311 child-years of observation (cyo), 133 RSV infections were found, of which 48 were lower respiratory tract infections (LRTIs) and 31 were severe LRTIs, resulting in 4 hospital admissions. There were 121 primary RSV infections (248 cyo), of which 45 were LRTIs and 30 were severe LRTIs, resulting in 4 hospital admissions; there was no association with age. RSV contributed significantly to total LRTI disease in this vaccine-target group.

The mammalian respiratory system and critical windows of exposure for children's health.

PubMed Central

Pinkerton, K E; Joad, J P

2000-01-01

The respiratory system is a complex organ system composed of multiple cell types involved in a variety of functions. The development of the respiratory system occurs from embryogenesis to adult life, passing through several distinct stages of maturation and growth. We review embryonic, fetal, and postnatal phases of lung development. We also discuss branching morphogenesis and cellular differentiation of the respiratory system, as well as the postnatal development of xenobiotic metabolizing systems within the lungs. Exposure of the respiratory system to a wide range of chemicals and environmental toxicants during perinatal life has the potential to significantly affect the maturation, growth, and function of this organ system. Although the potential targets for exposure to toxic factors are currently not known, they are likely to affect critical molecular signals expressed during distinct stages of lung development. The effects of exposure to environmental tobacco smoke during critical windows of perinatal growth are provided as an example leading to altered cellular and physiological function of the lungs. An understanding of critical windows of exposure of the respiratory system on children's health requires consideration that lung development is a multistep process and cannot be based on studies in adults. Images Figure 1 Figure 4 PMID:10852845

Near-infrared spectroscopic monitoring during cardiopulmonary exercise testing detects anaerobic threshold.

PubMed

Rao, Rohit P; Danduran, Michael J; Loomba, Rohit S; Dixon, Jennifer E; Hoffman, George M

2012-06-01

Cardiopulmonary exercise testing (CPET) provides assessment of the integrative responses involving the pulmonary, cardiovascular, and skeletal muscle systems. Application of exercise testing remains limited to children who are able to understand and cooperate with the exercise protocol. Near-infrared spectroscopy (NIRS) provides a noninvasive, continuous method to monitor regional tissue oxygenation (rSO2). Our specific aim was to predict anaerobic threshold (AT) during CPET noninvasively using two-site NIRS monitoring. Achievement of a practical noninvasive technology for estimating AT will increase the compatibility of CPET. Patients without structural or acquired heart disease were eligible for inclusion if they were ordered to undergo CPET by a cardiologist. Data from 51 subjects was analyzed. The ventilatory anaerobic threshold (VAT) was computed on [Formula: see text] and respiratory quotient post hoc using the standard V-slope method. The inflection points of the regional rSO2 time-series were identified as the noninvasive regional NIRS AT for each of the two monitored regions (cerebral and kidney). AT calculation made using an average of kidney and brain NIRS matched the calculation made by VAT for the same patient. Two-site NIRS monitoring of visceral organs is a predictor of AT.

SU-G-JeP3-09: Tumor Location Prediction Using Natural Respiratory Volume for Respiratory Gated Radiation Therapy (RGRT): System Verification Study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kim, M; Jung, J; Yoon, D

Purpose: Respiratory gated radiation therapy (RGRT) gives accurate results when a patient’s breathing is stable and regular. Thus, the patient should be fully aware during respiratory pattern training before undergoing the RGRT treatment. In order to bypass the process of respiratory pattern training, we propose a target location prediction system for RGRT that uses only natural respiratory volume, and confirm its application. Methods: In order to verify the proposed target location prediction system, an in-house phantom set was used. This set involves a chest phantom including target, external markers, and motion generator. Natural respiratory volume signals were generated using themore » random function in MATLAB code. In the chest phantom, the target takes a linear motion based on the respiratory signal. After a four-dimensional computed tomography (4DCT) scan of the in-house phantom, the motion trajectory was derived as a linear equation. The accuracy of the linear equation was compared with that of the motion algorithm used by the operating motion generator. In addition, we attempted target location prediction using random respiratory volume values. Results: The correspondence rate of the linear equation derived from the 4DCT images with the motion algorithm of the motion generator was 99.41%. In addition, the average error rate of target location prediction was 1.23% for 26 cases. Conclusion: We confirmed the applicability of our proposed target location prediction system for RGRT using natural respiratory volume. If additional clinical studies can be conducted, a more accurate prediction system can be realized without requiring respiratory pattern training.« less

Pulmonary function and respiratory symptoms of school children exposed to ambient air pollution

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kim, Yoon Shin; Ko, Ung Ring

1996-12-31

This study was undertaken to evaluate the health effect of air pollution on pulmonary function and respiratory symptoms of Korean school children between 7 and 10 years of age during November 1995-January 1996. A standard respiratory symptom questionnaire was administered and spirometry was performed to examine pulmonary function of 121 children in an urban polluted area, Seoul, and of 119 children in non-polluted area, Sokcho, respectively. There was significant difference in the level of pulmonary function [forced expiratory volume in second (FEV{sub 1.0}) and forced vital capacity (FVC)] between exposed groups to polluted area and non-polluted area. Parental smoking wasmore » significantly related to respiratory symptoms of cough, phlegm, and the level of pulmonary function. The observed changes in FEV{sub 1.0} and FVC seemed to relate to home cooking fuel, not to respiratory symptoms. The additional longitudinal work that carefully monitors ambient and indoor air pollution and health effects data should be conducted to confirm these results.« less

[Role of noninvasive mechanical ventilation in patients with severe avian influenza A (H7N9) complicated with acute respiratory distress syndrome].

PubMed

Luo, Haili; Wang, Shaohong; Shen, Feng; Yuan, Tongmei; Pan, Xianguo; Liu, Jingtao; Yao, Ling; Wu, Juncheng; Long, Xuemei

2018-05-01

Human infection with avian influenza A (H7N9) is an acute contagious respiratory disease. Acute respiratory distress syndrome (ARDS) is a common complication in patients with severe avian influenza A (H7N9), for whom mechanical ventilation (MV) is an important supportive method. A patient, suffered from severe avian influenza A (H7N9) and complicated with ARDS, was admitted to the Second Affiliated Hospital of Guizhou Medical University in January 2017. With very intensive care for oxygenation, respiration and consciousness, and monitoring, she was successfully cured by comprehensive managements, among which noninvasive mechanical ventilation (NIV) was the major respiratory support method. The result demonstrate that, in patients with conscious state, satisfied expectoration ability and relatively good cooperation, and with close observation of oxygenation and respiratory rate, NIV may be accepted as an effective method for patient with ARDS caused by severe avian influenza A (H7N9).

Respiratory pattern changes during costovertebral joint movement.

