P24: Impact of FiO2 on blood oxygenation in Pediatric MLung

Abstract

Purpose: Patient-healthcare provider access, increasingly strained in recent years, was further limited dramatically by COVID. Reduced physical access to care necessarily sparked near total reliance on telehealth/telemedicine modalities, which undoubtedly will continue to grow in the future. Platforms such as Zoom, Teams and Meet, while effective in facilitating video interactions are limited as to capabilities for physical examination and dynamic assessment of patients. We developed and validated a methodology, a mobile motion capturesystem, employing visual markers, smartphone-based video capture and computational analytics, for motion capture and analysis via telehealth. Here we examined the translational clinical utility of this approach applied to two physical diagnostic testing maneuvers: 1. Finger abduction/adduction, and 2. Lateral flex. Methods: Bright colored markers were placed on human volunteers wearing dark attire. Finger abduction/adduction: 3 markers (2x2 mm.) were placed – two on the distal inter-phalangeal joint of the second and third digits, and one in between the metacarpal phalangeal joints of the second and third digits. Lateral bending: 2 markers (10x10 mm.) were placed – one at the inferior aspect of the cervical spine, and a second at thoracic/superior lumbar spine. Subjects were instructed and performed diagnostic maneuvers – either as full excursion or as limited excursion - as facsimiles of disease with reduced range-of motion, tele-videos were recorded, analyzed and range of motion reported (degrees of excursion). Results: For all maneuvers performed, smartphone videos of marker-tagged patients allowed tracking and capture of regional body motion and analysis of the extent of motion quantitatively. Range of motion for finger abduction/adduction was measured as 34.3o for full excursion vs. 23.3o for the disease facsimile. For lateral flex, full excursion was 32o vs. 18o for the disease facsimile. All measurements are consistent with values of in-person testing. Conclusions: Our results demonstrate the translational clinical utility of video-based motion capture as a useful tool to enhance physical diagnosis for telemedicine. Visual marker tagging of patients combined with smartphone video capture and analysis is an effective method for adding outpatient remote physical examination capabilities to telemedicine visits to enhance quantitative follow-up.