Effect of variation in the COPD breathing flow pattern on end-tidal CO2 tension: An in vitro study

Adams, Cletus Fiifi; Jermy, Mark; Geoghegan, Patrick; Spence, Callum

doi:10.15761/mca.1000114

Cited by 2 publications

(2 citation statements)

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“…Capnography, which detects changes in end-tidal volume of carbon dioxide (ETCO 2 ), may have some utility in monitoring patients with AECOPD. Because these patients suffer from an obstructive airway process, the ETCO 2 waveform has a shark-fin morphology rather than a rectangular waveform (Figure 3) (62). Changes in ETCO 2 are associated with FEV 1 and PEFR, which help identify the severity of the disease (63).…”

Section: Case Study Imentioning

confidence: 99%

“…Additionally, ETCO 2 correlates with partial arterial carbon dioxide pressure (PaCO 2 ), however, using ETCO 2 as an alternative for PaCO 2 remains controversial (64). Notably, increased ETCO 2 correlates with ratio of dead space volume to tidal volume (62). Additional assessment techniques include identifying signs of respiratory failure for ventilatory support, such as respiratory acidosis, increased work of breathing, and persistent hypoxemia (1).…”

Section: Case Study Imentioning

confidence: 99%

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Acute Exacerbations of Chronic Obstructive Pulmonary Disease: A Primer for Emergency Physicians

Sorge

DeBlieux

2020

The Journal of Emergency Medicine

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Background: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) impose a significant burden on patients and the emergency health care system. Patients with COPD who present to the emergency department (ED) often have comorbidities that can complicate their management. Objective: To discuss strategies for the management of acute exacerbations in the ED, from initial assessment through disposition, to enable effective patient care and minimize the risk of treatment failure and prevent hospital readmissions. Discussion: Establishing a correct diagnosis early on is critical; therefore, initial evaluations should be aimed at differentiating COPD exacerbations from other life-threatening conditions. Disposition decisions are based on the intensity of symptoms, presence of comorbidities, severity of the disease, and response to therapy. Patients who are appropriate for discharge from the ED should be prescribed evidence-based treatments and smoking cessation to prevent disease progression. A patient-centric discharge care plan should include medication reconciliation; bedside ''teach-back,'' wherein patients demonstrate proper inhaler usage; and prompt follow-up. Conclusions: An effective assessment, accurate diagnosis, and appropriate discharge plan for patients with AECOPD could improve treatment outcomes, reduce hospitalization, and decrease unplanned repeat visits to the ED.

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Section: Case Study Imentioning

confidence: 99%

Section: Case Study Imentioning

confidence: 99%

Acute Exacerbations of Chronic Obstructive Pulmonary Disease: A Primer for Emergency Physicians

Sorge

DeBlieux

2020

The Journal of Emergency Medicine

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Non-Contact Monitoring of Inhalation-Exhalation (I:E) Ratio in Non-Ventilated Subjects

Addison,

Antunes,

Montgomery

et al. 2024

IEEE J. Transl. Eng. Health Med.

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The inhalation-exhalation (I:E) ratio, known to be an indicator of respiratory disease, is the ratio between the inhalation phase and exhalation phase of each breath. Here, we report on results from a non-contact monitoring method for the determination of the I:E ratio. This employs a depth sensing camera system that requires no sensors to be physically attached to the patient. A range of I:E ratios from 0.3 to 1.0 over a range of respiratory rates from 4 to 40 breaths/min were generated by healthy volunteers, producing a total of 3,882 separate breaths for analysis. Depth information was acquired using an Intel D415 RealSense camera placed at 1.1 m from the subjects’ torso. This data was processed in real-time to extract depth changes within the subjects’ torso region corresponding to respiratory activity. This was further converted into a respiratory signal from which the I:E ratio was determined (I:E \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{upgreek} \usepackage{mathrsfs} \setlength{\oddsidemargin}{-69pt} \begin{document} $_{\mathrm {depth}}$\end{document} ). I:Edepth was compared to spirometer data (I:E \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{upgreek} \usepackage{mathrsfs} \setlength{\oddsidemargin}{-69pt} \begin{document} $_{\mathrm {spiro}}$\end{document} ). A Bland Altman analysis produced a mean bias of –0.004, with limits of agreement [–0.234, 0.227]. A linear regression analysis produced a line of best fit given by I:E \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{upgreek} \usepackage{mathrsfs} \setlength{\oddsidemargin}{-69pt} \begin{document} $_{\mathrm {depth}} = 1.004\times $\end{document} I:Espiro – 0.006, with 95% confidence intervals for the slope [0.988, 1.019] and intercept [–0.017, 0.004]. We have demonstrated the viability of a non-contact monitoring method for determining the I:E ratio on healthy subjects breathing without mechanical support. This measure may be useful in monitoring the deterioration in respiratory status and/or response to therapy within the patient population. Clinical and Translational Impact Statement - The I:E ratio is an indicator of disease severity in COPD and asthma. Non-contact continuous monitoring of I:E ratio will offer the clinician a powerful new tool for respiratory monitoring

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Effect of variation in the COPD breathing flow pattern on end-tidal CO2 tension: An in vitro study

Cited by 2 publications

References 24 publications

Acute Exacerbations of Chronic Obstructive Pulmonary Disease: A Primer for Emergency Physicians

Acute Exacerbations of Chronic Obstructive Pulmonary Disease: A Primer for Emergency Physicians

Non-Contact Monitoring of Inhalation-Exhalation (I:E) Ratio in Non-Ventilated Subjects

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