PubMed

Shannon, R

1980-05-01

Experiments were conducted to determine if costovertebral joint manipulation (CVJM) could influence the respiratory pattern. Phrenic efferent activity (PA) was monitored in dogs that were anesthetized with Dial-urethane, vagotomized, paralyzed, and artificially ventilated. Ribs 6-10 (bilaterally) were cut and separated from ribs 5-11. Branches of thoracic nerves 5-11 were cut, leaving only the joint nerve supply intact. Manual joint movement in an inspiratory or expiratory direction had an inhibitory effect on PA. Sustained displacement of the ribs could inhibit PA for a duration equal to numerous respiratory cycles. CVJM in synchrony with PA resulted in an increased respiratory rate. The inspiratory inhibitory effect of joint receptor stimulation was elicited with manual chest compression in vagotomized spontaneously breathing dogs, but not with artificial lung inflation or deflation. It is concluded that the effect of CVJM on the respiratory pattern is due to stimulation of joint mechanoreceptors, and that they exert their influence in part via the medullary-pontine rhythm generator.

Self-Calibrating Respiratory-Flowmeter Combination

NASA Technical Reports Server (NTRS)

Westenskow, Dwayne R.; Orr, Joseph A.

1990-01-01

Dual flowmeters ensure accuracy over full range of human respiratory flow rates. System for measurement of respiratory flow employs two flowmeters; one compensates for deficiencies of other. Combination yields easily calibrated system accurate over wide range of gas flow.

Respiratory Sound Analysis for Flow Estimation During Wakefulness and Sleep, and its Applications for Sleep Apnea Detection and Monitoring

NASA Astrophysics Data System (ADS)

Yadollahi, Azadeh

Tracheal respiratory sounds analysis has been investigated as a non--invasive method to estimate respiratory flow and upper airway obstruction. However, the flow--sound relationship is highly variable among subjects which makes it challenging to estimate flow in general applications. Therefore, a robust model for acoustical flow estimation in a large group of individuals did not exist before. On the other hand, a major application of acoustical flow estimation is to detect flow limitations in patients with obstructive sleep apnea (OSA) during sleep. However, previously the flow--sound relationship was only investigated during wakefulness among healthy individuals. Therefore, it was necessary to examine the flow--sound relationship during sleep in OSA patients. This thesis takes the above challenges and offers innovative solutions. First, a modified linear flow--sound model was proposed to estimate respiratory flow from tracheal sounds. To remove the individual based calibration process, the statistical correlation between the model parameters and anthropometric features of 93 healthy volunteers was investigated. The results show that gender, height and smoking are the most significant factors that affect the model parameters. Hence, a general acoustical flow estimation model was proposed for people with similar height and gender. Second, flow--sound relationship during sleep and wakefulness was studied among 13 OSA patients. The results show that during sleep and wakefulness, flow--sound relation- ship follows a power law, but with different parameters. Therefore, for acoustical flow estimation during sleep, the model parameters should be extracted from sleep data to have small errors. The results confirm reliability of the acoustical flow estimation for investigating flow variations during both sleep and wakefulness. Finally, a new method for sleep apnea detection and monitoring was developed, which only requires recording the tracheal sounds and the blood's oxygen saturation level (SaO2) data. It automatically classifies the sound segments into breath, snore and noise. A weighted average of features extracted from sound segments and SaO2 signal was used to detect apnea and hypopnea events. The performance of the proposed approach was evaluated on the data of 66 patients. The results show high correlation (0.96, p < 0.0001) between the outcomes of our system and those of the polysomnography. Also, sensitivity and specificity of the proposed method in differentiating simple snorers from OSA patients were found to be more than 91%. These results are superior or comparable with the existing commercialized sleep apnea portable monitors.

Serious Allergic Reactions (Anaphylaxis)

MedlinePlus

... more of these body systems: skin digestive system respiratory system cardiovascular system For example, someone may feel tightness or closing in the throat (respiratory system) together with a fast heartbeat (cardiovascular system). Here ...

Management of adult recurrent respiratory papillomatosis with oral acyclovir following micro laryngeal surgery: a case series.

PubMed

Chaturvedi, Jagdish; Sreenivas, V; Hemanth, V; Nandakumar, R

2014-01-01

To demonstrate the role of oral acyclovir in monthly regimes after microdebrider assisted excision in 3 patients with adult recurrent respiratory papillomatosis (ARRP). Three patients with ARRP who presented to a tertiary referral hospital in stridor were initially treated with a tracheostomy in order to secure airway. On further evaluation by videolaryngoscopy extensive bilateral laryngeal papillomatosis was noted with history of similar conditions in the past for which they were repeatedly operated. They were admitted and underwent Microlaryngeal surgery and laryngeal microdebrider assisted surgery under general anesthesia. Post operatively a course of oral acyclovir at 800 mg/5 times/day for 5 days was administered. On repeat assessment with videolaryngoscopy at monthly intervals a complete remission of the disease was noted with no residual disease at the end of 1 year in 2 cases. One case had a recurrence. Renal parameters were monitored periodically. It may be concluded that the action of anti viral drugs at regular intervals in addition to a short course of oral steroids lead to rapid recovery and prevented latent virus activation within the laryngo tracheal system hence maintaining long term improvement. This can avoid multiple laryngeal surgeries, repeated respiratory emergencies and risk for malignant transformation in the future thereby reducing morbidity and effect on quality of life.

The application of a piezo-resistive cardiorespiratory sensor system in an automobile safety belt.

PubMed

Hamdani, Syed Talha Ali; Fernando, Anura

2015-03-30

Respiratory and heart failure are conditions that can occur with little warning and may also be difficult to predict. Therefore continuous monitoring of these bio-signals is advantageous for ensuring human health. The car safety belt is mainly designed to secure the occupants of the vehicle in the event of an accident. In the current research a prototype safety belt is developed, which is used to acquire respiratory and heart signals, under laboratory conditions. The current safety belt is constructed using a copper ink based nonwoven material, which works based on the piezo-resistive effect due to the pressure exerted on the sensor as a result of expansion of the thorax/abdomen area of the body for respiration and due to the principle of ballistocardiography (BCG) in heart signal sensing. In this research, the development of a theoretical model to qualitatively describe the piezo-resistive material is also presented in order to predict the relative change in the resistance of the piezo-resistive material due to the pressure applied.

Anesthesia and perioperative management of a pneumonectomized dog.

PubMed

Anagnostou, Tilemahos L; Pavlidou, Kiriaki; Savvas, Ioannis; Kazakos, George M; Papazoglou, Lysimachos G; Ververidis, Haralabos N; Raptopoulos, Dimitris

2012-01-01

Although left- or right-sided pneumonectomy is tolerated by normal dogs, complications impacting the respiratory, cardiovascular, and gastrointestinal systems are not uncommon. Pneumonectomy in dogs results in secondary changes in the remaining lung, which include: decreased compliance and vital capacity; and increased pulmonary vascular resistance potentially leading to right ventricular hypertrophy. Such alterations make the anesthetic management of an animal with one lung particularly challenging. This report describes a dog with a history of left pneumonectomy due to Aspergillus fumigatus pneumonia 3 yr before presentation. The dog presented with a vaginal wall prolapse, and surgical resection of the protruding vaginal wall, ovariectomy, and prophylactic gastropexy were performed. Anesthesia was induced with midazolam, fentanyl, and propofol and was maintained with isoflurane using intermittent positive pressure ventilation and a constant rate infusion of fentanyl. Epidural anesthesia was also used. Recovery and postoperative management were uncomplicated. Intensive hemodynamic and respiratory monitoring and appropriate response and treatment of any detected abnormalities, taking into consideration the pathophysiologic alterations occurring in a pneumonectomized animal, are required for successful perianesthetic management.

