Respiratory Devices Research Articles

Effectiveness of prone position with its moderating factors in non-intubated acute respiratory distress syndrome patients: a meta-analysis

Introduction: While numerous meta-analyses have explored the efficacy of awake prone position (APP), most have concentrated solely on intubation rate among Covid-19 patients without comprehensively identifying the influencing factors. This study aims to evaluate the efficacy of APP along with its moderating factors on oxygenation, intubation rate, and mortality in non-intubated acute respiratory distress syndrome (ARDS) patients. Methods: We conducted a systematic search in PubMed, Web of Science, and CINAHL from inception to December 2022. JBI critical appraisal tools were used to assess the study quality. Random-effects model was employed to calculate pooled standardized mean difference for continuous outcomes and risk ratio for dichotomous outcomes. Results: Among the 39 studies included, most patients were suffering from Covid-19, using conventional oxygen therapy, and receiving APP outside the ICU. APP significantly improved the PaO2/FiO2 ratio (SMD=0.70, 95% CI=0.51-0.88) and SpO2/FiO2 ratio (SMD=0.76, 95% CI=0.51-1.01), while also reducing the risk of intubation (RR=0.66, 95% CI=0.51-0.85) and mortality (RR=0.62, 95% CI=0.49-0.78). Factors including severity, respiratory device, body mass index, detail of position, use of medication assistance, total duration, follow-up time, position at follow-up, and study design significantly influence the effectiveness of APP. APP did not lead to significant improvements in length of stay and adverse events Conclusions: APP is a safe and beneficial intervention, enhancing oxygenation and reducing intubation and mortality rates in non-intubated ARDS patients. Importantly, various patient and intervention characteristics should be taken into account when implementing APP. Further well-designed experimental studies are needed to strengthen the evidence base.

Risk Factors for Hearing Screen Failure in a Single Family Room Neonatal Intensive Care Unit.

To determine hearing screen outcomes and identify clinical and environmental risk factors for hearing screen failure in very preterm infants at a level IV single family room (SFR) neonatal intensive care unit (NICU). We conducted a retrospective study of infants <33wks gestational age admitted to a level IV SFR NICU who survived to discharge and had automated auditory brainstem response results available. Demographics, antenatal and postnatal factors, and respiratory support modes and their duration were collected from the electronic medical record. Of 425 eligible infants with documented hearing screen results, 353 (83%) passed and 72 (17%) failed the hearing screen [unilateral, N= 44 (61%); bilateral, N= 28 (39%)]. Compared to infants who passed the hearing screen, infants with hearing screen failure were lower gestational age and birthweight, male sex, were screened at later postnatal and postmenstrual ages, had lower 1 and 5 min Apgar scores, longer duration of furosemide therapy, early hypotension, IVH≥ Grade 3, and BPD at 36 weeks PMA. Infants with hearing screen failure experienced longer exposures to invasive and non-invasive respiratory support. Heated, humidified, high flow nasal cannula >2LPM exposure was significantly longer in infants with bilateral hearing screen failure (18.4±18.4 d) compared to duration in infants who passed (7.4±12.8 d) and those with unilateral failure (9±13 d), (mean ± SD, p<0.001). In the final logistic model, IVH ≥Grade 3 (OR 3.22, 95% CI 1.15-8.98, p=0.026) and BPD (OR 2.27, 95% CI 1.25-4.11, p=0.007) were the factors with greatest risk for hearing screen failure. We speculate that the association of BPD with hearing screen failure may be mediated, in part, by chronic noise exposure, including from respiratory support devices. Attention to hearing protection in at-risk infants during respiratory support may mitigate the risk of hearing loss.

Analysis of Bacterial Metabolites in Breath Gas of Critically Ill Patients for Diagnosis of Ventilator-Associated Pneumonia—A Proof of Concept Study

