Breathing Patterns in Infants Utilizing Respiratory Inductive Plethysmography

doi:10.1378/chest.89.5.717

Chest

Volume 89, Issue 5, May 1986, Pages 717-722

https://doi.org/10.1378/chest.89.5.717 Get rights and content

Respiratory inductive plethysmography (RIP) is a method that can be used to assess breathing patterns in infants without an airway connection. Ribcage and abdomen transducers are used which require gain factor calculation for calibration. We employed a single position graphic (SPG) calibration technique for gain factor calculation in RIP to obtain breathing pattern data for 70 infants in the quietly awake state. The SPG technique utilizes selection of two breaths from a 20s run of breaths with different ribcage/pneumotachograph (RC/PNT) and abdomen/pneumotachograph (AB/PNT) ratios for the gain factor calculation. Validation of gain factors was performed by comparing volumes obtained simultaneously by RIP and PNT. In 46 of the infants, maintenance of gain factor accuracy was confirmed following position reversal. Revalidation after position change could not be accomplished in 24 infants who were aroused into an agitated state. Breathing patterns were collected by RIP alone on the 46 infants who remained accurately calibrated in the supine and prone positions. No significant correlations were found between breathing pattern data and anthropometric characteristics. When the infants were repositioned, no consistent pattern of change could be identified. This study suggests that the SPG technique provides time-efficient and accurate calibration of RIP in the newborn infant. Furthermore, accuracy is maintained through position change if the infant remains in the same behavioral state. Breathing pattern data presented is representative of normative values in the quietly awake state for our study population.

Section snippets

Subjects

Calibration procedures were performed using a computerized RIP on 70 nonsedated, quietly awake newborn human infants. Fortynine infants were delivered vaginally and 21 by cesarean section.

Gestational age ranged between 34 and 42 weeks (39.3 ± 1.6); postnatal age ranged between 6 and 90 hours (20.6 ± 11.8). Weight and length ranged between 2.1 and 4.8 kg (3.24 ± 0.55) and 45 and 55 cm (49.8 ± 2.2) respectively. The quietly awake state was determined by behavioral criteria.⁶ Fifty-one infants

Calibration

Seventy infants were calibrated: 19 initially in the supine position and 51 in the prone position. RC and AB gain factors ranged between 0.36 and 2.09 (0.78 ± 0.35) and 0.32 and 1.46 (0.74 ± 0.20) respectively. The difference in the abdominal signal amplitude change between the two selected breaths used to calculate gain factors ranged from 0 to 100 percent (15.8 ± 21.0). The difference in amplitude for the corresponding ribcage movement ranged from 0 to 900 percent (48.4 ± 113.9). Volume

Discussion

During the study period, we observed that infants were quiet, making only occasional motor movements. Their eyes were open and scanning movements were present. The predominant state of behavior during the study period was most compatible with newborn infant behavioral stages 3 and 4 described by Prechtl.⁶ Thirty to 60 minutes postprandial was the best time for study because infants were quietly awake. Breath-by-breath visualization of RC, AB, and PNT wave forms on the video monitor allowed

ACKNOWLEDGMENT

We wish to thank Dr. Don Hill, Medical Director, for his guidance, and the nursing staff of the UAMS Nursery for their cooperation and assistance.

