Comparison of Impedance and Inductance Ventilation Sensors on Adults During Breathing, Motion, and Simulated Airway Obstruction

The goal of this study was to compare the relative performance of two noninvasive ventilation sensing technologies on adults during artifacts. We recorded changes in transthoracic impedance and cross-sectional area of the abdomen (abd) and rib cage (rc) using impedance pneumography (IP) and respiratory inductance plethysmography (RIP) on ten adult subjects during natural breathing, motion artifact, simulated airway obstruction, yawning, snoring, apnea, and coughing. We used a pneumotachometer to measure air flow and tidal volume as the standard. We calibrated all sensors during natural breathing, and performed measurements during all maneuvers without changing the calibration parameters. No sensor provided the most-accurate measure of tidal volume for all maneuvers. Overall, the combination of inductance sensors [RIP(sum)] calibrated during an isovolume maneuver had a bias (weighted mean difference) as low or lower than all individual sensors and all combinations of sensors. The IP(rc) sensor had a bias as low or lower than any individual sensor. The cross-correlation coefficient between sensors was high during natural breathing, but decreased during artifacts. The cross correlation between sensor pairs was lower during artifacts without breathing than it was during maneuvers with breathing for four different sensor combinations. We tested a simple breath-detection algorithm on all sensors and found that RIP(sum) resulted in the fewest number of false breath detections, with sensitivity of 90.8% and positive predictivity of 93.6%.