Bacterial infection of the lower respiratory tract frequently occurs in mechanically ventilated patients and may develop into life-threatening conditions. Yet, existing diagnostic methods have moderate sensitivity and specificity, which results in the overuse of broad-spectrum antibiotics administered prophylactically. This study aims to evaluate the suitability of volatile bacterial metabolites for the breath-based test, which is used for diagnosing Ventilator-Associated Pneumonia (VAP). The in vitro experiments with pathogenic bacteria most prevalent in VAP etiology (i.e., Acinetobacter baumannii, Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa) were performed to identify bacteria-derived metabolites using a specially designed cultivation system enabling headspace sampling for GC-MS analysis. Thirty-nine compounds were found to be significantly metabolized by tested species and, therefore, selected for monitoring in the exhaled breath of critically ill, mechanically ventilated (MV) patients. The emission of volatiles from medical respiratory devices was investigated to estimate the risk of spoiling breath results with exogenous pollutants. Bacterial metabolites were then evaluated to differentiate VAP patients from non-infected MV controls using Receiver Operating Characteristic (ROC) analysis, with AUC, sensitivity, and specificity calculated. Nine bacterial metabolites that passed verification through a non-parametric ANOVA test for significance and LASSO penalization were identified as key discriminators between VAP and non-VAP patients. The diagnostic model achieved an AUC of 0.893, with sensitivity and specificity values of 87% and 82.4%, respectively, being competitive with traditional methods. Further validation could solidify its clinical utility in critical care settings.

SpiroTiger and KS Brief Stimulator: Specific Devices for Breathing and Well-Being in Post-COVID-19 Patients.

Post-COVID-19 patients may develop impaired lung function, with reduced lung capacities and volumes, respiratory muscle weakness, and physical inactivity. The aim of this study was to determine the effects of a detailed protocol based on breathing training with two specifically designed respiratory devices (SpiroTiger and KS Brief Stimulator) in post-COVID-19 individuals. Sixteen young volunteers were randomly allocated into two groups: experimental (n = 8) and control (n = 8). The experimental group performed breathing training for 12 min two times a week for 9 months (from August 2023 to May 2024). Spirometric and baropodometric measurements were recorded every 3 months to evaluate the effects of the protocol. Data analysis showed significant improvements in the forced vital capacity, peak expiratory flow indices, and postural parameters in the experimental group. In conclusion, based on the study findings, the specific breathing training protocol developed for post-COVID-19 patients has proven to be effective and significantly impacted the quality of breathing functions and the postural system.

Development of a novel humidity sensor for breath pattern recognition using large dislocation hollow core fiber infused with nano-carbon quantum water gel microfiber

This study presents a humidity sensor based on a large-core-offset hollow core optical fiber (LD-HCF) combined with polyvinyl alcohol carbon quantum dots (PVA-CQDs) nanocomposite microfiber for monitoring human respiratory. PVA-CQDs was introduced into the hollow core structure of LD-HCF to develope the respiratory sensor. The sensor has been integrated into a respiratory monitoring mask, exposed to ultraviolet (UV) light and demonstrated with a humidity sensitivity of 0.1721 nm/%RH as well as response and recovery times of 0.232 s and 0.252 s, respectively. The mask provides the real-time monitoring of human respiratory rates during various activities, including walking, standing, coughing, running, apnea 1 time and apnea 3 times. The typical respiratory patterns have been classified with a remarkable accuracy of 97.62 % using a WOA-1D CNN-LSTM neural network. The respiratory monitoring device is proposed by optical fiber, offering a promising potential in the real-time monitoring for healthcare process.

RFID-Based Respiration Monitoring Under Daily Body Motion Disturbances

Traditional respiratory monitoring methods typically use wearable sensors. In recent years, Radio Frequency Identification (RFID) tags have emerged as potential respiratory monitoring devices. However, existing research only detects respiration under static or simple body movements such as forward and backward motions, which limits the availability of RFID. In this article, an RFID-based respiratory monitoring system under body motion disturbances is proposed. In order to eliminate the effect of body movement on the signal, reference tags are placed on the user’s shoulders. The phase between different tags is calibrated and aligned to remove the discreteness. Then, a sliding window peak-seeking algorithm is designed to calculate respiratory rate over time. The system measures respiratory rate during daily exercise and maintains an accuracy of no less than 86.12%, even when influenced by lying down and turning. Additionally, the system can analyze estimated respiratory rates and intervals to provide alert information.

Medical device-related pressure injuries in the operating room: A scoping review.

