Breathing variability—implications for anaesthesiology and intensive care

Bosch, Oscar F C van den; Álvarez-Jiménez, Ricardo; Grooth, Harm-Jan de; Girbes, Armand R. J.; Loer, Stephan A.

doi:10.1186/s13054-021-03716-0

Cited by 36 publications

(26 citation statements)

References 89 publications

(88 reference statements)

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“…Three RPV measures were computed in this study by quantifying the coefficient of variation (CV) for the T i , T e , and RR time series. The CV is a standardized measure of dispersion computed by dividing the standard deviation by its mean and is one of the most widely used RPV metrics to date ( 20 ). As in prior work ( 16 ), the CV of T i , T e , and RR were computed using a 300 s moving window with a 299 s overlap, centered with respect to the RPV datapoint produced.…”

Section: Methodsmentioning

confidence: 99%

Pain is reduced by transcutaneous cervical vagus nerve stimulation and correlated with cardiorespiratory variability measures in the context of opioid withdrawal

Gazi

Harrison²,

Lambert³

et al. 2022

Front. Pain Res.

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Over 100,000 individuals in the United States lost their lives secondary to drug overdose in 2021, with opioid use disorder (OUD) being a leading cause. Pain is an important component of opioid withdrawal, which can complicate recovery from OUD. This study's objectives were to assess the effects of transcutaneous cervical vagus nerve stimulation (tcVNS), a technique shown to reduce sympathetic arousal in other populations, on pain during acute opioid withdrawal and to study pain's relationships with objective cardiorespiratory markers. Twenty patients with OUD underwent opioid withdrawal while participating in a two-hour protocol. The protocol involved opioid cues to induce opioid craving and neutral conditions for control purposes. Adhering to a double-blind design, patients were randomly assigned to receive active tcVNS (n = 9) or sham stimulation (n = 11) throughout the protocol. At the beginning and end of the protocol, patients' pain levels were assessed using the numerical rating scale (0–10 scale) for pain (NRS Pain). During the protocol, electrocardiogram and respiratory effort signals were measured, from which heart rate variability (HRV) and respiration pattern variability (RPV) were extracted. Pre- to post- changes (denoted with a Δ) were computed for all measures. Δ NRS Pain scores were lower (P = 0.045) for the active group (mean ± standard deviation: −0.8 ± 2.4) compared to the sham group (0.9 ± 1.0). A positive correlation existed between Δ NRS pain scores and Δ RPV (Spearman's ρ = 0.46; P = 0.04). Following adjustment for device group, a negative correlation existed between Δ HRV and Δ NRS Pain (Spearman's ρ = −0.43; P = 0.04). This randomized, double-blind, sham-controlled pilot study provides the first evidence of tcVNS-induced reductions in pain in patients with OUD experiencing opioid withdrawal. This study also provides the first quantitative evidence of an association between breathing irregularity and pain. The correlations between changes in pain and changes in objective physiological markers add validity to the data. Given the clinical importance of reducing pain non-pharmacologically, the findings support the need for further investigation of tcVNS and wearable cardiorespiratory sensing for pain monitoring and management in patients with OUD.

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Section: Methodsmentioning

confidence: 99%

Pain is reduced by transcutaneous cervical vagus nerve stimulation and correlated with cardiorespiratory variability measures in the context of opioid withdrawal

Gazi

Harrison²,

Lambert³

et al. 2022

Front. Pain Res.

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“…Meanwhile, REM sleep is characterized by increased respiratory frequency and reduced breathing regularity. Thus tidal volume decreases further in REM sleep than in NREM sleep, causing minute ventilation to decrease [15].…”

Section: Literature Reviewmentioning

confidence: 99%

Relationship between Degrees of Nasal Obstruction and Obstructive Sleep Apnea

Marlina

Hendrika

Adinda

2023

JOCAMR

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Obstructive sleep apnea (OSA) is a sleep-related breathing disorder caused by repeated upper airway obstruction. In OSA patients, 46.5%-58% reported having symptoms of hypersomnolence or excessive daytime sleepiness, and it was the most common symptom. Nasal obstruction is considered a risk factor for sleeping and breathing problems and a common problem in OSA sufferers. Nasal obstruction in the general population can reach 30-40% and is a problem that is often consulted in primary or secondary health services. This study aimed to determine the relationship between the degree of nasal obstruction and OSA in students of the Faculty of Medicine, Indonesian Christian University, Class of 2018-2020. This study uses an analytic observation method with a cross-sectional approach. The number of samples of 74 people was obtained by purposive sampling technique. Respondents who met the criteria were assessed for the degree of nasal obstruction using the NOSE scale questionnaire, while OSA was assessed using the ESS questionnaire, and then the data were analyzed using the Chi-Square Test. The results of the Chi-Square statistical test obtained p value = 0.041. So it was concluded that there was a significant relationship between the degree of nasal obstruction and OSA in students of the Faculty of Medicine, Indonesian Christian University Class of 2018-2020.

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“…In our case, we selected the coefficient of variation because it measures the degree of variability related to the mean of the values, which is useful to compare data with different means, as is the case for the bioimpedance amplitude. Moreover, CV can be used for shortterm variations [41]. The recordings length was at least 5 min for each phase, and we used 30 respiratory cycles to estimate breathing parameters and compute the corresponding CV.…”

Section: Focus and Target Application Domain Of The Studymentioning

confidence: 99%

Breathing Pattern Estimation Using Wearable Bioimpedance for Assessing COPD Severity

Blanco-Almazan

Groenendaal

Lijnen

et al. 2022

IEEE J. Biomed. Health Inform.

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Breathing pattern has been shown to be different in chronic obstructive pulmonary disease (COPD) patients compared to healthy controls during rest and walking. In this study we evaluated respiratory parameters and the breathing variability of COPD patients as a function of their severity. Thoracic bioimpedance was acquired on 66 COPD patients during the performance of the six-minute walk test (6MWT), as well as 5 minutes before and after the test while the patients were seated, i.e. resting and recovery phases. The patients were classified by their level of airflow limitation into moderate and severe groups. We characterized the breathing patterns by evaluating common respiratory parameters using only wearable bioimpedance. Specifically, we computed the median and the coefficient of variation of the parameters during the three phases of the protocol, and evaluated the statistical differences between the two COPD severity groups. We observed significant differences between the COPD severity groups only during the sitting phases, whereas the behavior during the 6MWT was similar. Particularly, we observed an inverse relationship between breathing pattern variability and COPD severity, which may indicate that the most severely diseased patients had a more restricted breathing compared to the moderate patients.

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Breathing variability—implications for anaesthesiology and intensive care

Cited by 36 publications

References 89 publications

Pain is reduced by transcutaneous cervical vagus nerve stimulation and correlated with cardiorespiratory variability measures in the context of opioid withdrawal

Pain is reduced by transcutaneous cervical vagus nerve stimulation and correlated with cardiorespiratory variability measures in the context of opioid withdrawal

Relationship between Degrees of Nasal Obstruction and Obstructive Sleep Apnea

Breathing Pattern Estimation Using Wearable Bioimpedance for Assessing COPD Severity

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