Respiratory Inductance Plethysmography Calibration for Pediatric Upper Airway Obstruction: an Animal Model

Overview

Journal Pediatr Res

Specialties Biology
Pediatrics

Date 2014 Oct 4

PMID 25279987

Citations 8

Authors

Robinder G Khemani

Rutger Flink

Justin Hotz

Patrick A Ross

Anoopindar Ghuman

Christopher J L Newth

Affiliations

Soon will be listed here.

Abstract

Background: We sought to determine optimal methods of respiratory inductance plethysmography (RIP) flow calibration for application to pediatric postextubation upper airway obstruction.

Methods: We measured RIP, spirometry, and esophageal manometry in spontaneously breathing, intubated Rhesus monkeys with increasing inspiratory resistance. RIP calibration was based on: ΔµV(ao) ≈ M[ΔµV(RC) + K(ΔµV(AB))] where K establishes the relationship between the uncalibrated rib cage (ΔµV(RC)) and abdominal (ΔµV(AB)) RIP signals. We calculated K during (i) isovolume maneuvers during a negative inspiratory force (NIF), (ii) quantitative diagnostic calibration (QDC) during (a) tidal breathing, (b) continuous positive airway pressure (CPAP), and (c) increasing degrees of upper airway obstruction (UAO). We compared the calibrated RIP flow waveform to spirometry quantitatively and qualitatively.

Results: Isovolume calibrated RIP flow tracings were more accurate (against spirometry) both quantitatively and qualitatively than those from QDC (P < 0.0001), with bigger differences as UAO worsened. Isovolume calibration yielded nearly identical clinical interpretation of inspiratory flow limitation as spirometry.

Conclusion: In an animal model of pediatric UAO, isovolume calibrated RIP flow tracings are accurate against spirometry. QDC during tidal breathing yields poor RIP flow calibration, particularly as UAO worsens. Routine use of a NIF maneuver before extubation affords the opportunity to use RIP to study postextubation UAO in children.

Citing Articles

Effort and work-of-breathing parameters strongly correlate with increased resistance in an animal model.

Flink R, Newth C, Hotz J, Kneyber M, Ross P, de Jongh F Pediatr Res. 2023; 94(3):944-949.

PMID: 36977768 DOI: 10.1038/s41390-023-02576-4.

Effect of pediatric ventilation weaning technique on work of breathing.

van Dijk J, Koopman A, de Langen L, Dijkstra S, Burgerhof J, Blokpoel R Respir Res. 2022; 23(1):184.

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High Breath-by-Breath Variability Is Associated With Extubation Failure in Children.

Knox K, Nava-Guerra L, Hotz J, Newth C, Khoo M, Khemani R Crit Care Med. 2020; 48(8):1165-1174.

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Estimation of respiratory volume from thoracoabdominal breathing distances: comparison of two models of machine learning.

Dumond R, Gastinger S, Rahman H, Le Faucheur A, Quinton P, Kang H Eur J Appl Physiol. 2017; 117(8):1533-1555.

PMID: 28612121 DOI: 10.1007/s00421-017-3630-0.

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