Pneumotachograph Research Articles

A Fast Calibration Method for Pneumotachograph with a 3L Syringe.

The pneumotachograph (PNT), a commonly used flowmeter in pulmonary function diagnostic equipment, is the required frequency calibration to maintain high accuracy. Aiming to simplify calibration steps, we developed a fast calibration system with a commercially available 3L syringe to provide a real output flow waveform. The acquisition of the real output flow waveform is based on the reliable measurement of in-cylinder pressure and the real-time detection of plunger speed. To improve the calibration accuracy, the tapping position for measuring in-cylinder pressure was optimized by CFD dynamic-mesh updating technique. The plunger speed was obtained by tracking the handle of the plunger with a smart terminal. Then, the real output flow was corrected using a compensation model equation. The calibration system was verified by the pulmonary waveform generator that the accuracy satisfied the requirements for respiratory flow measurement according to ATS standardization. The experimental results suggest that the developed method promises the fast calibration of PNT.

The syringe potentiometer: a low-cost device for pneumotachograph calibration.

The purpose of this report was to 1) detail the construction of a low-cost device that provides a "reference" flow waveform for pneumotachograph (PNT) calibration, i.e., the "syringe potentiometer" (SP), and to compare the 2) accuracy and 3) practical performance of "calibration curves" obtained with the SP device to other more established methods of PNT calibration, i.e., the weighted averaging (WA) and polynomial least-squares (PolyLS) methods. Volume and flow waveforms obtained via the SP device were validated against a motion capture system and were deemed accurate surrogates of actual syringe volume and flows. The SP device was used to construct a calibration curve of a PNT by dividing the flow waveform of the SP by the analog output of the PNT amplifier. A total of 187 inspiratory and 187 expiratory strokes were collected. When the entire data set of expiratory strokes was used, the SP, WA, and PolyLS methods together demonstrated acceptable volume and flow errors as per American Thoracic Society/European Respiratory Society recommendations (less than ±3.5% and less than ±5.0% errors, respectively). The "practical" performance of each method was assessed with a nested subsampling procedure, whereby volume and flow errors were evaluated as the number of strokes was increased (in blocks of 5 strokes). To this end, the SP method demonstrated practical performance superior to that of the WA and PolyLS approaches, whereby acceptable volume and flow errors were achieved after only 5 calibration strokes; the WA and PolyLS methods required 15 and 20 strokes, respectively, to achieve the same level of volume and flow accuracy.NEW & NOTEWORTHY This report describes the construction and validation of a low-cost device for the purposes of pneumotachograph (PNT) calibration: the "syringe potentiometer" (SP). Calibration of a PNT with the SP device yielded acceptable volume and flow errors (<3.5% and 5%, respectively) across a wide range of flows (<0.5 to 15 L/s). The SP device offered superior "practical performance" over other established PNT calibration methods, whereby acceptable volume and flow errors were achieved after only five calibration strokes.

Physiological Validation of an Airborne Ultrasound Based Surface Motion Camera for a Contactless Characterization of Breathing Pattern in Humans.

Characterizing the breathing pattern in naturally breathing humans brings important information on respiratory mechanics, respiratory muscle, and breathing control. However, measuring breathing modifies breathing (observer effect) through the effects of instrumentation and awareness: measuring human breathing under true ecological conditions is currently impossible. This study tested the hypothesis that non-contact vibrometry using airborne ultrasound (SONAR) could measure breathing movements in a contactless and invisible manner. Thus, first, we evaluated the validity of SONAR measurements by testing their interchangeability with pneumotachograph (PNT) measurements obtained at the same time. We also aimed at evaluating the observer effect by comparing breathing variability obtained by SONAR versus SONAR-PNT measurements. Twenty-three healthy subjects (12 men and 11 women; mean age 33 years – range: 20–54) were studied during resting breathing while sitting on a chair. Breathing activity was described in terms of ventilatory flow measured using a PNT and, either simultaneously or sequentially, with a SONAR device measuring the velocity of the surface motion of the chest wall. SONAR was focused either anteriorly on the xiphoid process or posteriorly on the lower part of the costal margin. Discrete ventilatory temporal and volume variables and their coefficients of variability were calculated from the flow signal (PNT) and the velocity signal (SONAR) and tested for interchangeability (Passing-Bablok regression). Tidal volume (VT) and displacement were linearly related. Breathing frequency (BF), total cycle time (TT), inspiratory time (TI), and expiratory time (TE) met interchangeability criteria. Their coefficients of variation were not statistically significantly different with PNT and SONAR-only. This was true for both the anterior and the posterior SONAR measurements. Non-contact vibrometry using airborne ultrasound is a valid tool for measuring resting breathing pattern.

