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Contact-Free Detection of Central Apnea and Respiratory Depression
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A2641 - Contact-Free Detection of Central Apnea and Respiratory Depression
Author Block: Z. Shinar1, M. L. Yizraeli Davidovich2; 1EarlySense ltd., Ramat-Gan, Israel, 2EarlySense ltd., Ramat Gan, Israel.
Rationale: Respiratory depression may result in serious consequences if not treated on time. When using non-invasive monitoring, counting respiratory cycles cannot be used as the only parameter for detection of respiratory depression, as pauses between respirations as well as shallow breathing may also cause insufficient ventilation. This work seeks to expand the capabilities of a contact-free under-the-mattress monitor that is currently being used to continuously monitor respiratory rate as well as motion and heart rate in medical-surgical units and nursing homes. In this study, we retrospectively examined waveforms from this monitor to evaluate the possibility of detecting central apnea events compared to gold-standard polysomnography (PSG). Methods: Subjects referred to a sleep laboratory for suspected sleep disordered breathing were simultaneously monitored by the contact-free system (EarlySense, Israel), as well as full over-night Polysomnography (including thorax and abdomen Respiratory Inductive Plethysmographs, nasal cannula and pulse oximetry) as gold standard. All PSG recordings were analyzed by a sleep expert to score apnea and hypopnea according to AASM guidelines. Subjects with at least 10 apnea events that were classified as either mixed or central by a sleep expert were selected for this study (N=24 out of 111 subjects who were recorded). Segments of 30 minutes with at least 4 central (or mixed) apnea events, according to the PSG reference, were tagged as positive for reduced central respiratory drive. 30-minute segments with 3 central (or mixed) events or less, according to PSG, were classified as ""no significant respiratory depression"". This classification was compared to the contact-free system classification and reported in a 2x2 confusion table. Results: 17 men and 7 women were included (age: 28-71 years, mean 51.7 ± 12.4; BMI: 21.8 - 62.1, mean 35.9 ± 11.3). The contact-free system results had a sensitivity of 80.0%, a specificity of 92.6%, a positive predictive value of 93.3%, a negative predictive value of 78.1%, and a total accuracy of 85.5% correct classifications.Conclusions: This work complements previous work on detection of obstructive sleep apnea, and shows that the contact-free system can detect and alert for central apnea with high sensitivity and high positive predictive value. This feature can be added to the monitoring of respiratory rate (that is already performed by this system) as a second safety mechanism for patients in medical surgical units that are at risk of respiratory depression. Disclosure: The authors are employees of EarlySense ltd.
Author Block: Z. Shinar1, M. L. Yizraeli Davidovich2; 1EarlySense ltd., Ramat-Gan, Israel, 2EarlySense ltd., Ramat Gan, Israel.
Rationale: Respiratory depression may result in serious consequences if not treated on time. When using non-invasive monitoring, counting respiratory cycles cannot be used as the only parameter for detection of respiratory depression, as pauses between respirations as well as shallow breathing may also cause insufficient ventilation. This work seeks to expand the capabilities of a contact-free under-the-mattress monitor that is currently being used to continuously monitor respiratory rate as well as motion and heart rate in medical-surgical units and nursing homes. In this study, we retrospectively examined waveforms from this monitor to evaluate the possibility of detecting central apnea events compared to gold-standard polysomnography (PSG). Methods: Subjects referred to a sleep laboratory for suspected sleep disordered breathing were simultaneously monitored by the contact-free system (EarlySense, Israel), as well as full over-night Polysomnography (including thorax and abdomen Respiratory Inductive Plethysmographs, nasal cannula and pulse oximetry) as gold standard. All PSG recordings were analyzed by a sleep expert to score apnea and hypopnea according to AASM guidelines. Subjects with at least 10 apnea events that were classified as either mixed or central by a sleep expert were selected for this study (N=24 out of 111 subjects who were recorded). Segments of 30 minutes with at least 4 central (or mixed) apnea events, according to the PSG reference, were tagged as positive for reduced central respiratory drive. 30-minute segments with 3 central (or mixed) events or less, according to PSG, were classified as ""no significant respiratory depression"". This classification was compared to the contact-free system classification and reported in a 2x2 confusion table. Results: 17 men and 7 women were included (age: 28-71 years, mean 51.7 ± 12.4; BMI: 21.8 - 62.1, mean 35.9 ± 11.3). The contact-free system results had a sensitivity of 80.0%, a specificity of 92.6%, a positive predictive value of 93.3%, a negative predictive value of 78.1%, and a total accuracy of 85.5% correct classifications.Conclusions: This work complements previous work on detection of obstructive sleep apnea, and shows that the contact-free system can detect and alert for central apnea with high sensitivity and high positive predictive value. This feature can be added to the monitoring of respiratory rate (that is already performed by this system) as a second safety mechanism for patients in medical surgical units that are at risk of respiratory depression. Disclosure: The authors are employees of EarlySense ltd.
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