To map the existing literature describing medical device-related pressure injuries in patients during surgery, including investigation of the incidence, types of medical devices, risk factors and strategies for preventing medical device-related pressure injuries. A scoping review. In April 2023, three databases were searched. Studies about adult patients undergoing surgery, from 2014 onwards, in English and Chinese were included. Data were extracted about study characteristics and data related to research questions. The Patterns, Advances, Gaps, Evidence for practice and Research recommendations framework were used to synthesize findings. Two different types of evidence were included in this review; 14 research studies and two quality improvement studies. The incidence of medical device-related pressure injuries in the operating room was 0.56%-24.5% and respiratory devices were the most common medical devices investigated. Length of surgery, age and BMI were risk factors for medical device-related pressure injuries in a few studies. The application of a prophylactic dressing and dressing maintenance was the most common prevention strategy. Ongoing research is needed to confirm the incidence of, and risk factors for, medical device-related pressure injuries in the operating room. Additionally, more high-quality evidence is needed to underpin current prevention strategies. Operating room nurses need to be aware of the risks of medical device-related pressure injuries and assess and plan prevention strategies accordingly. Once more high-quality evidence is available, operating room nurses could implement prevention strategies like prophylactic dressings. Scoping Reviews (PRISMA-ScR) checklist. No patient or public contribution.

OSA diagnosis goes wearable: are the latest devices ready to shine?

From 2019-2023, the United States Food and Drug Administration has cleared 9 novel obstructive sleep apnea-detecting wearables for home sleep apnea testing, with many now commercially available for sleep clinicians to integrate into their clinical practices. To help clinicians comprehend these devices and their functionalities, we meticulously reviewed their operating mechanisms, sensors, algorithms, data output, and related performance evaluation literature. We collected information from PubMed, United States Food and Drug Administration clearance documents, ClinicalTrials.gov, and web sources, with direct industry input whenever feasible. In this "device-centered" review, we broadly categorized these wearables into 2 main groups: those that primarily harness photoplethysmography data and those that do not. The former include the peripheral arterial tonometry-based devices. The latter was further broken down into 2 key subgroups: acoustic-based and respiratory effort-based devices. We provided a performance evaluation literature review and objectively compared device-derived metrics and specifications pertinent to sleep clinicians. Detailed demographics of study populations, exclusion criteria, and pivotal statistical analyses of the key validation studies are summarized. In the foreseeable future, these novel obstructive sleep apnea-detecting wearables may emerge as primary diagnostic tools for patients at risk for moderate-to-severe obstructive sleep apnea without significant comorbidities. While more devices are anticipated to join this category, there remains a critical need for cross-device comparison studies as well as independent performance evaluation and outcome research in diverse populations. Now is the moment for sleep clinicians to immerse themselves in understanding these emerging tools to ensure our patient-centered care is improved through the appropriate implementation and utilization of these novel sleep technologies. Chiang AA, Jerkins E, Holfinger S, etal. OSA diagnosis goes wearable: are the latest devices ready to shine? J Clin Sleep Med. 2024;20(11):1823-1838.

CONSTRUCTION METHOD AND VERIFICATION OF DIGITAL TWIN MECHANISM MODEL OF PULMONARY VENTILATION

The establishment of a fully functional and accurate pulmonary ventilation mechanism model is of great significance to simulate the real respiratory states of the specified human and configure respiratory therapeutic equipment (such as ventilators and simulated lungs). This paper proposed an alternative method to establish the digital twin mechanism model of pulmonary ventilation, which is a composition of the geometric and physical model mapping to the real respiratory process of humans. Through simulation, it could more intuitively reflect respiratory states and generate reliable respiratory data. The consistency of the digital twin of pulmonary ventilation was verified by the respiratory experiments. According to the verification results, the correlation coefficient and goodness of fit were 98.4% and 96.8%, respectively, in different respiratory patterns; 98.4% and 96.2%, respectively, in different examinees. It can be concluded that the digital twin of pulmonary ventilation could well mimic various respiratory patterns of different human bodies. Then it can generate reliable data to support the parameter settings of the respiratory therapeutic devices and auxiliary respiratory devices such as simulated lungs and ventilators.

Use of a gas-operated ventilator as a noninvasive bridging respiratory therapy in critically Ill COVID-19 patients in a middle-income country.