High-resolution respiratory inductive plethysmography in rats: validation in anesthetized conditions

Respiratory monitoring is often required in experimental physiological and pharmacological studies in rodents. Currently, the mostly used techniques are direct measurement of airflow on intubated animals and whole body plethysmography. Objective: Although the reliability of these methods has been broadly demonstrated, they also have several drawbacks such as invasiveness, high cost of use or confinement of the animals. Respiratory inductive plethysmography (RIP) is a non-invasive technique already used in medium-sized mammals that has not yet been evaluated in small rodents. The implementation of inductive plethysmography in rats represents an instrumental challenge because of the small inductances that are expected. Approach: A rodent-specific RIP apparatus has been developed and compared to direct airflow measurement provided by a pneumotachograph (PNT) considered as the invasive gold standard for respiratory monitoring. The experiments were carried out on anesthetized rats artificially ventilated at different levels of tidal volumes (VT) covering the whole physiological range. Main results: Based on the Euclidian distance between signals, this study shows that after calibration, signals from RIP fit at 93% with PNT values. The Bland and Altman plot evidences differences between RIP and PNT lower than 20% and the values obtained are highly correlated (R = 0.98, p < 0.001). Significance: This study demonstrates that it is possible to design RIP systems suitable for measurement of tidal volumes and airflow in anesthetized rats. Further studies will now be focused on the validation in extended physiological conditions.

Measuring Ventilatory Activity with Structured Light Plethysmography (SLP) Reduces Instrumental Observer Effect and Preserves Tidal Breathing Variability in Healthy and COPD.

The use of a mouthpiece to measure ventilatory flow with a pneumotachograph (PNT) introduces a major perturbation to breathing (“instrumental/observer effect”) and suffices to modify the respiratory behavior. Structured light plethysmography (SLP) is a non-contact method of assessment of breathing pattern during tidal breathing. Firstly, we validated the SLP measurements by comparing timing components of the ventilatory pattern obtained by SLP vs. PNT under the same condition; secondly, we compared SLP to SLP+PNT measurements of breathing pattern to evaluate the disruption of breathing pattern and breathing variability in healthy and COPD subjects. Measurements were taken during tidal breathing with SLP alone and SLP+PNT recording in 30 COPD and healthy subjects. Measurements included: respiratory frequency (Rf), inspiratory, expiratory, and total breath time/duration (Ti, Te, and Tt). Passing-Bablok regression analysis was used to evaluate the interchangeability of timing components of the ventilatory pattern (Rf, Ti, Te, and Tt) between measurements performed under the following experimental conditions: SLP vs. PNT, SLP+PNT vs. SLP, and SLP+PNT vs. PNT. The variability of different ventilatory variables was assessed through their coefficients of variation (CVs). In healthy: according to Passing-Bablok regression, Rf, TI, TE and TT were interchangeable between measurements obtained under the three experimental conditions (SLP vs. PNT, SLP+PNT vs. SLP, and SLP+PNT vs. PNT). All the CVs describing “traditional” ventilatory variables (Rf, Ti, Te, Ti/Te, and Ti/Tt) were significantly smaller in SLP+PNT condition. This was not the case for more “specific” SLP-derived variables. In COPD: according to Passing-Bablok regression, Rf, TI, TE, and TT were interchangeable between measurements obtained under SLP vs. PNT and SLP+PNT vs. PNT, whereas only Rf, TE, and TT were interchangeable between measurements obtained under SLP+PNT vs. SLP. However, most discrete variables were significantly different between the SLP and SLP+PNT conditions and CVs were significantly lower when COPD patients were assessed in the SLP+PNT condition. Measuring ventilatory activity with SLP preserves resting tidal breathing variability, reduces instrumental observer effect and avoids any disruptions in breathing pattern induced by the use of PNT-mouthpiece-nose-clip combination.