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Age-related ranges of respiratory inductance plethysmography (RIP) reference values for infants and children
2019, Paediatric Respiratory Reviews
Citation Excerpt :
Not all studies discussed body position with respect to RR studies. Additionally, few studies have reported normal LBI values in pediatric and adolescent populations [18,22,28,31,38], limiting the significance of the normal LBI regression analysis provided herein. In those studies that reported body position, some studies were conducted in the sitting position, whereas others reported standing, supine, or prone positions; however, these studies were specifically designed to investigate the physiological effect of posture on thoracoabdominal motion (TAM) at a specific age, not the determination of normative reference values (for our review, we selected only the sitting and supine data).
The current noninvasive method for respiratory monitoring is respiratory inductance plethysmography (RIP); two bands are connected, one each to the chest and the abdomen, to measure the breathing pattern. RIP requires post hoc analysis to calculate indices such as respiratory rate, phase angle, labored breathing index, and percent of rib cage contribution to breathing. Clinical studies have provided patient RIP values and age-matched normal values, but they lack global evaluation of normative data for a wide age range of pediatric subjects. Herein, we compiled normative RIP indices from numerous studies for a large range of pediatric ages.
From these data, we derived regression equations useful for computing normal RIP parameters as a function of age.
The presented review will provide caregivers the ability to compare RIP data of pediatric patients against the regression analysis. This comparison will help identify patients with pulmonary complications and aid in guiding respiratory therapy.
Measurement of tidal volume using Respiratory Ultrasonic Plethysmography in anaesthetized, mechanically ventilated horses
2013, Veterinary Anaesthesia and Analgesia
Citation Excerpt :
An alternative completely non-invasive approach for estimating tidal volume and respiratory rate uses the measurement of thoracic and abdominal excursions following volume changes of the lungs during spontaneous and mechanical ventilation. Respiratory Inductive Plethysmography (RIP) is based on this principle and is an established method to monitor respiration in infants (Warren & Alderson 1986) but it is also used in standing horses (Amory et al. 1994; Miller et al. 2000; Hoffman et al. 2001, 2007). The RIP technique is based on measurement of changes of a cross-sectional area.
To compare tidal volume estimations obtained from Respiratory Ultrasonic Plethysmography (RUP) with simultaneous spirometric measurements in anaesthetized, mechanically ventilated horses.
Prospective randomized experimental study.
Five experimental horses.
Five horses were anaesthetized twice (1 week apart) in random order in lateral and in dorsal recumbency. Nine ventilation modes (treatments) were scheduled in random order (each lasting 4 minutes) applying combinations of different tidal volumes (8, 10, 12 mL kg⁻¹) and positive end-expiratory pressures (PEEP) (0, 10, 20 cm H₂O). Baseline ventilation mode (tidal volume = 15 mL kg⁻¹, PEEP = 0 cm H₂O) was applied for 4 minutes between all treatments. Spirometry and RUP data were downloaded to personal computers. Linear regression analyses (RUP versus spirometric tidal volume) were performed using different subsets of data. Additonally RUP was calibrated against spirometry using a regression equation for all RUP signal values (thoracic, abdominal and combined) with all data collectively and also by an individually determined best regression equation (highest R²) for each experiment (horse versus recumbency) separately. Agreement between methods was assessed with Bland-Altman analyses.
The highest correlation of RUP and spirometric tidal volume (R² = 0.81) was found with the combined RUP signal in horses in lateral recumbency and ventilated without PEEP. The bias ± 2 SD was 0 ± 2.66 L when RUP was calibrated for collective data, but decreased to 0 ± 0.87 L when RUP was calibrated with individual data.
A possible use of RUP for tidal volume measurement during IPPV needs individual calibration to obtain limits of agreement within ± 20%.
Calibration of the respiratory inductive plethysmograph with the single position graphic technique: Accuracy in different behavior states in lambs
1988, Chest
Respiratory inductive plethysmography (RIP) can measure breathing patterns noninvasively. Calibration is required for rib cage and abdomen transducers utilizing breaths with different compartment contribution correlated with tidal volume measured by integrated pneumotachography (PNT). This study was performed to determine if RIP remains accurate during sleep states following calibration in the quietly awake state. We used our single position graphic calibration technique (SPG) to calculate gain factors in seven tracheostomized lambs. Validation of gain factors was accomplished by comparing tidal volume obtained simultaneously by RIP and PNT during quiet wakefulness (QW), quiet sleep (QS) and active sleep (AS). Results of the study showed that RIP was accurately calibrated during QW. Accuracy was decreased during QS and AS.
Telemonitoring Techniques for Lung Volume Measurement: Accuracy, Artifacts and Effort
2020, Frontiers in Digital Health
Tidal volume measurements in infants: Opto-electronic plethysmography versus pneumotachograph
2016, Pediatric Pulmonology
Measurement of total and compartmental lung volume changes in newborns by optoelectronic plethysmography
2010, Pediatric Research

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: Manuscript received August 24; revision accepted November 27

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Chest

Clinical InvestigationsBreathing Patterns in Infants Utilizing Respiratory Inductive Plethysmography

Section snippets

Subjects

Calibration

Discussion

ACKNOWLEDGMENT

Brain Res

Chest

J Pediatr

J Pediatr

Chest

Respiratory inductive plethysmography (Respitrace): An evaluation of its use in the infant

Am Rev Respir Dis

Monitoring of ventilation without physical connection to the airway; a review

Changes in respiratory pattern resulting from the use of a face mask to record respiration in newborn infants

Pediatr Res

Effects of a face mask and pneumotachograph on breathing in sleeping infants

Am Rev Respir Dis

Calibration of computer assisted (Respicomp) respiratory inductive plethysmography in newborn infants

Am Rev Respir Dis

Clinical Investigations
Breathing Patterns in Infants Utilizing Respiratory Inductive Plethysmography