During the COVID-19 pandemic, there was a notable undersupply of respiratory support devices, especially in low- and middle-income countries. As a result, many hospitals turned to alternative respiratory therapies, including the use of gas-operated ventilators (GOV). The aim of this study was to describe the use of GOV as a noninvasive bridging respiratory therapy in critically ill COVID-19 patients and to compare clinical outcomes achieved with this device to conventional respiratory therapies. Retrospective cohort analysis of critically ill COVID-19 patients during the first local wave of the pandemic. The final analysis included 204 patients grouped according to the type of respiratory therapy received in the first 24h, as follows: conventional oxygen therapy (COT), n = 28 (14%); GOV, n = 72 (35%); noninvasive ventilation (NIV), n = 49 (24%); invasive mechanical ventilation (IMV), n = 55 (27%). In 72, GOV served as noninvasive bridging respiratory therapy in 42 (58%) of these patients. In the other 30 patients (42%), 20 (28%) presented clinical improvement and were discharged; 10 (14%) died. In the COT and GOV groups, 68% and 39%, respectively, progressed to intubation (P ≤ 0.001). Clinical outcomes in the GOV and NIV groups were similar (no statistically significant differences). GOV was successfully used as a noninvasive bridging respiratory therapy in more than half of patients. Clinical outcomes in the GOV group were comparable to those of the NIV group. These findings support the use of GOV as an emergency, noninvasive bridging respiratory therapy in medical crises when alternative approaches to the standard of care may be justifiable.

Extracorporeal membrane oxygenation states basilar artery thrombectomy and left posterior cerebral artery stent thrombectomy: A case report

BACKGROUND Extracorporeal membrane oxygenation (ECMO) is a new type of extracorporeal respiratory and circulatory assistance device. It can drain venous blood out of the body and inject it into veins or arteries after being oxygenated by an oxygenator (membrane lung) to replace lung and heart functions in a short time. ECMO can provide tissue blood perfusion and gas exchange almost equivalent to cardiac output and extend the effective treatment time window for patients with acute circulatory failure to restore cardiopulmonary function. CASE SUMMARY We report a case of an 81-year-old woman who underwent whole cerebral angiography, basilar artery thrombectomy and stent thrombectomy in the posterior artery of the left brain after implantation of ECMO. The patient was admitted to the hospital due to myocardial infarction. Considering that the cause of the patient’s disturbance of consciousness was unknown and cerebrovascular accident could not be ruled out after the implantation of ECMO, the department of Radioactive Intervention performed cerebral angiography. And the result of the angiography indicated vascular occlusion. After the basilar artery thrombectomy and stent thrombectomy in the posterior artery of the left brain, the patency of the occlusive vessel was achieved. CONCLUSION Although the patient eventually died of circulatory failure, the result of this case verifies the feasibility of cerebral angiography and thrombectomy in patients with implanted ECMO in the intubated state.

Respiratory Assist Devices in Pulmonary Rehabilitation.

Patients with advanced lung disease, especially patients with COPD, suffer from dyspnea at rest that worsens during the performance of even limited physical activities. The causes of dyspnea are multifactorial and are related to structural changes found in the parenchymal compartment of the lung as well as the airway and pulmonary vasculature. Alterations in any of the lung compartments may have negative consequences for the physiological performance of exercise. Respiratory assist devices that attenuate the pathophysiological derangements induced by the underlying lung disease, and/or unload the increased work of breathing, can enhance the performance of exercise, and help to produce more robust training effects in patients with lung disease. Herein we review the data that examines these approaches using respiratory assist devices to improve exercise outcomes in patients with COPD.

Implementing a challenge-based learning experience in a bioinstrumentation blended course

BackgroundBioinstrumentation is essential to biomedical engineering (BME) undergraduate education and professional practice. Several strategies have been suggested to provide BME students with hands-on experiences throughout the curriculum, promoting their preparedness to pursue careers in industry and academia while increasing their learning and engagement. This paper describes the implementation of challenge-based learning (CBL) in an undergraduate bioinstrumentation blended course over the COVID-19 pandemic.MethodsThe CBL experience was implemented in a third-year bioinstrumentation course from the BME program at Tecnologico de Monterrey. Thirty-nine students enrolled in two sections formed fourteen teams that tackled blended learning activities, including online communication, lab experiments, and in-person CBL activities. Regarding the latter, students were challenged to design, prototype, and test a respiratory or cardiac gating device for radiotherapy. An institutional student opinion survey was used to assess the success of our CBL implementation.ResultsStudent responses to the end-of-term survey showed that they strongly agreed that this course challenged them to learn new concepts and develop new skills. Furthermore, they rated the student-lecturer interaction very positively despite the blended format. Overall, students assessed their learning experience positively. However, implementing this CBL experience required a substantial time increase in planning, student tutoring, and constant communication between lecturers and the industry partner.ConclusionThis work provides an effective instance of CBL for BME education to improve students’ learning experience despite decreased resource efficiency. Our claim is supported by the student’s performance and the positive feedback from our industrial partner.

