Thoracic impedance monitoring of respiratory rate during sedation – is it safe?

Wilkinson, Jonathan; Thanawala, V.

doi:10.1111/j.1365-2044.2009.05908.x

Cited by 47 publications

(26 citation statements)

References 3 publications

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“…Intrathecal placement of epidural catheters is much debated and we read Harris and Hussain's letter with interest [1]. We accept that in some circumstances there is no totally correct course of action.…”

Section: ó 2009 the Association Of Anaesthetists Of Great Britain Andmentioning

confidence: 96%

“…There is a strong association between low spine anomalies and genitourinary and colorectal structures [1,2]. Genitourinary, colorectal, and musculoskeletal systems are all of mesodermal origin and develop at the same time in the embryo, so that any insult inducing congenital vertebral malformations during organogenesis may also lead to congenital genitourinary or colorectal abnormalities [2].…”

Section: ó 2009 the Association Of Anaesthetists Of Great Britain Andmentioning

confidence: 99%

“…We were interested to read Frerk and Lee's editorial [1] advocating a change of view on laryngoscopy. We feel this should be accompanied by a change in our approach to difficult airway algorithms.…”

mentioning

confidence: 99%

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Thoraco‐abdominal impedance monitoring of respiratory rate during sedation

Wilson¹,

Keeling²,

Wright³

et al. 2009

Anaesthesia

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Section: ó 2009 the Association Of Anaesthetists Of Great Britain Andmentioning

confidence: 96%

Section: ó 2009 the Association Of Anaesthetists Of Great Britain Andmentioning

confidence: 99%

See 1 more Smart Citation

Thoraco‐abdominal impedance monitoring of respiratory rate during sedation

Wilson¹,

Keeling²,

Wright³

et al. 2009

Anaesthesia

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“…Numerous factors influence the accuracy of thoracic impedance measurements. For example, this technology may rely on chest movements such as those during obstructive apneic episodes in which the chest wall continues to move as the patient attempts to breathe [4,5]. Capnometry requires a nasal cannula or a face mask that may be unpleasant or can be removed by patients.…”

Section: Introductionmentioning

confidence: 99%

Risk factors for bradypnea in a historical cohort of surgical patients receiving fentanyl-based intravenous analgesia

et al. 2018

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Introduction: The use of both pulse oximetry (SpO 2 ) and respiration rate (RR) monitoring is recommended to prevent the development of respiratory deterioration, particularly after extubation and narcotic analgesic use for pain management. In this study, we investigated the factors contributing to the development of bradypnea in surgical patients receiving fentanyl-based intravenous analgesia after general anesthesia. Methods: This study involved a historical chart review of postoperative patients outside an intensive care unit setting. We divided the patients according to the data collected during the first hour postoperatively, into those developing bradypnea (RR < 8 breaths per min for > 2 min) and those with normal RR under oxygen administration. We defined oxygen desaturation as SpO 2 < 90% for > 10 s. We calculated the effect-site concentrations for fentanyl at the end of surgery and 1 h postoperatively using custom-made software based on chart records. A multivariable analysis was used to determine bradypnea-associated explanatory factors. Results: For the final analysis, we included 258 patients. We detected bradypnea in 125 patients (48%) and oxygen desaturation in 46 patients (18%). We found no difference in the effect-site fentanyl concentrations between patients with and without bradypnea. The logistic regression model revealed that liver dysfunction [odds ratio (OR), 2.918; 95% confidence interval (CI), 1.329-6.405], renal dysfunction (OR, 0.349; 95% CI, 0.128-0.955), and smoking history (OR, 0.236; 95% CI, 0.075-0.735) were independently associated with bradypnea. We found similar incidences of oxygen desaturation between the groups. Conclusions: Bradypnea was observed in 48% of postoperative patients receiving fentanyl-based intravenous analgesia under oxygen therapy. According to our results, impaired liver function associated positively, whereas smoking history associated negatively with its development. Renal dysfunction was paradoxically associated with less incidence of bradypnea.

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“…Clinical observation and thoracic auscultation is time consuming and by nature intermittent. Thoracic impedance is the mostly common monitoring method used in clinical practice, but it may fail to detect apnoea secondary to airway obstruction [5,6]. Capnometry is the standard of care, but in spontaneously breathing patients, specially designed nasal cannulae or a mask that may be easily dislodged by the patient are required, leading to false alarms [7,8].…”

Section: Introductionmentioning

confidence: 99%

Comparison of acoustic and impedance methods with mask capnometry to assess respiration rate in obese patients recovering from general anaesthesia

et al. 2014

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SummaryRespiratory depression, a potentially serious complication after general anaesthesia, can be detected promptly by close monitoring of both oxygen saturation and respiratory rate. Obese patients have morphological changes that may impair the reliability of monitoring devices. In this study, respiration rate was simultaneously recorded every second for up to 60 min using a computer in 30 adult obese patients (body mass index ≥ 35 kg.m À2 ), by three methods: acoustic; thoracic impedance; and capnometry via a facemask (Capnomask â , reference method). Of the 99 771 data triplets collected, only 85 520 (86%) were included; 12 021 (84%) were not studied due to failure of capnometry and 2240 (16%) due to failure of the acoustic method. Compared with capnometry, bias was similar using both the acoustic method and impedance (À0.3 bpm vs À0.6 bpm, respectively, p = 0.09), but limits of agreement were narrower for the acoustic method (AE3.5 bpm vs AE5.3 bpm, respectively, p = 0.0008). The proportion of respiration rate values obtained with the acoustic method and impedance that differed by at least 10% or 20% for more than 15 s were 11% vs 23% and 2% vs 6%, respectively (p = 0.0009 for both comparisons). The acoustic sensor was well tolerated, while the facemask was pulled off on several occasions by four (13%) agitated patients. In obese patients requiring close monitoring of respiration rate, the acoustic method may be more precise than thoracic impedance and better tolerated than capnometry with a facemask.

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Thoracic impedance monitoring of respiratory rate during sedation – is it safe?

Cited by 47 publications

References 3 publications

Thoraco‐abdominal impedance monitoring of respiratory rate during sedation

Thoraco‐abdominal impedance monitoring of respiratory rate during sedation

Risk factors for bradypnea in a historical cohort of surgical patients receiving fentanyl-based intravenous analgesia

Comparison of acoustic and impedance methods with mask capnometry to assess respiration rate in obese patients recovering from general anaesthesia

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