Measurement of tidal breathing flows in infants using impedance pneumography.

Tidal breathing flow volume (TBFV) profiles have been used to characterise altered lung function. Impedance pneumography (IP) is a novel option for assessing TBFV curves noninvasively. The aim of this study was to extend the application of IP for infants and to estimate the agreement between IP and direct pneumotachograph (PNT) measurements in assessing tidal airflow and flow-derived indices.Tidal flow profiles were recorded for 1 min simultaneously with PNT and uncalibrated IP at baseline in 44 symptomatic infants, and after methacholine-induced bronchoconstriction in a subgroup (n=20).The agreement expressed as the mean deviation from linearity ranged between 3.9 and 4.3% of tidal peak inspiratory flow, but was associated with specific airway conductance (p=0.002) and maximal flow at functional residual capacity (V'maxFRC) (p=0.004) at baseline. Acute bronchoconstriction induced by methacholine did not significantly affect the agreement of IP with PNT. TBFV indices derived from IP were slightly underestimated compared to PNT, but were equally well repeatable and associated with baseline V'maxFRC (p=0.012 and p=0.013, respectively).TBFV profiles were consistent between IP and PNT in most infants, but the agreement was affected by reduced lung function. TBFV parameters were not interchangeable between IP and PNT, but had a similar association with lung function in infants.

Assessment of an alternative calibration technique to record breathing pattern and its variability with respiratory inductive plethysmography.

Recent literature has raised doubts on the existing calibration methods for respiratory inductive plethysmography (RIP) which can lead to erroneous estimation of tidal volume. This study sought to validate an alternative calibration method to record tidal volume and tidal volume variability during rest and exercise by comparing the measurements obtained from a RIP device against a pneumotachograph (PT) for breath-by-breath analysis. 11 healthy individuals were recruited. Tidal volume and variability were simultaneously recorded during 30min of rest and 20min of exercises. Pearson correlation coefficients for group mean tidal volume between PT and RIP were 0.8 during rest and exercises. No statistical significant difference was observed in tidal volume variability between devices during rest and exercises. This study provides support for an alternative calibration method, which addresses existing limitations. The simplicity of equipment set up process and no need to perform subject cooperated calibration procedure will improve the respiratory monitoring process.

Tidal volume measurements in infants: Opto-electronic plethysmography versus pneumotachograph.

Tidal breathing measurements by Opto-Electronic Plethysmography (OEP) has been reported for infants limited to protocols with two chest wall compartments. Standard protocol for the analysis of adults, with three compartments of chest wall, has been unavailable for analysis of infants. We aimed to study the agreement of simultaneous measurements of tidal volume by OEP (VT,OEP ) and a heated pneumotachograph (PNT) (VT,PNT ) performed during sleeping in 20 infants (gestational age 35.1 ± 4.6 weeks) at 3-4 months postconceptual age with a three compartment protocol. From PNT and OEP measurements, tidal volume corrected (VT,PNT ) for ambient conditions were calculated with a total number of 200 breaths. The two methods were in good agreement with tidal volume mean difference of 0.02 ml and limit of agreement -4.11 to 4.08 ml (95%CI), no relationship was found between differences and means of OEP and PNT measurements. Pulmonary rib cage, abdominal rib cage and abdomen contributed by 12.4 ± 9.7%, 5.2 ± 5.1%, and 82.4 ± 11.4% to VT,OEP , respectively. The OEP experimental protocol based on 52 markers and a three-compartment model of the chest wall could be used in spontaneously sleeping infants. Pediatr Pulmonol. 2016;51:850-857. © 2016 Wiley Periodicals, Inc.