CT respiratory motion synthesis using joint supervised and adversarial learning

Objective. Four-dimensional computed tomography (4DCT) imaging consists in reconstructing a CT acquisition into multiple phases to track internal organ and tumor motion. It is commonly used in radiotherapy treatment planning to establish planning target volumes. However, 4DCT increases protocol complexity, may not align with patient breathing during treatment, and lead to higher radiation delivery. Approach. In this study, we propose a deep synthesis method to generate pseudo respiratory CT phases from static images for motion-aware treatment planning. The model produces patient-specific deformation vector fields (DVFs) by conditioning synthesis on external patient surface-based estimation, mimicking respiratory monitoring devices. A key methodological contribution is to encourage DVF realism through supervised DVF training while using an adversarial term jointly not only on the warped image but also on the magnitude of the DVF itself. This way, we avoid excessive smoothness typically obtained through deep unsupervised learning, and encourage correlations with the respiratory amplitude. Main results. Performance is evaluated using real 4DCT acquisitions with smaller tumor volumes than previously reported. Results demonstrate for the first time that the generated pseudo-respiratory CT phases can capture organ and tumor motion with similar accuracy to repeated 4DCT scans of the same patient. Mean inter-scans tumor center-of-mass distances and Dice similarity coefficients were 1.97 mm and 0.63, respectively, for real 4DCT phases and 2.35 mm and 0.71 for synthetic phases, and compares favorably to a state-of-the-art technique (RMSim). Significance. This study presents a deep image synthesis method that addresses the limitations of conventional 4DCT by generating pseudo-respiratory CT phases from static images. Although further studies are needed to assess the dosimetric impact of the proposed method, this approach has the potential to reduce radiation exposure in radiotherapy treatment planning while maintaining accurate motion representation. Our training and testing code can be found at https://github.com/cyiheng/Dynagan.

A novel sensible smart mask using micro thermal-electric energy conversion elements

With the improvement of people’s living standards, more and more people begin to pay attention to their own health status. The mode of monitoring human physiological indicators is gradually shifting to a family-based and miniaturized development model that focuses on prevention. Respiratory rate is an important parameter that reflects the health status of the human body. It is an important diagnostic basis for doctors in clinical prevention and diagnosis of related diseases. Therefore, it is necessary to develop a portable monitoring instrument that can dynamically monitor the human respiratory frequency index in real time. Since most of the existing wearable respiratory frequency detection devices have some disadvantages such as low accuracy, high cost and difficulty in promotion, this paper proposes a new type of smart mask based on thermoelectric effect to monitor human respiratory frequency in real time. The respirator system has the advantages of small size, light weight and suitable for face. Compared with other heavy breathing devices, it has obvious advantages. The Seebeck effect of thermoelectric energy conversion element (TECE) can be used to reflect the respiratory frequency of human body under different respiratory conditions. Experiments show that the sensor has high accuracy and can accurately reflect even small changes in respiratory frequency.

Wearable strain sensor utilizing the synergistic effect of Ti3C2Tx MXene/AgNW nanohybrid for point-of-care respiratory monitoring

Respiratory signals are significant indicators for detecting changes in physiological conditions and early diagnosis of numerous respiratory illnesses. Herein, we have integrated a high-performance strain sensor and portable circuit board (PCB) with personalized interface to develop point-of-care respiratory monitoring device. The ultrasensitive strain sensor utilizes a conductive polymeric nanocomposite that harnesses the synergistic effect of Ti3C2Tx (MXene)/AgNW nanohybrid to develop a wearable device. The wearable device is capable of analysing pulmonary volumes, such as forced volume capacity (FVC) and forced expiratory volume (FEV1), while accurately recognizing various breathing patterns in a resting state (such as normal, forced, and obstructive), as well as during different physical activities. It shows excellent correlation (>93%) with commercial spirometer for measurement of pulmonary parameters. In addition, we present a wireless device for lab rat respiratory monitoring in anaesthetic state. The device is implemented for real-time respiratory monitoring under mild, normal and high anaesthesia doses. The levels of anaesthesia doses including a critical limit can be significantly discriminated by means of breathing frequency and amplitude, which ultimately results in saving their lives. These results demonstrate the practical feasibility of the strain sensing device as wearable electronics for point-of-care respiratory monitoring in humans and other species.

