Comparison of Acoustic Respiration Rate, Impedance Pneumography and Capnometry Monitors for Respiration Rate Accuracy and Apnea Detection during GI Endoscopy Anesthesia

DOI: 10.4236/ojanes.2013.32019   PDF   HTML   XML   5,002 Downloads   8,486 Views   Citations

Abstract

Study Objective: To assess the accuracy of respiration rate measurements and the ability to detect apnea by capnometry, impedance pneumography and a new method, acoustic respiration rate monitoring, in anesthetized patients undergoing gastrointestinal endoscopy procedures. Design: Prospective observational study. Setting: Endoscopy procedures laboratory. Patients: 98 patients scheduled for upper gastrointestinal endoscopy with propofol-based anesthesia. Interventions: Patients were monitored for respiration rate with acoustic respiration rate monitoring, capnometry and impedance pneumography and values were compared to the manual counting of breaths by observation of chest wall movements. Additionally, when any respiration rate monitor indicated a cessation of breathing for 30 seconds or greater, the presumed apnea was confirmed by direct observation of the patient for absence of chest wall movements. Measurements and Main Results: Bias and precision for respiration rate measurement was 0 ± 1.0 bpm for acoustic monitoring, 4.8 ± 15.1 bpm for capnometry and 0.4 ± 5.9 bpm for impedance pneumography. Sensitivity and specificity for detection of apnea was 73% and 93% for acoustic monitoring, 73% and 12% for capnometry and 45% and 93% for impedance pneumography. Conclusions: Acoustic respiration rate monitoring was found to be accurate for assessment of respiration rate and to have similar or better sensitivity and specificity for detection of apnea compared to capnometry and impedance pneumography in the setting of upper GI endoscopy.

Share and Cite:

B. Goudra, L. Penugonda, R. Speck and A. Sinha, "Comparison of Acoustic Respiration Rate, Impedance Pneumography and Capnometry Monitors for Respiration Rate Accuracy and Apnea Detection during GI Endoscopy Anesthesia," Open Journal of Anesthesiology, Vol. 3 No. 2, 2013, pp. 74-79. doi: 10.4236/ojanes.2013.32019.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] J. J. Vargo, G. Zuccaro Jr., J. A. Dumot, S. S. Shay, D. L. Conwell and J. B. Morrow, “Gastroenterologist-Administered Propofol for Therapeutic Upper Endoscopy with Graphic Assessment of Respiratory Activity: A Case Series,” Gastrointestinal Endoscopy, Vol. 52, No. 2, 2000, pp. 250-255.
[2] J. J. Vargo, G. Zuccaro Jr., J. A. Dumot, S. S. Shay, D. L. Conwell and J. B. Morrow, “Automated Graphic Assessment of Respiratory Activity Is Superior to Pulse Oximetry and Visual Assessment for the Detection of Early Respiratory Depression during Therapeutic Upper Endoscopy,” Gastrointestinal Endoscopy, Vol. 55, No. 7, 2002, pp. 826-831.
[3] G. A. Cote, R. M. Hovis, M. A. Ansstas, L. Waldbaum, A R. R. zar, D. S. Early, S. A. Edmundowicz, D. K. Mullady and S. S. Jonnalagadda, “Incidence of Sedation-Related Complications with Propofol Use during Advanced Endoscopic Procedures,” Clinical Gastroenterology and Hepatology, Vol. 8, No. 2, 2009, pp. 137-142.
[4] American Society of Anesthesiologists, “Standard for Basic Anesthetic Monitoring,” American Society of Anesthesiologists, Inc., Park Ridge, 2011.
[5] E. S. Fu, J. B. Downs, J. W. Schweiger, R. V. Miguel and R. A. Smith, “Supplemental Oxygen Impairs Detection of Hypoventilation by Pulse Oximetry,” Chest, Vol. 126, No. 5, 2004, pp. 1552-1558.
[6] J. M. Bland and D. G. Altman, “Agreement between Methods of Measurement with Multiple Observations per Individual,” Journal of Biopharmaceutical Statistics, Vol. 17, No. 4, 2007, pp. 571-582. doi:10.1080/10543400701329422
[7] K. P. Cohen, W. M. Ladd, D. M. Beams, W. S. Sheers, R. G. Radwin, W. J. Tompkins and J. G. Webster, “Comparison of Impedance and Inductance Ventilation Sensors on Adults during Breathing, Motion, and Simulated Airway Obstruction,” IEEE Transactions on Biomedical Engineering, Vol. 44, No. 7, 1997, pp. 555-566. doi:10.1109/10.594896
[8] O. Mimoz, T. Benard, A. Gaucher, D. Frasca and B. Debaene, “Accuracy of Respiratory Rate Monitoring Using a Non-Invasive Acoustic Method after General Anaesthesia,” British Journal of Anaesthesia, Vol. 108, No. 5, 2012, pp. 872-875. doi:10.1093/bja/aer510
[9] M. A. Ramsay and M. Usman, “Accuracy of Respiration Rate and Detection of Respiratory Pause by Acoustic Respiratory Monitoring in the PACU,” The 65th Annual Post Graduate Assembly in Anesthesiology, New York, 9-11 December 2011, p. P9137.
[10] B. J. Semmes, M. J. Tobin, J. V. Snyder and A. Grenvik, “Subjective and Objective Measurement of Tidal Volume in Critically Ill Patients,” Chest, Vol. 87, No. 5, 1985, pp. 577-579. doi:10.1378/chest.87.5.577

  
comments powered by Disqus

Copyright © 2020 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.