First results from experiments performed with the ESA Anthrorack during the D-2 Spacelab mission.

PubMed

Kuipers, A

1996-06-01

In 1993 four astronauts performed physiological experiments on the payload "Anthrorack" during the second German Spacelab mission D-2. The Anthrorack set-up is a Spacelab double rack developed under the management of the European Space Agency. It consists of an ECHO machine, a respiratory monitoring system (gas analyzer with flow meter), a blood centrifuge, an ergometer, a finger blood pressure device, ECG, body impedance measurement device and a respiratory inductance plethysmograph. Experiment-specific equipment was used as well. Nineteen investigators performed experiments in the cardiovascular, pulmonary, fluid-renal and nutritional physiology area. Results on central venous pressure, ocular pressure, vascular resistance, cardiac output, tissue thickness and orthostatic intolerance are presented in the cardiovascular area. In the pulmonary area first results are mentioned on O2 transport perfusion and ventilation distribution and breathing pattern. From the fluid-renal experiments, data from diuresis, sodium excretion and hormonal determinations are given. Finally results from glucose metabolism and nitrogen turnover experiments are presented.

First results from experiments performed with the ESA Anthrorack during the D-2 spacelab mission

NASA Astrophysics Data System (ADS)

Kuipers, A.

1996-06-01

In 1993 four astronauts performed physiological experiments on the payload "Anthrorack" during the second German Spacelab mission D-2. The Anthrorack set-up is a Spacelab double rack developed under the management of the European Space Agency. It consists of an ECHO machine, a respiratory monitoring system (gas analyzer with flow meter), a blood centrifuge, an ergometer, a finger blood pressure device, ECG, body impedance measurement device and a respiratory inductance plethysmograph. Experiment-specific equipment was used as well. Nineteen investigators performed experiments in the cardiovascular, pulmonary, fluid-renal and nutritional physiology area. Results on central venous pressure, ocular pressure, vascular resistance, cardiac output, tissue thickness and orthostatic intolerance are presented in the cardiovascular area. In the pulmonary area first results are mentioned on O 2 transport perfusion and ventilation distribution and breathing pattern. From the fluid-renal experiments, data from diuresis, sodium excretion and hormonal determinations are given. Finally results from glucose metabolism and nitrogen turnover experiments are presented.

The Circadian System Contributes to Apnea Lengthening across the Night in Obstructive Sleep Apnea

PubMed Central

Butler, Matthew P.; Smales, Carolina; Wu, Huijuan; Hussain, Mohammad V.; Mohamed, Yusef A.; Morimoto, Miki; Shea, Steven A.

2015-01-01

Study Objective: To test the hypothesis that respiratory event duration exhibits an endogenous circadian rhythm. Design: Within-subject and between-subjects. Settings: Inpatient intensive physiologic monitoring unit at the Brigham and Women's Hospital. Participants: Seven subjects with moderate/severe sleep apnea and four controls, age 48 (SD = 12) years, 7 males. Interventions: Subjects completed a 5-day inpatient protocol in dim light. Polysomnography was recorded during an initial control 8-h night scheduled at the usual sleep time, then through 10 recurrent cycles of 2 h 40 min sleep and 2 h 40 min wake evenly distributed across all circadian phases, and finally during another 8-h control sleep period. Measurements and Results: Event durations, desaturations, and apnea-hypopnea index for each sleep opportunity were assessed according to circadian phase (derived from salivary melatonin), time into sleep, and sleep stage. Average respiratory event durations in NREM sleep significantly lengthened across both control nights (21.9 to 28.2 sec and 23.7 to 30.2 sec, respectively). During the circadian protocol, event duration in NREM increased across the circadian phases that corresponded to the usual sleep period, accounting for > 50% of the increase across normal 8-h control nights. AHI and desaturations were also rhythmic: AHI was highest in the biological day while desaturations were greatest in the biological night. Conclusions: The endogenous circadian system plays an important role in the prolongation of respiratory events across the night, and might provide a novel therapeutic target for modulating sleep apnea. Citation: Butler MP, Smales C, Wu H, Hussain MV, Mohamed YA, Morimoto M, Shea SA. The circadian system contributes to apnea lengthening across the night in obstructive sleep apnea. SLEEP 2015;38(11):1793–1801. PMID:26039970

The Respiratory System. Instructional Materials in Anatomy and Physiology for Pennsylvania Health Occupations Programs.

ERIC Educational Resources Information Center

National Evaluation Systems, Inc., Amherst, MA.

This instructional modular unit with instructor's guide provides materials on aspects of one of the major systems of the human body--the respiratory system. Its purpose is to introduce the student to the structures and functions of the human respiratory system--and the interrelationships of the two--and to famlliarize the student with some of the…

Development of an Environmental Monitoring Program. Volume 1. Marine Hazardous Chemical Worker.

DTIC Science & Technology

1985-10-01

policy that prohibits its employees from entering cargo tanks for any reason. Therefore, the two scenarios selected for the field test, involve activities...a respiratory protection program that is in compliance with OSHA 1910.134 will have to enforce a "clean shaven" policy for tankermen who wear...ben- zene loading, did not enforce their safety policy requiring respiratory protection on a ,, SIl 23 barge tankerman working on the barge. This

The cardio-respiratory effects of intra-abdominal hypertension: Considerations for critical care nursing practice.

PubMed

Christensen, Martin; Craft, Judy

2018-02-01

Intra-abdominal hypertension can be classified as either primary or secondary. Primary intra-abdominal hypertension is often associated through trauma or diseases of the abdominopelvic region such as pancreatitis or abdominal surgery, while secondary intra-abdominal hypertension is the result of extra-abdominal causes such as sepsis or burns. The critically ill patient offers some challenges in monitoring in particular secondary intra-abdominal hypertension because of the effects of fluid resuscitation, the use of inotropes and positive pressure ventilation. Recent work suggests that intensive care unit nurses are often unaware of the secondary effects of intra-abdominal pressure and therefore this is not monitored effectively. Therefore being aware of the cardio-respiratory effects may alert theintensive care nurse nurse to the development of intra-abdominal hypertension. The aim of this paper is to discuss the pathophysiology associated with the cardio-respiratory effects seen with intra-abdominal hypertension in the critically ill. In particular it will discuss how intra-abdominal hypertension can inadvertently be overlooked because of the low flow states that it produces which could be misconstrued as something else. It will also discuss how intra-abdominal hypertension impedes ventilation and respiratory mechanics which can often result in a non-cardiogenic pulmonary oedema. To close, the paper will offer some implications for critical care nursing practice. Copyright © 2017 Elsevier Ltd. All rights reserved.