Metrological Aspects of Peak Expiratory Flow-Meters After Prolonged Use

SESSION TITLE: Pulmonary Physiology Posters SESSION TYPE: Original Investigation Poster PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM PURPOSE: There is scant information about the accuracy and reproducibility of the readings after prolonged use of mechanical peak expiratory flow-meters (PEF-meters) for monitoring of large airway function, both for clinical research purposes and routine management of asthma. The aim of this study was to test the reliability of peak expiratory flow (PEF) values measured with PEF-meters that have been used a prolonged period (two devices of five different types) using a clinical calibration procedure. METHODS: Five types of adult PEF-meters were tested before (new devices) and after a period of use of several years: Assess-Healthscan (8 years), Mini-Wright-Clement Clarke (7 years), Vitalograph-Vitalograph (5 years), PocketPeak-Ferraris (3 years) and Truzone-Monaghan (2 years). Comparisons with values from a Lily pneumotachograph (PT) (Pneumoscreen - E. Jaeger, Germany) were performed. In the first series of comparisons every PEF-meter was connected downstream in series with the PT and the same subject performed 40 partial to maximal forced expiratory maneuvers (MFEM), during a period of 160 minutes. In the second series of comparisons 30 adult patients performed randomized MFEM on each PEF-meter and on the PT, during a period of 30 minutes. RESULTS: ANOVA analysis revealed some differences in the accuracy of the different PEF-meters before and after a prolonged using period: the closest agreements to the PT before were Truzone and Mini-Wright, and after Assess and Mini-Wright. The best reproducibility for the before and after using period values was obtained in Assess and PocketPeak. CONCLUSIONS: The period for using of PEF-meters in a good conditions is much longer than that usually accepted and the replacement of PEF-meters should be restricted to cases of physical damage or obvious malfunction. Our results don't involve in any way the brand name of PEF-meters because we have the possibility to assess only two devices from every PEF-meters type and the number is statistically too small to characterise the brand name of PEF-meter type. CLINICAL IMPLICATIONS: These findings proved that PEF-meters can be used safely a longer period than expected, if their maintenance is flawless. DISCLOSURE: The following authors have nothing to disclose: Paraschiva Postolache, Octavian Petrescu, Floarea Mimi Nitu, Roxana Maria Nemes No Product/Research Disclosure Information

A robust electrode configuration for bioimpedance measurement of respiration.

Electrode configuration is an important issue in the continuous measurement of respiration using impedance pneumography (IP). The robust configuration is usually confirmed by comparing the amplitude of the IP signals acquired with different electrode configurations, while the relative change in waveform and the effects of body posture and respiratory pattern are ignored. In this study, the IP signals and respiratory volume are simultaneously acquired from 8 healthy subjects in supine, left lying, right lying and prone postures, and the subjects are asked to perform four respiratory patterns including free breathing, thoracic breathing, abdominal breathing and apnea. The IP signals are acquired with four different chest electrode configurations, and the volume are measured using pneumotachograph (PNT). Differences in correlation and absolute deviation between the IP-derived and PNT-derived respiratory volume are assessed. The influences of noise, respiratory pattern and body posture on the IP signals of different configurations have significant difference (p < 0.05). The robust electrode configuration is found on the axillary midline, which is suitable for long term respiration monitoring.

