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Related Concept Videos

Alterations in Respiration II01:30

Alterations in Respiration II

There are numerous types of normal and abnormal respiration. Based on ventilatory movements, breathing patterns are classified as regular, deep, or shallow. Examples include Biot's breathing, Cheyne-Stokes respiration, Kussmaul's breathing, hyperventilation, and hypoventilation. Each pattern is clinically significant and aids in evaluating patients.
In Biot's breathing, the respiratory rate and depth are irregular, alternating between periods of deep gasping and apnea. Common causes include...
Sleep Apnea01:21

Sleep Apnea

Sleep apnea is a condition where breathing stops intermittently during sleep, often leading to significant health issues. Each episode can last from 10 to 20 seconds or more and is frequently accompanied by a brief arousal from sleep. This disturbance, largely unnoticed by the individual, can lead to severe daytime fatigue. Commonly, individuals seek help after being informed by their partners about loud snoring and noticeable breathing pauses during sleep.
The condition is more prevalent among...
Respiratory Volumes and Capacities I01:26

Respiratory Volumes and Capacities I

Assessing the respiratory rate and rhythm for a complete minute is crucial for evaluating the breathing pattern. Even a minor increase in the patient's average respiratory rate, by as little as three to five breaths per minute, is an early and vital indicator of respiratory distress. Patients with a respiratory rate exceeding twenty-four breaths per minute require close monitoring to determine the physiological alterations. This careful observation is essential for prompt recognition and...
Physical Assessment of the Respiratory Tract II: Inspection01:27

Physical Assessment of the Respiratory Tract II: Inspection

Physical assessment of the respiratory tract through inspection is a crucial step in understanding the patient's respiratory health. It provides insights into the functioning of the respiratory system, the musculoskeletal structure, and even the patient's nutritional status. This comprehensive approach involves observing several vital aspects: chest configuration, breathing patterns, respiratory rates, skin color, and use of accessory muscles.
Chest Configuration
The chest configuration can...
Respiratory System Abnormal Finding I: Inspection and Percussion01:30

Respiratory System Abnormal Finding I: Inspection and Percussion

Respiratory system abnormalities are a significant concern in healthcare due to their potential to indicate underlying severe conditions like Chronic Obstructive Pulmonary Disease (COPD), asthma, and pneumonia. These abnormalities can often be detected through physical examination methods like inspection and percussion.
Inspection Findings
During an inspection, several findings may suggest the presence of respiratory distress or disease. Pursed-lip breathing, where exhalation is slowed by...
Assessment of Ventilation II: Respiratory Depth and Rhythm01:29

Assessment of Ventilation II: Respiratory Depth and Rhythm

Respiratory Depth
Respiratory depth measures the volume of air inhaled or exhaled during a breath. It can vary from shallow to deep and typically remains consistent when a person is at rest or asleep. Occasionally, individuals will automatically inhale deeply, known as sighing, which inflates the lungs with more air than normal breathing.
To assess respiratory depth, observe the degree of chest excursion or movement:

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Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea
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Patterns in pharyngeal airflow associated with sleep-disordered breathing.

Nelson B Powell1, Mihai Mihaescu, Goutham Mylavarapu

  • 1Stanford University School of Medicine, Department of Otolaryngology and Division of Sleep Medicine, Atherton, CA 94027, USA. nelsonpowell@sbcglobal.net

Sleep Medicine
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Summary

This study shows a new noninvasive method using CT scans and computer modeling to analyze airflow in sleep-disordered breathing. The technique successfully visualized and improved airflow characteristics after treatment.

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Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea
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Published on: December 1, 2023

Area of Science:

  • Biomedical Engineering
  • Respiratory Medicine
  • Medical Imaging

Background:

  • Sleep-disordered breathing (SDB) significantly impacts patient health.
  • Accurate assessment of pharyngeal airflow is crucial for understanding SDB.
  • Current methods for evaluating pharyngeal airflow can be invasive or lack detailed characterization.

Purpose of the Study:

  • To establish the feasibility of a noninvasive method to identify pharyngeal airflow characteristics in sleep-disordered breathing.
  • To visualize airflow dynamics within the pharynx using advanced modeling techniques.
  • To assess the impact of treatment on pharyngeal airflow parameters.

Main Methods:

  • Employed three-dimensional CT imaging and computational fluid dynamics (CFD) modeling.
  • Characterized pharyngeal airflow in four SDB patients (pre- and post-treatment) and four healthy controls.
  • Utilized standard steady-state and dynamic unsteady flow simulations.

Main Results:

  • Pre-treatment SDB showed airflow separation, recirculation, and turbulence.
  • Post-treatment, airflow instabilities vanished, with significant reductions in maximum airflow velocity (18.3 to 6.3 m/s) and wall shear stress (4.8 to 0.9 Pa).
  • Airway resistance improved significantly (4.3 to 0.7 Pa/L/min), with post-treatment characteristics similar to controls.

Conclusions:

  • Pharyngeal airflow variables can be effectively derived from CT imaging and CFD modeling.
  • This noninvasive approach provides high-quality visualizations of airflow characteristics (velocity, pressure, shear stress) in SDB.
  • The method holds promise for improved diagnosis and management of sleep-disordered breathing.