Association between air pollution and hospital admission: Case study at three monitoring stations in Malaysia

NASA Astrophysics Data System (ADS)

Zahari, Marina; Zin@Ibrahim, Wan Zawiah Wan; Ismail, Noriszura; Ni, Tan Hui

2014-06-01

The relationships between the exposure of pollutants towards hospitalized admission and mortality have been identified in several studies on Asian cities such as Taipei, Bangkok and Tokyo. In Malaysia, evidence on the health risks associated with exposure to pollutants is limited. In this study, daily time-series data were analysed to estimate risks of cardiovascular and respiratory hospitalized admissions associated with particulate matter ≤ 10 μm (PM10), carbon monoxide (CO), nitrogen dioxide, sulphur dioxide, and ozone concentrations in Klang Valley during 2004-2009. Daily counts of hospital admissions for cardiovascular and respiratory outcomes were obtained from eleven hospitals while pollutants data were taken from several air quality monitoring stations located nearest to the hospitals. These data were fitted with Generalised Additive Poisson regression models. Additionally, temperature, humidity, and time data were also included to allow for potential effect of weather and time-varying influences on hospital admissions. CO showed the most significant (P < 0.05) relationship to cardiovascular admissions. An increment of 1 ppm in CO predicted an increase of 4% to 20% in cardiovascular admissions. Respiratory admissions were associated with PM10, which had about 1% increase in risk of admission per 10 ug/m3 increment in PM10. Exposure to CO and PM10 increases the risk of hospitalization for cardiovascular and respiratory illnesses in Klang Valley, Malaysia.

Monitoring of immunological parameters in adolescent basketball athletes during and after a sports season.

PubMed

Brunelli, Diego Trevisan; Rodrigues, Ariel; Lopes, Wendell Arthur; Gáspari, Arthur Fernandes; Bonganha, Valéria; Montagner, Paulo César; Borin, João Paulo; Cavaglieri, Cláudia Regina

2014-01-01

The objective of the present study was to monitor the immunological and hormonal responses and the occurrence of upper respiratory symptoms in adolescent basketball athletes during the different stages of a sports season. Anthropometric measures, biochemical analyses (interleukin-6, interleukin-10, tumour necrosis factor-alpha, C-reactive protein, testosterone and cortisol), neuromuscular evaluations (standing vertical jumping ability, agility and estimated VO2max) and leukocyte counts were performed at four moments: 72 h before the season (-72 h); before the season (Pre-season); after six weeks, at the end of the preparatory period (Preparatory); and after 20 weeks, at the end of the competitive period (Competitive). Also, the occurrence of upper respiratory symptoms was collected weekly during all stages of the season. There were significant increases in monocytes, cortisol, tumour necrosis factor-alpha and C-reactive protein at the Competitive moment as compared to the Pre-season. In addition, interleukin-10 decreased at the Competitive moment as compared to the Pre-season. Occurrence of upper respiratory symptoms demonstrated increases (38%) during the competitive period as compared to the preparatory. These results suggest that periods of training and competition could increase the occurrence of upper respiratory symptoms in adolescent athletes and this may be due to the unwanted effects of an inflammatory process in response to the excessive stress of training and competition.

The Borg scale as an important tool of self-monitoring and self-regulation of exercise prescription in heart failure patients during hydrotherapy. A randomized blinded controlled trial.

PubMed

Carvalho, Vitor Oliveira; Bocchi, Edimar Alcides; Guimarães, Guilherme Veiga

2009-10-01

The Borg Scale may be a useful tool for heart failure patients to self-monitor and self-regulate exercise on land or in water (hydrotherapy) by maintaining the heart rate (HR) between the anaerobic threshold and respiratory compensation point. Patients performed a cardiopulmonary exercise test to determine their anaerobic threshold/respiratory compensation points. The percentage of the mean HR during the exercise session in relation to the anaerobic threshold HR (%EHR-AT), in relation to the respiratory compensation point (%EHR-RCP), in relation to the peak HR by the exercise test (%EHR-Peak) and in relation to the maximum predicted HR (%EHR-Predicted) was calculated. Next, patients were randomized into the land or water exercise group. One blinded investigator instructed the patients in each group to exercise at a level between "relatively easy and slightly tiring". The mean HR throughout the 30-min exercise session was recorded. The %EHR-AT and %EHR-predicted did not differ between the land and water exercise groups, but they differed in the %EHR-RCP (95 +/-7 to 86 +/-7, P<0.001) and in the %EHR-Peak (85 +/-8 to 78 +/-9, P=0.007). Exercise guided by the Borg scale maintains the patient's HR between the anaerobic threshold and respiratory compensation point (ie, in the exercise training zone).

[Development of expert diagnostic system for common respiratory diseases].

PubMed

Xu, Wei-hua; Chen, You-ling; Yan, Zheng

2014-03-01

To develop an internet-based expert diagnostic system for common respiratory diseases. SaaS system was used to build architecture; pattern of forward reasoning was applied for inference engine design; ASP.NET with C# from the tool pack of Microsoft Visual Studio 2005 was used for website-interview medical expert system.The database of the system was constructed with Microsoft SQL Server 2005. The developed expert system contained large data memory and high efficient function of data interview and data analysis for diagnosis of various diseases.The users were able to perform this system to obtain diagnosis for common respiratory diseases via internet. The developed expert system may be used for internet-based diagnosis of various respiratory diseases,particularly in telemedicine setting.

Comparison of Postoperative Respiratory Monitoring by Acoustic and Transthoracic Impedance Technologies in Pediatric Patients at Risk of Respiratory Depression.

PubMed

Patino, Mario; Kalin, Megan; Griffin, Allison; Minhajuddin, Abu; Ding, Lili; Williams, Timothy; Ishman, Stacey; Mahmoud, Mohamed; Kurth, C Dean; Szmuk, Peter

2017-06-01

In children, postoperative respiratory rate (RR) monitoring by transthoracic impedance (TI), capnography, and manual counting has limitations. The rainbow acoustic monitor (RAM) measures continuous RR noninvasively by a different methodology. Our primary aim was to compare the degree of agreement and accuracy of RR measurements as determined by RAM and TI to that of manual counting. Secondary aims include tolerance and analysis of alarm events. Sixty-two children (2-16 years old) were admitted after tonsillectomy or receiving postoperative patient/parental-controlled analgesia. RR was measured at regular intervals by RAM, TI, and manual count. Each TI or RAM alarm resulted in a clinical evaluation to categorize as a true or false alarm. To assess accuracy and degree of agreement of RR measured by RAM or TI compared with manual counting, a Bland-Altman analysis was utilized showing the average difference and the limits of agreement. Sensitivity and specificity of RR alarms by TI and RAM are presented. Fifty-eight posttonsillectomy children and 4 patient/parental-controlled analgesia users aged 6.5 ± 3.4 years and weighting 35.3 ± 22.7 kg (body mass index percentile 76.6 ± 30.8) were included. The average monitoring time per patient was 15.9 ± 4.8 hours. RAM was tolerated 87% of the total monitoring time. The manual RR count was significantly different from TI (P = .007) with an average difference ± SD of 1.39 ± 10.6 but were not significantly different from RAM (P = .81) with an average difference ± SD of 0.17 ± 6.8. The proportion of time when RR measurements differed by ≥4 breaths was 22% by TI and was 11% by RAM. Overall, 276 alarms were detected (mean alarms/patient = 4.5). The mean number of alarms per patient were 1.58 ± 2.49 and 2.87 ± 4.32 for RAM and TI, respectively. The mean number of false alarms was 0.18 ± 0.71 for RAM and 1.00 ± 2.78 for TI. The RAM was found to have 46.6% sensitivity (95% confidence interval [CI], 0.29-0.64), 95.9% specificity (95% CI, 0.90-1.00), 88.9% positive predictive value (95% CI, 0.73-1.00), and 72.1% negative predictive value (95% CI, 0.61-0.84), whereas the TI monitor had 68.5% sensitivity (95% CI, 0.53-0.84), 72.0% specificity (95% CI, 0.60-0.84), 59.0% positive (95% CI, 0.44-0.74), and 79.5% negative predictive value (95% CI, 0.69-0.90). In children at risk of postoperative respiratory depression, RR assessment by RAM was not different to manual counting. RAM was well tolerated, had a lower incidence of false alarms, and had better specificity and positive predictive value than TI. Rigorous evaluation of the negative predictive value is essential to determine the role of postoperative respiratory monitoring with RAM.