Tidal breathing flow measurement in awake young children by using impedance pneumography

Characteristics of tidal breathing (TB) relate to lung function and may be assessed even in young children. Thus far, the accuracy of impedance pneumography (IP) in recording TB flows in young children with or without bronchial obstruction has not been evaluated. The aim of this study was to evaluate the agreement between IP and direct flow measurement with pneumotachograph (PNT) in assessing TB flow and flow-derived indices relating to airway obstruction in young children. Tidal flow was recorded for 1 min simultaneously with IP and PNT during different phases of a bronchial challenge test with methacholine in 21 wheezy children aged 3 to 7 years. The agreement of IP with PNT was found to be excellent in direct flow signal comparison, the mean deviation from linearity ranging from 2.4 to 3.1% of tidal peak inspiratory flow. Methacholine-induced bronchoconstriction or consecutive bronchodilation induced only minor changes in the agreement. Between IP and PNT, the obstruction-related tidal flow indices were equally repeatable, and agreement was found to be high, with intraclass correlation coefficients for T PTEF/T E, V PTEF/V E, and parameter S being 0.94, 0.91, and 0.68, respectively. Methacholine-induced changes in tidal flow indices showed significant associations with changes in mechanical impedance of the respiratory system assessed by the oscillometric technique, with the highest correlation found in V PTEF/V E (r = -0.54; P < 0.005 and r = -0.55; P < 0.005 by using IP or PNT, respectively). The results indicate that IP can be considered as a valid method for recording tidal airflow profiles in young children with wheezing disorders.

Comparison of artificial neural network (ANN) and partial least squares (PLS) regression models for predicting respiratory ventilation: an exploratory study

The objective of this study was to assess the potential for using artificial neural networks (ANN) to predict inspired minute ventilation (V(I)) during exercise activities. Six physiological/kinematic measurements obtained from a portable ambulatory monitoring system, along with individual's anthropometric and demographic characteristics, were employed as input variables to develop and optimize the ANN configuration with respect to reference values simultaneously measured using a pneumotachograph (PT). The generalization ability of the resulting two-hidden-layer ANN model was compared with a linear predictive model developed through partial least squares (PLS) regression, as well as other V(I) predictive models proposed in the literature. Using an independent dataset recorded from nine 80-min step tests, the results showed that the ANN-estimated V(I) was highly correlated (R(2) = 0.88) with V(I) measured by the PT, with a mean difference of approximately 0.9%. In contrast, the PLS and other regression-based models resulted in larger average errors ranging from 7 to 34%. In addition, the ANN model yielded estimates of cumulative total volume that were on average within 1% of reference PT measurements. Compared with established statistical methods, the proposed ANN model demonstrates the potential to provide improved prediction of respiratory ventilation in workplace applications for which the use of traditional laboratory-based instruments is not feasible. Further research should be conducted to investigate the performance of ANNs for different types of physical activity in larger and more varied worker populations.

DEVELOPMENT OF A COMBINATION FORCED OSCILLATION - SPIROMETER DEVICE

We developed a novel device, called the oscillation spirometer (OS) that can track changes in respiratory system impedance (Zrs) and can provide standard measures of respiratory resistance and spirometry. Current devices do not easily track temporal variation in Zrs. The device consists of a self-actuated piston containing an airflow resistance. During spirometry mode, the screen mesh pneumotachograph (PT) is stationary while during oscillation modes the PT translates generating oscillatory pressure. The actuator position is monitored continuously by a laser position sensing detector. To facilitate the design process, we developed a computer simulation of the actuator including mechanical and electromechanical compartments. A second model was created to simulate the patient Zrs and the two models were coupled and used to optimize design parameters such as magnet size, stroke volume, and piston cross-section, in a recursive design process. The result was a portable device with optimal stroke volume for expected patient loads. Three different designs were considered for the airflow resistance (orifice, groove and screen mesh resistances), and were tested using mock-up models. The final screen mesh resistance was linear, with a 98% lower 2nd order nonlinearity term than the next best design, and met American Thoracic Society standards. The OS could be used as a hand-held spirometer, or as a mounted FOT device suitable for detecting respiratory system resistance (Rrs) and its variation. It therefore has the potential to have a substantial impact in the respiratory market.

