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The assessment of apnea and asynchronous breathing requires the application of a facemask connected to a pneumotachograph and inductive transducer bands placed around the chest wall. These contact devices may alter the breathing pattern and are difficult to implement, especially in infants and children. This study validates a contactless image-processing system that simultaneously retrieves breath-related thermal variations from nasal, ribcage, and abdomen regions of interest (ROI) from infrared thermographic video recordings of children. Thermographic videos were obtained in 17 supine, spontaneously breathing unsedated children (0.33-13.75 years), including 8 patients with respiratory pathology. Representative thermographic signals were obtained from each ROI on a frame-by-frame basis. Cronbach's Alpha reliability coefficient assessed the correlation between control nasal pressure period, the visually scored respiratory rate and the fundamental period in the frequency domain of thermographic signals. A cross-correlation function calculated the time delay and the phase angle between ribcage and abdomen variability. A Cronbach's Alpha value of 0.976 (0.992-0.944 95% CI) suggests a small-scale measurement error between thermographic and control periods. The ribcage-abdomen time delay in children with respiratory disease (-0.42 ± 0.707 sec) significantly differed from healthy children (0.22 ± 0.426 sec, P = 0.0125). This novel system reliably acquired time-aligned nasal airflow and thoracoabdominal motion estimates without relying on attached sensor performance and detected asynchronous breathing in pediatric patients.

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