A brief clinical case of monitoring of oxygenator performance and patient-machine interdependency during prolonged veno-venous extracorporeal membrane oxygenation.

PubMed

Belliato, Mirko; Degani, Antonella; Buffa, Antonino; Sciutti, Fabio; Pagani, Michele; Pellegrini, Carlo; Iotti, Giorgio Antonio

2017-10-01

Monitoring veno-venous extracorporeal membrane oxygenation (vvECMO) during 76 days of continuous support in a 42-years old patient with end-stage pulmonary disease, listed for double-lung transplantation. Applying a new monitor (Landing ® , Eurosets, Medolla, Italy) and describing how measured and calculated parameters can be used to understand the variable interdependency between artificial membrane lung (ML) and patient native lung (NL). During vvECMO, in order to understand how the respiratory function is shared between ML and NL, ideally we should obtain data about oxygen transfer and CO 2 removal, both by ML and NL. Measurements for NL can be made on the mechanical ventilator. Measurements for ML are typically made from gas analysis on blood samples drawn from the ECMO system before and after the oxygenator, and therefore are non-continuous. Differently, the Landing monitor provides a continuous measurement of the oxygen transfer from the ML, combined with hemoglobin level, saturation of drained blood and saturation of reinfused blood. Moreover, the Landing monitor provides hemodynamics data about circulation through the ECMO system, with blood flow, pre-oxygenator pressure and post-oxygenator pressure. Of note, measurements include the drain negative pressure, whose monitoring may be particularly useful to prevent hemolysis. Real-time monitoring of vvECMO provides data helpful to understand the complex picture of a patient with severely damaged lungs on one side and an artificial lung on the other side. Data from vvECMO monitoring may help to adapt the settings of both mechanical ventilator and vvECMO. Data about oxygen transfer by the oxygenator are important to evaluate the performance of the device and may help to avoid unnecessary replacements, thus reducing risks and costs.

[Characteristics of the sympathoadrenal system response to psychoemotional stress under hypoxic conditions in aged people with physiological and accelerated aging of the respiratory system].

PubMed

Asanov, E O; Os'mak, Ie D; Kuz'mins'ka, L A

2013-01-01

The peculiarities of the response of the sympathoadrenal system to psychoemotional and hypoxic stress in healthy young people and in aged people with physiological and accelerated aging of respiratory system were studied. It was shown that in aging a more pronounced response of the sympathoadrenal system to psychoemotional stress. At the same time, elderly people with different types of aging of the respiratory system did not demonstrate a difference in the response of the sympathoadrenal system to psychoemotional stress. Unlike in young people, in aged people, combination of psychoemotional and hypoxic stresses resulted in further activation of the sympathoadrenal system. The reaction of the sympathoadrenal system was more expressed in elderly people with accelerated ageing of the respiratory system.

Disease and Non-Battle Injury Rates For Marine Corps Enlisted Personnel during Peacetime

DTIC Science & Technology

1990-05-30

Infective and Parasitic Diseases, Diseases of the Respiratory System, and Injury and Poisoning. Although these rates were consistently lower than those...rates were 6 Diseases of the Digestive System, Infective and Parasitic Diseases, Diseases of the Respiratory System, and Injury and Poisoning. The...Diseases of the Digestive System in Europe and Northeast Asia, and Diseases of the Respiratory System in Southwest Asia. Conclusions Although these results

Tetany During Intravenous Conscious Sedation in Dentistry Resulting From Hyperventilation-Induced Hypocapnia

PubMed Central

McCarthy, Caroline; Brady, Paul; O'Halloran, Ken D.; McCreary, Christine

2016-01-01

Hyperventilation can be a manifestation of anxiety that involves abnormally fast breathing (tachypnea) and an elevated minute ventilation that exceeds metabolic demand. This report describes a case of hyperventilation-induced hypocapnia resulting in tetany in a 16-year-old girl undergoing orthodontic extractions under intravenous conscious sedation. Pulse oximetry is the gold standard respiratory-related index in conscious sedation. Although the parameter has great utility in determining oxygen desaturation, it provides no additional information on respiratory function, including, for example, respiratory rate. In this case, we found capnography to be a very useful aid to monitor respiration in this patient and also to treat the hypocapnia. PMID:26866408

TH-E-17A-01: Internal Respiratory Surrogate for 4D CT Using Fourier Transform and Anatomical Features

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hui, C; Suh, Y; Robertson, D

Purpose: To develop a novel algorithm to generate internal respiratory signals for sorting of four-dimensional (4D) computed tomography (CT) images. Methods: The proposed algorithm extracted multiple time resolved features as potential respiratory signals. These features were taken from the 4D CT images and its Fourier transformed space. Several low-frequency locations in the Fourier space and selected anatomical features from the images were used as potential respiratory signals. A clustering algorithm was then used to search for the group of appropriate potential respiratory signals. The chosen signals were then normalized and averaged to form the final internal respiratory signal. Performance ofmore » the algorithm was tested in 50 4D CT data sets and results were compared with external signals from the real-time position management (RPM) system. Results: In almost all cases, the proposed algorithm generated internal respiratory signals that visibly matched the external respiratory signals from the RPM system. On average, the end inspiration times calculated by the proposed algorithm were within 0.1 s of those given by the RPM system. Less than 3% of the calculated end inspiration times were more than one time frame away from those given by the RPM system. In 3 out of the 50 cases, the proposed algorithm generated internal respiratory signals that were significantly smoother than the RPM signals. In these cases, images sorted using the internal respiratory signals showed fewer artifacts in locations corresponding to the discrepancy in the internal and external respiratory signals. Conclusion: We developed a robust algorithm that generates internal respiratory signals from 4D CT images. In some cases, it even showed the potential to outperform the RPM system. The proposed algorithm is completely automatic and generally takes less than 2 min to process. It can be easily implemented into the clinic and can potentially replace the use of external surrogates.« less

Fluorescence diagnosis of upper respiratory tract infections

NASA Astrophysics Data System (ADS)

Blanco, Kate C.; Inada, Natalia M.; Kurachi, Cristina; Bagnato, Vanderlei S.