Ongoing exposure to endocrine disrupting phthalates and alternative plasticizers in neonatal intensive care unit patients

Due to endocrine disrupting effects, di-(2-ethylhexyl) phthalate (DEHP), a plasticizer used to soften plastic medical devices, was restricted in the EU Medical Devices Regulation (EU MDR 2017/745) and gradually replaced by alternative plasticizers. Neonates hospitalized in the neonatal intensive care unit (NICU) are vulnerable to toxic effects of plasticizers. From June 2020 to August 2022, urine samples (n = 1070) were repeatedly collected from premature neonates (n = 132, 4–10 samples per patient) born at <31 weeks gestational age and/or <1500 g birth weight in the Antwerp University Hospital, Belgium. Term control neonates (n = 21, 1 sample per patient) were included from the maternity ward. Phthalate and alternative plasticizers’ metabolites were analyzed using liquid-chromatography coupled to tandem mass spectrometry. Phthalate metabolites were detected in almost all urine samples. Metabolites of alternative plasticizers, di-(2-ethylhexyl)-adipate (DEHA), di-(2-ethylhexyl)-terephthalate (DEHT) and cyclohexane-1,2-dicarboxylic-di-isononyl-ester (DINCH), had detection frequencies ranging 30–95 %. Urinary phthalate metabolite concentrations were significantly higher in premature compared to control neonates (p = 0.023). NICU exposure to respiratory support devices and blood products showed increased phthalate metabolite concentrations (p < 0.001). Phthalate exposure increased from birth until four weeks postnatally. The estimated phthalate intake exceeded animal-derived no-effect-levels (DNEL) in 10 % of samples, with maximum values reaching 24 times the DNEL. 29 % of premature neonates had at least once an estimated phthalate intake above the DNEL. Preterm neonates are still exposed to phthalates during NICU stay, despite the EU Medical Devices Regulation. NICU exposure to alternative plasticizers is increasing, though currently not regulated, with insufficient knowledge on their hazard profile.

COVID-19 PORTABLE RESPIRATORY DIAGNOSTIC DEVICE

COVID-19 PORTABLE RESPIRATORY DIAGNOSTIC DEVICE

Screening for Sleep Disordered Breathing in Three Distinct Neurological Diseases in the Bulgarian Population

Sleep disordered breathing (SDB) is a common medical problem in the general population. Neurological disorders such as ischemic stroke (IS), myasthenia gravis (MG), or multiple sclerosis (MS) seem to be of higher risk of SDB. Nevertheless, the implementation of screening for SDB in such disorders has not been well studied. Therefore, the aim of this study was to explore screening parameters for SDB in IS, MG and MS, in our region. We included prospectively patients with diagnosed IS, MG and MS. Psychometric tools such as the Epworth Sleepiness Scale (ESS), the STOP-BANG, and the Berlin questionnaire were implemented. For the respiratory screening portable recording device was used. Seventy-two patients, 25 with IS (mean age 66.3 years), 24 with MG (mean age 47.9 years), and 23 with MS (mean age 40.1 years) were enrolled. Basic anthropometric parameters such as BMI, neck and waist circumference were higher in IS than in MG and MS ($$p&lt;0.001$$). The ESS scores were 5.5±3.2 for IS, 5.6±3.3 for MG, and 5.9±4.5 for MS, but without significant difference between the groups. Contrariwise, STOP-BANG scores in IS were 4.8±1.3, significantly higher ($$p&lt;0.0001$$) than both MG (2.1±1.4) and MS (1.2±0.9). A high risk for OSA in BQ was calculated in 68% of IS, much higher ($$p&lt;0.0001$$) than in MG (33.3%) and in MS (13%). In the respiratory screening, the mean apnea-hypopnea index in the IS group (20±18.3) was statistically higher than in MG (8.1±12.7, $$p&lt;0.005$$), and in MS patients (2.3±4.9, $$p&lt;0.001$$). Oxygen desaturation index in IS (19.3±19) differed statistically from the one in MG (8.1±12.9, $$p&lt;0.005$$), and in MS (2.6±5.5, $$p&lt;0.001$$). The oxygen saturation (SO2) showed difference only between IS and MS in all three measured values – baseline SO2 ($$p&lt;0.001$$), median SO2 ($$p&lt;0.05$$) and lowest SO2 ($$p&lt;0.05$$). IS, MG and MS, as distinct neurological entities, show different clinical profiles with respect to screening for SDB. These should be taken into consideration in the individual evaluation for sleep disordered breathing.

Standard technical specifications for methacholine chloride (Methacholine) bronchial challenge test (2023)

Standard technical specifications for methacholine chloride (Methacholine) bronchial challenge test (2023)