A method for suppressing cardiogenic oscillations in impedance pneumography

The transthoracic electrical impedance signal originates from the cardiac and respiratory functions. In impedance pneumography (IP) the lung function is assessed and the cardiac impedance signal, cardiogenic oscillations (CGOs), is considered an additive noise in the measured signal. In order to accurately determine pulmonary flow parameters from the signal, the CGO needs to be attenuated without distorting the respiratory part of the signal. We assessed the suitability of a filtering technique, originally described by Schuessler et al (1998 Ann. Biomed. Eng. 26 260–7) for an esophageal pressure signal, for CGO attenuation in the IP signal. The technique is based on ensemble averaging the CGO events using the electrocardiogram (ECG) R-wave as the trigger signal. Lung volume is known to affect the CGO waveforms. Therefore we modified the filtering method to produce a lung volume-dependent parametric model of the CGO waveform. A simultaneous recording of ECG, IP and pneumotachograph (PNT) was conducted on 41 healthy, sitting adults. The performance of the proposed method was compared to a low-pass filter and a Savitzky–Golay filter in terms of CGO attenuation and respiratory signal distortion. The method was found to be excellent, exhibiting CGO attenuation of 35.0±12.5 dB (mean±SD) and minimal distortion of the respiratory part of the impedance signal.

P125 Non-invasive assessment of ventilation distribution in infants using electrical impedance tomography (EIT)

BackgroundEarly detection of lung disease in conditions such as cystic fibrosis (CF) is vital to maximise lung health but lung function tests (LFT) during the 1st year of life are...

Assessment of Pulmonary Flow Using Impedance Pneumography

There is a lack of noninvasive pulmonary function measurement techniques suitable for continuous long-term measurement of tidal breathing in mobile subjects, although tidal breathing analysis has been shown to contain information that relates to the level airway obstruction. This paper is the first to assess the suitability of impedance pneumography (IP) for measurement of continuous pulmonary flow and volume signals instead of only the respiration rate (RR) or tidal volume ( V(T)). We measured pneumotachograph (PNT) and IP signals simultaneously from 20 healthy male subjects in erect, dorsal supine, and lateral supine positions while voluntarily varying V(T). IP was measured using five different impedance lead configurations with electrodes integrated into a textile chest belt. The IP signals were compared with PNT signals to assess agreement of IP with a more well-established measurement method. The pulmonary flow signal waveform agreement was assessed with standard error of measurement (SEM) between the time-differentiated IP signal and the PNT signal as rho = 1-SEM. Additionally, we assessed the agreement of IP and PNT in V(T) estimation and the magnitude of the cardiogenic oscillation present in the impedance signal. The agreement in the pulmonary flow signal waveform shapes was found excellent at all tidal volumes and postures (mean rho > 0.90). The agreement between the PNT-derived and the IP-derived V(T) estimates was very high when IP values were calibrated per subject and posture (mean difference < 3%). The main source of error in visual inspection of the IP signal was the cardiogenic distortion. From the five novel electrode configurations tested, the lateral ones were found clearly better than the anteroposterior ones. IP potentially enables the development of a noninvasive ambulatory measurement device for long-term studies of certain tidal breathing parameters in mobile subjects.

Measurement of Total and Compartmental Lung Volume Changes in Newborns by Optoelectronic Plethysmography

The study of respiratory mechanics in infants requires a noninvasive accurate measurement of the lung volume changes (DeltaVL). Optoelectronic plethysmography (OEP) allows the assessment of DeltaVL through the measurement of the chest wall surface motion and it has been proved to be accurate in adults. The aim of this study was to apply OEP to newborns and to validate it by comparison to pneumotachography. Twenty term and preterm newborns (GA = 34 +/- 5 wk) in stable condition were studied during 1 to 2 min periods of quiet breathing in supine position. Airway opening flow was measured by applying a facemask connected to a pneumotachograph (PNT) and integrated to provide the DeltaVL. Chest wall volume changes were simultaneously measured by OEP. The tidal volume values measured by pneumotachography and by OEP were compared for each breath. A total of 771 breaths from all patients were considered. Bland-Altmann analysis showed a mean difference of -0.08 mL and a limit of agreement ranging from -2.98 to 2.83 mL. Linear regression analysis demonstrated good correlation between the two techniques (r = 0.95, q = 1.00 mL, m = 0.96). OEP provides accurate measurements of DeltaVL in newborns and may be useful to study respiratory mechanics and breathing patterns during spontaneous breathing and mechanical ventilation.