2015-06-01

The pharyngitis and laryngitis are respiratory tract infections highly common. Pharyngitis can be accompanied by fever, especially if caused by a systemic infection. Laryngitis is an inflammation of your voice box (larynx) from irritation or infection. The conventional treatment is the antibiotics administration, which may be responsible by an increase of identification of bacterial strains resistant to drug. This fact associated to high incidence of these infections become important to develop new technologies for diagnosis. This study aims to evaluate the use of widefield fluorescence imaging for the characterization of oropharynx infections, in order to diagnose the bacteria colonization. The imaging system for wide field fluorescence visualization is Evince® (MMOptics, São Carlos, SP, Brazil) coupled to an Apple iPhone® cell phone device. The system consists of Light Emitting Diodes (LEDs) operating in the violet blue region centered at green-red spectrum 450 nm and optical filters that allow viewing of fluorescence. A tongue depressor was adapted to Evince® for mouth opening. The same images were captured with white light and fluorescence with an optical system. The red fluorescence may be a bacterial marker for physiological monitoring of oropharynx infection processes. The bacterial biofilm on tissue were assigned to the presence of protoporphyrin IX. This work indicates that the autofluorescence of the tissue may be used as a non-invasive technique to aid in the oropharynx infection diagnostic.

MO-FG-BRA-08: Swarm Intelligence-Based Personalized Respiratory Gating in Lung SAbR

DOE Office of Scientific and Technical Information (OSTI.GOV)

Modiri, A; Sabouri, P; Sawant, A

Purpose: Respiratory gating is widely deployed as a clinical motion-management strategy in lung radiotherapy. In conventional gating, the beam is turned on during a pre-determined phase window; typically, around end-exhalation. In this work, we challenge the notion that end-exhalation is always the optimal gating phase. Specifically, we use a swarm-intelligence-based, inverse planning approach to determine the optimal respiratory phase and MU for each beam with respect to (i) the state of the anatomy at each phase and (ii) the time spent in that state, estimated from long-term monitoring of the patient’s breathing motion. Methods: In a retrospective study of fivemore » lung cancer patients, we compared the dosimetric performance of our proposed personalized gating (PG) with that of conventional end-of-exhale gating (CEG) and a previously-developed, fully 4D-optimized plan (combined with MLC tracking delivery). For each patient, respiratory phase probabilities (indicative of the time duration of the phase) were estimated over 2 minutes from lung tumor motion traces recorded previously using the Synchrony system (Accuray Inc.). Based on this information, inverse planning optimization was performed to calculate the optimal respiratory gating phase and MU for each beam. To ensure practical deliverability, each PG beam was constrained to deliver the assigned MU over a time duration comparable to that of CEG delivery. Results: Maximum OAR sparing for the five patients achieved by the PG and the 4D plans compared to CEG plans was: Esophagus Dmax [PG:57%, 4D:37%], Heart Dmax [PG:71%, 4D:87%], Spinal cord Dmax [PG:18%, 4D:68%] and Lung V13 [PG:16%, 4D:31%]. While patients spent the most time in exhalation, the PG-optimization chose end-exhale only for 28% of beams. Conclusion: Our novel gating strategy achieved significant dosimetric improvements over conventional gating, and approached the upper limit represented by fully 4D optimized planning while being significantly simpler and more clinically translatable. This work was partially supported through research funding from National Institutes of Health (R01CA169102) and Varian Medical Systems, Palo Alto, CA, USA.« less

A rate-based transcutaneous CO2 sensor for noninvasive respiration monitoring.

PubMed

Chatterjee, M; Ge, X; Kostov, Y; Luu, P; Tolosa, L; Woo, H; Viscardi, R; Falk, S; Potts, R; Rao, G

2015-05-01

The pain and risk of infection associated with invasive blood sampling for blood gas measurements necessitate the search for reliable noninvasive techniques. In this work we developed a novel rate-based noninvasive method for a safe and fast assessment of respiratory status. A small sampler was built to collect the gases diffusing out of the skin. It was connected to a CO2 sensor through gas-impermeable tubing. During a measurement, the CO2 initially present in the sampler was first removed by purging it with nitrogen. The gases in the system were then recirculated between the sampler and the CO2 sensor, and the CO2 diffusion rate into the sampler was measured. Because the measurement is based on the initial transcutaneous diffusion rate, reaching mass transfer equilibrium and heating the skin is no longer required, thus, making it much faster and safer than traditional method. A series of designed experiments were performed to analyze the effect of the measurement parameters such as sampler size, measurement location, subject positions, and movement. After the factor analysis tests, the prototype was sent to a level IV NICU for clinical trial. The results show that the measured initial rate of increase in CO2 partial pressure is linearly correlated with the corresponding arterial blood gas measurements. The new approach can be used as a trending tool, making frequent blood sampling unnecessary for respiratory status monitoring.

Non-contact assessment of obstructive sleep apnea cardiovascular biomarkers using photoplethysmography imaging

NASA Astrophysics Data System (ADS)

Amelard, Robert; Pfisterer, Kaylen J.; Jagani, Shubh; Clausi, David A.; Wong, Alexander

2018-02-01

Obstructive sleep apnea (OSA) affects 20% of the adult population, and is associated with cardiovascular and cognitive morbidities. However, it is estimated that up to 80% of treatable OSA cases remain undiagnosed. Cur- rent methods for diagnosing OSA are expensive, labor-intensive, and involve uncomfortable wearable sensors. This study explored the feasibility of non-contact biophotonic assessment of OSA cardiovascular biomarkers via photoplethysmography imaging (PPGI). In particular, PPGI was used to monitor the hemodynamic response to obstructive respiratory events. Sleep apnea onset was simulated using Muller's maneuver in which breathing was obstructed by a respiratory clamp. A custom PPGI system, coded hemodynamic imaging (CHI), was positioned 1 m above the bed and illuminated the participant's head with 850 nm light, providing non-intrusive illumination for night-time monitoring. A video was recorded before, during and following an apnea event at 60 fps, yielding 17 ms temporal resolution. Per-pixel absorbance signals were extracted using a Beer-Lambert derived light transport model, and subsequently denoised. The extracted hemodynamic signal exhibited dynamic temporal modulation during and following the apnea event. In particular, the pulse wave amplitude (PWA) decreased during obstructed breathing, indicating vasoconstriction. Upon successful inhalation, the PWA gradually increased toward homeostasis following a temporal phase delay. This temporal vascular tone modulation provides insight into autonomic and vascular response, and may be used to assess sleep apnea using non-contact biophotonic imaging.

Neonatal non-contact respiratory monitoring based on real-time infrared thermography

PubMed Central

2011-01-01

Background Monitoring of vital parameters is an important topic in neonatal daily care. Progress in computational intelligence and medical sensors has facilitated the development of smart bedside monitors that can integrate multiple parameters into a single monitoring system. This paper describes non-contact monitoring of neonatal vital signals based on infrared thermography as a new biomedical engineering application. One signal of clinical interest is the spontaneous respiration rate of the neonate. It will be shown that the respiration rate of neonates can be monitored based on analysis of the anterior naris (nostrils) temperature profile associated with the inspiration and expiration phases successively. Objective The aim of this study is to develop and investigate a new non-contact respiration monitoring modality for neonatal intensive care unit (NICU) using infrared thermography imaging. This development includes subsequent image processing (region of interest (ROI) detection) and optimization. Moreover, it includes further optimization of this non-contact respiration monitoring to be considered as physiological measurement inside NICU wards. Results Continuous wavelet transformation based on Debauches wavelet function was applied to detect the breathing signal within an image stream. Respiration was successfully monitored based on a 0.3°C to 0.5°C temperature difference between the inspiration and expiration phases. Conclusions Although this method has been applied to adults before, this is the first time it was used in a newborn infant population inside the neonatal intensive care unit (NICU). The promising results suggest to include this technology into advanced NICU monitors. PMID:22243660

Speckle POF sensor for detecting vital signs of patients

NASA Astrophysics Data System (ADS)

Lomer, M.; Rodriguez-Cobo, L.; Revilla, P.; Herrero, G.; Madruga, F.; Lopez-Higuera, J. M.

