979 resultados para Respiratory Tract


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The aim of this work was to develop a low-cost circuit for real-time analog computation of the respiratory mechanical impedance in sleep studies. The practical performance of the circuit was tested in six patients with obstructive sleep apnea. The impedance signal provided by the analog circuit was compared with the impedance calculated simultaneously with a conventional computerized system. We concluded that the low-cost analog circuit developed could be a useful tool for facilitating the real-time assessment of airway obstruction in routine sleep studies.

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Large phasic variations of respiratory mechanical impedance (Zrs) have been observed during induced expiratory flow limitation (EFL) (M. Vassiliou, R. Peslin, C. Saunier, and C. Duvivier. Eur. Respir. J. 9: 779-786, 1996). To clarify the meaning of Zrs during EFL, we have measured from 5 to 30 Hz the input impedance (Zin) of mechanical analogues of the respiratory system, including flow-limiting elements (FLE) made of easily collapsible rubber tubing. The pressures upstream (Pus) and downstream (Pds) from the FLE were controlled and systematically varied. Maximal flow (Vmax) increased linearly with Pus, was close to the value predicted from wave-speed theory, and was obtained for Pus-Pds of 4-6 hPa. The real part of Zin started increasing abruptly with flow (V) >85%Vmax and either further increased or suddenly decreased in the vicinity of V¿max. The imaginary part of Zin decreased markedly and suddenly above 95%Vmax. Similar variations of Zin during EFL were seen with an analogue that mimicked the changes of airway transmural pressure during breathing. After pressure andV measurements upstream and downstream from the FLE were combined, the latter was analyzed in terms of a serial (Zs) and a shunt (Zp) compartment. Zs was consistent with a large resistance and inertance, and Zp with a mainly elastic element having an elastance close to that of the tube walls. We conclude that Zrs data during EFL mainly reflect the properties of the FLE.

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This paper presents a new respiratory impedance estimator to minimize the error due to breathing. Its practical reliability was evaluated in a simulation using realistic signals. These signals were generated by superposing pressure and flow records obtained in two conditions: 1) when applying forced oscillation to a resistance- inertance- elastance (RIE) mechanical model; 2) when healthy subjects breathed through the unexcited forced oscillation generator. Impedances computed (4-32 Hz) from the simulated signals with the new estimator resulted in a mean value which was scarcely biased by the added breathing (errors less than 1 percent in the mean R, I , and E ) and had a small variability (coefficients of variation of R, I, and E of 1.3, 3.5, and 9.6 percent, respectively). Our results suggest that the proposed estimator reduces the error in measurement of respiratory impedance without appreciable extracomputational cost.