Comparison of four methods to calibrate respiratory inductive plethysmograph in premature infants

Respiratory inductive plethysmography (RIP) is a widely used method providing important information on the breathing pattern. This non-invasive technique is particularly interesting in infants and newborns. However, the different calibration methods developed in adults to allow the measurement of volume have not been validated in premature infants, even if they are frequently used. We developed a calibration method using the least square method to identify the coefficients (α ; β) to calculate the reconstructed volume from the RIP signals (V = α ribcage + β abdomen) with a pneumotachograph (PNT) signal as reference, and using an individually adapted filter to suppress heart artefacts.

Development of a flexible cardiorespiratory monitor based on induction plethysmography

Induction plethysmography (IP) utilizes changes in the inductance of sinusoidal wires embedded in elastic bands placed around the chest and abdomen to detect volume changes in the two compartments. These changes can be attributed to respiration or heart beat. To date, most applications have been tailored to an investigation of respiration. More sensitive systems have been employed for the detection of cardiac activity. The wires within the bands, which function as the coil in a resonant circuit, are excited by an oscillator. Among other factors, the inductance of the coil depends on the cross-sectional area of the coie, and changes with respiration in coils placed around the chest and abdomen. Using LabView software, the biosignals obtained undergo an analog-to-digital conversion prior to processing. The system was calibrated using the isovolume method. In 10 adults, IP was tested against a pneumotachograph (PNT) in different body positions (standing, sitting, supine, prone). Correlation between tidal volumes measured with IP and PNT was of r > or = 0.96 on average, recalibration being done after each change in position. The absolute mean error ranged between 3.7 and 8.5%, depending on body position. The smallest error (3.7%) and greatest agreement between the two methods was found in the supine position (93.3% of the IP measurements within +/- 10% of the PNT measurements). An IP application that could be used to collect data over the long term and which is in good agreement with PNT was developed by employing a "virtual instrument" (VI, LabView) for flexible data acquisition and data processing. Agreement was best when the volunteer adopted a supine position. A smaller correlation was found in standing or seated subjects. This might be due to the fact that in the latter two positions, the respiratory system may have more than 2 degrees of freedom, and thus cannot be adequately monitored by only two bands around the thorax and abdomen. Signals produced by cardiac activity were detectable on the surface of the body.

Respiratory inductance plethysmography in healthy infants: a comparison of three calibration methods.

Respiratory inductance plethysmography (RIP) measures respiration from body surface movements. Various techniques have been proposed for calibration in order that RIP may be used quantitatively. These include calculation of the proportionality constant of ribcage to abdominal volume change (K). The aims of this study were to 1) establish whether a fixed value of K could be used for calibration, and 2) compare this technique with multiple linear regression (MLR) and qualitative diagnostic calibration (QDC) in normal healthy infants. Recordings of pneumotachograph (PNT) flow and RIP were made during quiet (QS) and active sleep (AS) in 12 infants. The first 5 min in a sleep state were used to calculate calibration factors, which were applied to subsequent validation data. The absolute percentage error between RIP and PNT tidal volumes was calculated. The percentage error was similar over a wide range of K during QS. However, K became more critical when breathing was out of phase. A standard for K of 0.5 was chosen. There was good agreement between calibration methods during QS and AS. In the first minute following calibration during QS, the mean absolute errors were 3.5, 4.1 and 5.3% for MLR, QDC and fixed K respectively. The equivalent errors in AS were 11.5, 13.1 and 13.7% respectively. The simple fixed ratio method can be used to measure tidal volume with similar accuracy to multiple linear regression and qualitative diagnostic calibration in healthy unsedated sleeping infants, although it remains to be validated in other groups of infants, such as those with respiratory disease.