2014-05-01

In this work, both arterial pulse and respiratory rate have been successfully measured based on changes in speckle patterns of multimode fibers. Using two fiber-based transducers, one located on the wrist and another in the chest, both disturbances were transmitted to the fiber, varying the speckle pattern. These variations of the speckle pattern were captured using a commercial webcam and further processed using different methods. The achieved results have been presented and the simultaneous monitoring of both vital signs has been also discussed. The feasibility to use the proposed sensor system for this application is demonstrated.

Pneumotachometer counts respiration rate of human subject

NASA Technical Reports Server (NTRS)

Graham, O.

1964-01-01

To monitor breaths per minute, two rate-to-analog converters are alternately used to read and count the respiratory rate from an impedance pneumograph sequentially displayed numerically on electroluminescent matrices.

Critical care nursing: Embedded complex systems.

PubMed

Trinier, Ruth; Liske, Lori; Nenadovic, Vera

2016-01-01

Variability in parameters such as heart rate, respiratory rate and blood pressure defines healthy physiology and the ability of the person to adequately respond to stressors. Critically ill patients have lost this variability and require highly specialized nursing care to support life and monitor changes in condition. The critical care environment is a dynamic system through which information flows. The critical care unit is typically designed as a tree structure with generally one attending physician and multiple nurses and allied health care professionals. Information flow through the system allows for identification of deteriorating patient status and timely interventionfor rescue from further deleterious effects. Nurses provide the majority of direct patient care in the critical care setting in 2:1, 1:1 or 1:2 nurse-to-patient ratios. The bedside nurse-critically ill patient relationship represents the primary, real-time feedback loop of information exchange, monitoring and treatment. Variables that enhance information flow through this loop and support timely nursing intervention can improve patient outcomes, while barriers can lead to errors and adverse events. Examining patient information flow in the critical care environment from a dynamic systems perspective provides insights into how nurses deliver effective patient care and prevent adverse events.

Mood recognition in bipolar patients through the PSYCHE platform: preliminary evaluations and perspectives.

PubMed

Valenza, Gaetano; Gentili, Claudio; Lanatà, Antonio; Scilingo, Enzo Pasquale

2013-01-01

Bipolar disorders are characterized by a series of both depressive and manic or hypomanic episodes. Although common and expensive to treat, the clinical assessment of bipolar disorder is still ill-defined. In the current literature several correlations between mood disorders and dysfunctions involving the autonomic nervous system (ANS) can be found. The objective of this work is to develop a novel mood recognition system based on a pervasive, wearable and personalized monitoring system using ANS-related biosignals. The monitoring platform used in this study is the core sensing system of the personalized monitoring systems for care in mental health (PSYCHE) European project. It is comprised of a comfortable sensorized t-shirt that can acquire the inter-beat interval time series, the heart rate, and the respiratory dynamics for long-term monitoring during the day and overnight. In this study, three bipolar patients were followed for a period of 90 days during which up to six monitoring sessions and psychophysical evaluations were performed for each patient. Specific signal processing techniques and artificial intelligence algorithms were applied to analyze more than 120 h of data. Experimental results are expressed in terms of confusion matrices and an exhaustive descriptive statistics of the most relevant features is reported as well. A classification accuracy of about 97% is achieved for the intra-subject analysis. Such an accuracy was found in distinguishing relatively good affective balance state (euthymia) from severe clinical states (severe depression and mixed state) and is lower in distinguishing euthymia from the milder states (accuracy up to 88%). The PSYCHE platform could provide a viable decision support system in order to improve mood assessment in patient care. Evidences about the correlation between mood disorders and ANS dysfunctions were found and the obtained results are promising for an effective biosignal-based mood recognition. Copyright © 2012 Elsevier B.V. All rights reserved.

Prevalence and seasonality of six respiratory viruses during five consecutive epidemic seasons in Belgium.

PubMed

Ramaekers, Kaat; Keyaerts, Els; Rector, Annabel; Borremans, Annie; Beuselinck, Kurt; Lagrou, Katrien; Van Ranst, Marc

2017-09-01

Acute Respiratory Infections (ARIs) are a major health problem, especially in young children and the elderly. Insights into the seasonality of respiratory viruses can help us understand when the burden on society is highest and which age groups are most vulnerable. We monitored six respiratory viruses during five consecutive seasons (2011-2016) in Belgium. Patient specimens (n=22876), tested for one or more of the following respiratory viruses, were included in this analysis: Influenza viruses (IAV & IBV), Human respiratory syncytial virus (hRSV), Human metapneumovirus (hMPV), Adenovirus (ADV) and Human parainfluenza virus (hPIV). Data were analysed for four age categories: <6y, 6-17y, 18-64y and ≥65y. Children <6y had the highest infection rates (39% positive vs. 20% positive adults) and the highest frequency of co-infections. hRSV (28%) and IAV (32%) caused the most common respiratory viral infections and followed, like hMPV, a seasonal pattern with winter peaks. hRSV followed an annual pattern with two peaks: first in young children and ±7 weeks later in elderly. This phenomenon has not been described in literature so far. hPIV and ADV occurred throughout the year with higher rates in winter. Children <6y are most vulnerable for respiratory viral infections and have a higher risk for co-infections. hRSV and IAV are the most common respiratory infections with peaks during the winter season in Belgium. Copyright © 2017 Elsevier B.V. All rights reserved.

Respiratory symptoms and lung function in bauxite miners.

PubMed

Beach, J R; de Klerk, N H; Fritschi, L; Sim, M R; Musk, A W; Benke, G; Abramson, M J; McNeil, J J

2001-09-01

To determine whether cumulative bauxite exposure is associated with respiratory symptoms or changes in lung function in a group of bauxite miners. Current employees at three bauxite mines in Australia were invited to participate in a survey comprising: questionnaire on demographic details, respiratory symptoms, and work history; skin prick tests for four common aeroallergens; and spirometry. A task exposure matrix was constructed for bauxite exposure in all tasks in all jobs based on monitoring data. Data were examined for associations between cumulative bauxite exposure, and respiratory symptoms and lung function, by regression analyses. The participation rate was 86%. Self-reported work-related respiratory symptoms were reported by relatively few subjects (1.5%-11.8%). After adjustment for age and smoking no significant differences in the prevalence of respiratory symptoms were identified between subjects, in the quartiles of cumulative bauxite exposure distribution. The forced expiratory volume in I s (FEV1) of the exposed group was found to be significantly lower than that for the unexposed group. After adjustment for age, height, and smoking there were no statistically significant differences between quartiles in FEVI, forced vital capacity (FVC) and FEVl/FVC ratio. These data provide little evidence of a serious adverse effect on respiratory health associated with exposure to bauxite in an open-cut bauxite mine in present day conditions.

Instantaneous Respiratory Estimation from Thoracic Impedance by Empirical Mode Decomposition.

PubMed

Wang, Fu-Tai; Chan, Hsiao-Lung; Wang, Chun-Li; Jian, Hung-Ming; Lin, Sheng-Hsiung

2015-07-07

Impedance plethysmography provides a way to measure respiratory activity by sensing the change of thoracic impedance caused by inspiration and expiration. This measurement imposes little pressure on the body and uses the human body as the sensor, thereby reducing the need for adjustments as body position changes and making it suitable for long-term or ambulatory monitoring. The empirical mode decomposition (EMD) can decompose a signal into several intrinsic mode functions (IMFs) that disclose nonstationary components as well as stationary components and, similarly, capture respiratory episodes from thoracic impedance. However, upper-body movements usually produce motion artifacts that are not easily removed by digital filtering. Moreover, large motion artifacts disable the EMD to decompose respiratory components. In this paper, motion artifacts are detected and replaced by the data mirrored from the prior and the posterior before EMD processing. A novel intrinsic respiratory reconstruction index that considers both global and local properties of IMFs is proposed to define respiration-related IMFs for respiration reconstruction and instantaneous respiratory estimation. Based on the experiments performing a series of static and dynamic physical activates, our results showed the proposed method had higher cross correlations between respiratory frequencies estimated from thoracic impedance and those from oronasal airflow based on small window size compared to the Fourier transform-based method.

Instantaneous Respiratory Estimation from Thoracic Impedance by Empirical Mode Decomposition

PubMed Central

Wang, Fu-Tai; Chan, Hsiao-Lung; Wang, Chun-Li; Jian, Hung-Ming; Lin, Sheng-Hsiung

2015-01-01

Impedance plethysmography provides a way to measure respiratory activity by sensing the change of thoracic impedance caused by inspiration and expiration. This measurement imposes little pressure on the body and uses the human body as the sensor, thereby reducing the need for adjustments as body position changes and making it suitable for long-term or ambulatory monitoring. The empirical mode decomposition (EMD) can decompose a signal into several intrinsic mode functions (IMFs) that disclose nonstationary components as well as stationary components and, similarly, capture respiratory episodes from thoracic impedance. However, upper-body movements usually produce motion artifacts that are not easily removed by digital filtering. Moreover, large motion artifacts disable the EMD to decompose respiratory components. In this paper, motion artifacts are detected and replaced by the data mirrored from the prior and the posterior before EMD processing. A novel intrinsic respiratory reconstruction index that considers both global and local properties of IMFs is proposed to define respiration-related IMFs for respiration reconstruction and instantaneous respiratory estimation. Based on the experiments performing a series of static and dynamic physical activates, our results showed the proposed method had higher cross correlations between respiratory frequencies estimated from thoracic impedance and those from oronasal airflow based on small window size compared to the Fourier transform-based method. PMID:26198231

Investigations of respiratory control systems simulation

NASA Technical Reports Server (NTRS)

Gallagher, R. R.

1973-01-01

The Grodins' respiratory control model was investigated and it was determined that the following modifications were necessary before the model would be adaptable for current research efforts: (1) the controller equation must be modified to allow for integration of the respiratory system model with other physiological systems; (2) the system must be more closely correlated to the salient physiological functionings; (3) the respiratory frequency and the heart rate should be expanded to illustrate other physiological relationships and dependencies; and (4) the model should be adapted to particular individuals through a better defined set of initial parameter values in addition to relating these parameter values to the desired environmental conditions. Several of Milhorn's respiratory control models were also investigated in hopes of using some of their features as modifications for Grodins' model.

National Training Course. Emergency Medical Technician. Paramedic. Instructor's Lesson Plans. Module V. Respiratory System.

ERIC Educational Resources Information Center

National Highway Traffic Safety Administration (DOT), Washington, DC.

This instructor's lesson plan guide on the respiratory system is one of fifteen modules designed for use in the training of emergency medical technicians (paramedics). Five units of study are presented: (1) anatomy and physiology of the respiratory system; (2) pathophysiology assessment of the patient; (3) pathophysiology and management of…

Measures of Autonomic Nervous System

DTIC Science & Technology

2011-04-01

activation encompass non-invasive tools, which measure cardiac, skin conductance, respiratory , and vascular activity. Choice of tools is dependent upon...digestion, excretion, and cardiac and respiratory activity. The ANS consists of the sympathetic and parasympathetic divisions and acts through a... respiratory cycles. Generally, these two systems should be seen as permanently modulating vital functions to achieve homeostasis. Since both systems are

Tissue artifact removal from respiratory signals based on empirical mode decomposition.

PubMed

Liu, Shaopeng; Gao, Robert X; John, Dinesh; Staudenmayer, John; Freedson, Patty

2013-05-01

On-line measurement of respiration plays an important role in monitoring human physical activities. Such measurement commonly employs sensing belts secured around the rib cage and abdomen of the test object. Affected by the movement of body tissues, respiratory signals typically have a low signal-to-noise ratio. Removing tissue artifacts therefore is critical to ensuring effective respiration analysis. This paper presents a signal decomposition technique for tissue artifact removal from respiratory signals, based on the empirical mode decomposition (EMD). An algorithm based on the mutual information and power criteria was devised to automatically select appropriate intrinsic mode functions for tissue artifact removal and respiratory signal reconstruction. Performance of the EMD-algorithm was evaluated through simulations and real-life experiments (N = 105). Comparison with low-pass filtering that has been conventionally applied confirmed the effectiveness of the technique in tissue artifacts removal.

Clinical validation of the nursing diagnosis Risk for Aspiration among patients who experienced a cerebrovascular accident.

PubMed

Cavalcante, Tahissa Frota; de Araújo, Thelma Leite; Moreira, Rafaella Pessoa; Guedes, Nirla Gomes; Lopes, Marcos Venicios de Oliveira; da Silva, Viviane Martins

2013-01-01

the study's objective was the clinical validation of the nursing diagnosis Risk for Aspiration among patients who experienced cerebrovascular accidents (CVA). a prospective cohort study was conducted with 24 patients hospitalized due to a CVA. The instrument used to collect the data addressed the risk factors for respiratory aspiration, validated by concept analysis and by experts. the most frequent risk factors for respiratory aspiration were: dysphagia (54.2%) and impaired physical mobility (41.7%). The prevalence of the nursing diagnosis Risk for Aspiration was 58.3% and the prevalence of respiratory aspiration over the span of 48 hours (monitoring period) was 37.5%. Risk factors for dysphagia and impaired physical mobility were significantly associated with respiratory aspiration. the risk factors dysphagia and impaired physical mobility are good predictors of the nursing diagnosis Risk for Aspiration. This study contributed to improving the NANDA-I Taxonomy and the systematization of the nursing process.